May 2018

Lower-extremity amputation feared more than death 628747786

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.


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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