Fewer diabetic lower-limb amputations indicate improvements in treatments, study finds

Study finds 28.8% decrease in lower-limb amputations, 143.3% increase in orthopedic surgery

ROSEMONT, Ill. — Fewer Americans are undergoing lower-limb amputations, a statistic that indicates advances in treating foot ulcers related to diabetes, according to a new study.

The study, conducted by researchers at the University of Iowa and published in the journal Foot & Ankle International, found "dramatic" decreases in the number and severity of lower-limb amputations over the past decade, while improvements in foot ulcer treatment may be reducing the need for them. Still, the number of people living with diabetes, mostly Type 2 — which is related to lifestyle — has increased significantly, afflicting nearly 26 million Americans, according to the American Diabetes Association. The ADA expects that number to reach 44 million by 2034, and diabetes is responsible for more than 60% of lower-limb amputations from non-trauma causes.

The researchers studied lower-limb amputation rates and diabetic foot ulcer treatments under Medicare claims between 2000 and 2010, finding that amputations decreased by 28.8%, while surgical orthopedic treatments for ulcers rose by 143.3%. Such treatments include total-contact casting, Achilles tendon release and calf muscle lengthening.

"The shift in amputation level observed in the Medicare population is also quite striking," study author Phinit Phisitkul said. "Amputations at the upper and lower leg level are down 47%, while amputations at the partial-toe level increased by 24%. What this means for patients is increased mobility, independence and survival rates."


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