This study aimed to examine the rates and risk factors for ipsilateral re-amputation in 121 patients with diabetic foot and prior amputation. Twenty-six (21.5%) patients required re-amputation during a mean follow-up of 18 months. Most re-amputations were performed within the first 6 months of the initial amputation. Re-amputation was more common among patients in whom the initial amputation had only affected one or two toes. Age (hazard ratio: 1.06) and heel lesions (hazard ratio: 2.69) were significantly associated with re-amputation. There is a high risk of re-amputation in the diabetic foot, especially within the first 6 months of the initial amputation, mainly due to poor selection of the original amputation level in an effort to save a greater part of the lower extremity. Patients 70 years and those with heel lesions are at greatest risk of re-amputation.

The present review outlines the role of breastfeeding in diabetes. In the mother, breastfeeding has been suggested to reduce the incidence of type 2 diabetes mellitus, the metabolic syndrome and cardiovascular disease. Moreover, it appears to reduce the risk of premenopausal breast cancer and ovarian cancer. In the neonate and infant, among other benefits, lactation confers protection from future both type 1 and type 2 diabetes. Whether lactation protects women with gestational diabetes mellitus and their offspring from future T2DM remains to be answered. Importantly, for diabetic mothers, antidiabetic treatment itself may affect breastfeeding. There is not enough data to allow the use of oral hypoglycaemic agents. Therefore, insulin currently remains the optimal antidiabetic treatment during lactation. In conclusion, breastfeeding could be considered a modifiable risk factor for the development of diabetes and even a potential protective lifestyle measure from future cardio-metabolic and malignant diseases. Therefore, health care professionals should encourage both women with and without diabetes to breastfeed their children.

It appears that potential biases in reporting family history data, especially between the various racial groups, have contributed to the controversy over the existence of excess maternal transmission of DM.

Alpha2B adrenoceptor (alpha2B-AR) mediates a variety of functions, including insulin secretion. An insertion/deletion (I/D) polymorphism of the alpha2B-AR gene located on chromosome 2 has recently been described. The aim of the present study was to examine if there is a difference in the D allele frequency of alpha2B-AR gene between type 2 diabetic patients and controls, as well as to ascertain whether the D allele confers an increased risk for earlier onset of diabetes. This study included 199 type 2 diabetic patients and 204 age- and sex-matched healthy volunteers. Genotyping of I/D polymorphism was performed by PCR. No significant difference in the D allele frequency was observed between the two groups (22.1% vs. 19.1%, p = 0.409). Among type 2 diabetic patients, however, presence of the D allele was associated with significantly younger age at onset of diabetes (51.4+/-8.6 vs. 59.2+/-9.7 years, p < 0.001). Multiple stepwise linear regression identified alpha2B I/D genotype as an independent predictor of age at onset of DMT2, explaining 14.3% of its variance. This result indicates that the D allele may be implicated in impaired glucose metabolism leading to earlier manifestation of diabetes in predisposed subjects.

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