Ethnic Differences in the Incidence of Lower Extremity Amputation Secondary to Diabetes Mellitus

Abstract

Patients of Asian ethnic origin with diabetes mellitus living in the United Kingdom (UK) have been shown to have a higher prevalence of coronary heart disease and renal disease. Little is known about the incidence of lower extremity amputation in this racial group. The incidence of lower extremity amputation was estimated for patients of Asian ethnic origin and White Caucasians with diabetes mellitus in the county of Leicestershire from 1980 to 1985. The age and sex-adjusted incidence rate of lower extremity amputation for the estimated population of patients with diabetes mellitus in patients of Asian ethnic origin was 3.4 (95% CI, 1.1-10.7) cases per 10,000 patients year-1, compared to 14.2 (12.6-15.9) in White Caucasians. Similarly, a lower incidence rate of lower extremity amputation was recorded in patients of Asian ethnic origin without diabetes mellitus (0.4 (0.2-0.6) vs 1.5 (1.4 to 1.6) cases per 10,000 persons year-1). These findings contrast markedly with the high rates of coronary heart disease and renal disease previously reported in patients of Asian ethnic origin residing in the UK.

Age and Sex May Significantly Interact With Diabetes on the Risks of Lower-Extremity Amputation and Peripheral Revascularization Procedures

“…Generally, the incidence density of LEA of the diabetic cohort noted in our study was lower than that of previous studies (17)(18)(19)(20)(21)(22). A relatively low incidence (23,24) and prevalence (25) rate of LEA among diabetic patients was also previously reported in Eastern-Asian ethnic groups. It has been postulated that a lower incidence rate of LEA associated with Asian people may be due to a lower prevalence of peripheral vascular disease (26).…”

Predictors, consequences and costs of diabetes-related lower extremity amputation complicating type 2 diabetes: The Fremantle Diabetes Study

“…Reported incidence rates of diabetes-related LEAs range between 0.03% per year for Asians living in Leicestershire, UK, from 1980 to 1985 [29], to 1.80% per year in American Indians [30]. During a mean 9.1 years of follow-up from entry into the FDS, 3.4% of our patients had a first-ever LEA, representing a crude annual incidence of 0.4%.…”

Pain in traumatic upper limb amputees in Sierra Leone

“…Hours/day 1 (1-1) n ¼ 2 1.6 (0.5-3) n ¼ 6 common operation worldwide (Muyembe and Muhinga, 1999;Gujral et al, 1993). Pain after limb amputation is common (Jensen et al, 1985) and hard to treat (Sherman et al, 1980).…”