Aims/hypothesis.
To assess the results of the strategy used in avoiding major amputations in patients with diabetes mellitus.
Methods. A retrospective study for the years 1981 to 1995 in a central district hospital in Copenhagen with a catchment area population of about 178,000.
Results. There were 463 major leg amputations and the incidence decreased from 27.2 to 6.9/100,000 population (75 %). The decrease in patients with Type I (insulin-dependent) diabetes mellitus was from 10.0 to 4.1 (59 %) and in Type II (non-insulin-dependent) diabetes mellitus from 17.2 to 2.8/100,000 people (84 %). Analysis showed that the diabetic population remained constant despite a considerable fall in the number of older people. During the study period infra-popliteal arterial bypass was introduced for the treatment of critical lower limb ischaemia and in diabetic patients the number of bypasses increased from zero to 13/100,000 population. The total number of revascularisation procedures in people with diabetes increased from 2.6 to 19.2/ 100,000 population. Moreover, a multidisciplinary diabetic foot clinic was established.
Conclusion/interpretation. A 75 % reduction in the incidence of major amputations coincided with a sevenfold increase in revascularization procedures and the establishment of a multidisciplinary diabetic foot clinic suggesting these measures are important in the prevention of diabetic leg amputations. [Diabetologia (2000) 43: 844–847]
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Received: 8 November 1999 and in revised form: 14 March 2000
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Holstein, P., Ellitsgaard, N., Bornefeldt Olsen, B. et al. Decreasing incidence of major amputations in people with diabetes. Diabetologia 43, 844–847 (2000). https://doi.org/10.1007/s001250051459
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DOI: https://doi.org/10.1007/s001250051459