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Diabetes Care. 2002 Mar;25(3):570-4.

Foot ulceration and lower limb amputation in type 2 diabetic patients in dutch primary health care.

Author information

1
Julius Centre for General Practice and Patient Oriented Research, University Medical Centre Utrecht, Utrecht, the Netherlands.

Abstract

OBJECTIVE:

To determine the incidence of foot ulceration and lower limb amputation in type 2 diabetic patients in primary health care.

RESEARCH DESIGN AND METHODS:

Data on type 2 diabetes were collected by the Nijmegen Monitoring Project between 1993 and 1998 as part of a study of chronic diseases. The records of all patients recorded as having diabetic foot problems and those who died, moved to a nursing home, or were under specialist care were included. The annual incidence of foot ulceration was defined as the number of type 2 diabetic patients per patient-year who developed a new foot ulcer. Incidence of lower limb amputation was similarly defined. Additional information was collected on treatment of foot ulcers.

RESULTS:

The study population of type 2 diabetic patients increased from 511 patient-years in 1993 to 665 in 1998. The annual incidence of foot ulceration varied between 1.2 and 3.0% (mean 2.1) per year; 25% of the patients had recurrent episodes. The annual incidence of lower limb amputation varied between 0.5 and 0.8% (mean 0.6). Ten of the 15 amputees died, and 12 of 52 (23%) patients with ulceration had a subsequent amputation or a previous history of amputation. In 35 of the 73 (48%) episodes of ulceration, only the family physician provided treatment. Patients with foot problems were older and had more cardiovascular disease, retinopathy, and absent peripheral pulses.

CONCLUSIONS:

The incidence of foot ulceration and lower limb amputation in type 2 diabetes is low; nevertheless, recurrence rates of ulceration and risk of amputation are high, with high mortality.

PMID:
11874949
[Indexed for MEDLINE]

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