Decreasing incidence of major amputation in diabetic patients: a consequence of a multidisciplinary foot care team approach?

J Larsson, Jan Apelqvist, Carl-David Agardh, Anders Stenström

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The purpose of this retrospective study was to evaluate the changes in diabetes-related lower extremity amputations following the implementation of a multidisciplinary programme for prevention and treatment of diabetic foot ulcers in a 0.2 million population with a 2.4% prevalence of diabetes. All diabetes-related primary amputations from toe to hip from 1 January 1982 to 31 December 1993 were included. In 294 diabetic patients, 387 primary major (above the ankle) or minor (through or below the ankle) amputations were performed, constituting 48% of all lower extremity amputations. The annual number of amputations at all levels decreased from 38 to 21, equalling a decrease of incidence from 19.1 to 9.4/100,000 inhabitants (p = 0.001). The incidence of major amputations decreased by 78% from 16/1 to 3.6/100,000 inhabitants (p < 0.001). The absolute number of amputations with a final level below the ankle showed no increase, but their proportion increased from 28 to 53% (p < 0.001) and the reamputation rate decreased from 36 to 22% (p < 0.05) between the first and last 3-year period. Thus, a substantial long-term decrease in the incidence of major amputations was seen as well as a decrease in the total incidence of amputations in diabetic patients. Seventy-one per cent of the amputations were precipitated by a foot ulcer. These findings indicate that a multidisciplinary approach plays an important role to reduce and maintain a low incidence of major amputations in diabetic patients.
Original languageEnglish
Pages (from-to)770-776
JournalDiabetic Medicine
Issue number9
Publication statusPublished - 1995

Bibliographical note

The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Unit on Vascular Diabetic Complications (013241510), Department of Orthopaedics (Lund) (013028000), Diabetes and Endocrinology (013241530)

Subject classification (UKÄ)

  • Endocrinology and Diabetes


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