ArticleDiabetologia2018
Decreasing rates of major lower-extremity amputation in people with diabetes but not in those without: a nationwide study in Belgium.
Article in Diabetologia, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The effect of negative pressure wound therapy on the outcome of diabetic foot ulcers: A meta-analysis.International wound journal · 2024Pooled it
- NPWT in diabetic foot wounds-a systematic review and meta-analysis of observational studies.Endocrine · 2020Pooled it
- Lower extremity amputations in Switzerland: Trends in patients with and without diabetes, 2013-2023.International journal of cardiology. Cardiovascular risk and prevention · 2026Article
- Epidemiology of first-time major lower extremity amputations- A Danish Nationwide cohort study from 2010 to 2021.European journal of epidemiology · 2025Observational
- Temporal trends in patients with peripheral artery disease influenced by diabetes mellitus in Germany.Journal of diabetes · 2022Article
- Trends of Non-Traumatic Lower-Extremity Amputation and Type 2 Diabetes: Spain, 2001-2019.Journal of clinical medicine · 2022Article
- Lower Limb Amputation Rates in Germany.Medicina (Kaunas, Lithuania) · 2022Article
- Incidence of lower limb amputation in people with and without diabetes: a nationwide 5-year cohort study in Japan.BMJ open · 2021Article
- Evaluating the Impact of the Diabetes Mellitus Strategy for the National Health System: An Interrupted Time Series Analysis.Healthcare (Basel, Switzerland) · 2021Article
- Assessing data on the incidence of lower limb amputation in diabetes.Diabetologia · 2021Article
- Quantifying Step Count and Oxygen Consumption with Portable Technology during the 2-Min Walk Test in People with Lower Limb Amputation.Sensors (Basel, Switzerland) · 2021Article
- Amputations of Lower Limb in Subjects with Diabetes Mellitus: Reasons and 30-Day Mortality.Journal of diabetes research · 2021Article
- Article
- National and State-Level Trends in Nontraumatic Lower-Extremity Amputation Among U.S. Medicare Beneficiaries With Diabetes, 2000-2017.Diabetes care · 2020Article
- [Expert assessment of lower extremity prosthetics].Der Orthopade · 2020Article
- Major amputations in type 2 diabetes between 2001 and 2015 in Spain: regional differences.BMC public health · 2020Observational
- Article
- Population-based secular trends in lower-extremity amputation for diabetes and peripheral artery disease.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2019Article
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aims/hypothesisThe reduction of major lower-extremity amputations (LEAs) is one of the main goals in diabetes care. Our aim was to estimate annual LEA rates in individuals with and without diabetes in Belgium, and corresponding time trends.
methodsData for 2009-2013 were provided by the Belgian national health insurance funds, covering more than 99% of the Belgian population (about 11 million people). We estimated the age-sex standardised annual amputation rate (first per year) in the populations with and without diabetes for major and minor LEAs, and the corresponding relative risks. To test for time trends, Poisson regression models were fitted.
resultsA total of 5438 individuals (52.1% with diabetes) underwent a major LEA, 2884 people with above- and 3070 with below-the-knee major amputations. A significant decline in the major amputation rate was observed in people with diabetes (2009: 42.3; 2013: 29.9 per 100,000 person-years, 8% annual reduction, p < 0.001), which was particularly evident for major amputations above the knee. The annual major amputation rate remained stable in individuals without diabetes (2009: 6.1 per 100,000 person-years; 2013: 6.0 per 100,000 person-years, p = 0.324) and thus the relative risk reduced from 6.9 to 5.0 (p < 0.001). A significant but weaker decrease was observed for minor amputation in individuals with and without diabetes (5% and 3% annual reduction, respectively, p < 0.001). CONCLUSIONS/
interpretationIn this nationwide study, the risk of undergoing a major LEA in Belgium gradually declined for individuals with diabetes between 2009 and 2013. However, continued efforts should be made to further reduce the number of unnecessary amputations.
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