Amputations in Patients with Diabetes Mellitus pp. 61-122
Authors: (Ioanna Eleftheriadou, Nicholas Tentolouris, First Department of Propaedeutic and Internal Medicine, Athens, University Medical School, Athens, Greece)
Abstract: Amputations in patients with diabetes mellitus remain 10-20-fold higher than in those without diabetes with an incidence of 4.5-10.5 cases per 1,000 patients with diabetes per year. There is a trend for a reduction in the major and an increase in the minor amputations in diabetes, while a multidisciplinary approach and management can reduce them. Amputations in patients with diabetes are performed at a younger age and many patients are candidates for a second or multiple amputations. Overall, about 40% (20-50%) of the patients with diabetes have a second amputation on the same or the contralateral foot within a period of 2-3 years after the first amputation. The main reasons for a foot or leg amputation in diabetes are ischemia (70%) and/or infection (30%). Additionally, mortality risk following amputation is high and the median survival duration is only 2-5 years.