The 25-year cumulative incidence of lower extremity amputations in people with type 1 diabetes

Abstract

OBJECTIVE - To examine the 25-year cumulative incidence of lower-extremity amputation (LEA) in people with type 1 diabetes. RESEARCH DESIGN AND METHODS - Cumulative incidence of LEA was ascertained in Wisconsin Epidemiologic Study of Diabetic Retinopathy participants (n = 943) using the Kaplan-Meier approach accounting for competing risk of death. Relationships of baseline characteristics with incidence of LEA were explored using a proportional hazards approach with discrete linear regression modeling. RESULTS - The overall 25-year incidence of LEA was 10.1%. In multivariate analyses (results reported as odds ratio; 95%CI), being male (3.90; 2.29-6.65), heavy smoking (2.07; 1.11-3.85), having hypertension (3.36; 1.91-5.93), diabetic retinopathy (2.62; 1.13-6.09), neuropathy (1.68; 1.02-2.76), and higher HbA 1c (per 1% 1.40; 1.24-1.58) were independently associated with the incidence of LEA. CONCLUSIONS - Our results show a high 25-year incidence of LEA and suggest that glycemic control and blood pressure control and preventing heavy smokingmay result in reduction in its incidence. © 2011 by the American Diabetes Association.