May 2018

Lower-extremity amputation feared more than death

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Both type 1 and type 2 diabetes are known for their life-threatening complications—in particular, blindness from retinopathy, kidney failure, and peripheral neuropathy. For patients with diabetes and foot pathology, amputation is a significant worry. A recent study in Foot & Ankle Specialist sought to understand just how much this population fears lower-extremity amputation (LEA).

The study enrolled 461 patients; the control group (n=254) had non-diabetes-related foot complications; the study group (n=207) had diabetic foot pathology (including 61 [32%] with diabetic foot ulcer, Charcot neuropathy, foot infection, or acute neuropathic fractures and dislocations).

Researchers found no significant differences between the 2 groups related to fear of blindness, diabetic foot infection, or kidney failure needing dialysis. When compared to those without diabetic foot problems, the authors found that the 32% of the study group with identified diabetic foot disease were 136% more likely to rate LEA as their greatest fear and that 49% were less likely to rate death as their greatest fear. In their conclusion, the authors noted that the presence of a diabetic foot-related complication, having diabetes for more than 10 years, use of insulin, and having peripheral neuropathy were all variables that subjects associated with identifying LEA as the greatest fear.

Source:

Wukich DK, Raspovic KM, Suder NC. Patients with diabetic foot disease fear major lower extremity amputation more than death. Foot Ankle Spec. 2018;11(1):17-21.

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