There is an increase in the risk for diabetes-related lower-limb amputations in geographically underserved and minority groups, according to a study published online July 22 in Diabetes Care.
Marvellous A. Akinlotan, Ph.D., from Texas A&M University in Bryan, and colleagues used data from the National Inpatient Sample (2009 to 2017) to identify trends in lower-extremity amputation (LEA) rates among those primarily hospitalized with diabetes. The risk for LEA based on race/ethnicity, geography, and rurality of residence was also assessed.
The researchers found that during the study period, the rates of minor LEAs increased across all racial/ethnic, rural/urban, and census region categories. Native Americans (annual percent change [APC], 7.1 percent) and Asian/Pacific Islanders (APC, 7.8 percent) drove the increase in minor LEAs. Native Americans and Hispanics were more likely to have a minor or major LEA versus White patients. The highest increases over time were seen for residents of noncore (APC, 5.4 percent) and large central metropolitan areas (APC, 5.5 percent). For major LEA, the odds increased with rurality and among residents of the South versus the Northeast.
“Given the important consequences of amputation for mobility, employment, mental health status, and other health outcomes, targeted public health interventions and additional investment emphasizing diabetes education and management are needed for these populations,” the authors write.