ArticleBMJ open diabetes research & care2019
Excess risk of lower extremity amputations in people with type 1 diabetes compared with the general population: amputations and type 1 diabetes.
Article in BMJ open diabetes research & care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 34 citations in OpenAlex.
- Hybrid closed-loop glucose control compared with sensor augmented pump therapy in older adults with type 1 diabetes: an open-label multicentre, multinational, randomised, crossover study.The lancet. Healthy longevity · 2022Trial
- Type 1 diabetes and cardiovascular medicine.Cardiovascular diabetology. Endocrinology reports · 2026Review
- Excess risk of cardiovascular disease and mortality after amputation in type 2 diabetes: a nationwide population study from the Swedish National Diabetes Register.Cardiovascular diabetology · 2026Observational
- Risk score for lower-limb amputation and its ability to predict major kidney and cardiovascular events in people with type 1 diabetes.Cardiovascular diabetology · 2026Article
- Cardiovascular disease in women with type 1 diabetes: a narrative review and insights from a population-based cohort analysis.Cardiovascular diabetology · 2025Review
- 2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2025Review
- 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2024Review
- Risk Factors Associated with Amputation for Patients with Diabetic Foot Ulcers: A Retrospective Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2024Article
- Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association.Circulation · 2023Review
- Differential prognostic burden of cardiovascular disease and lower-limb amputation on the risk of all-cause death in people with long-standing type 1 diabetes.Cardiovascular diabetology · 2022Article
- Time trends (2001-2019) and sex differences in incidence and in-hospital mortality after lower extremity amputations among patients with type 1 diabetes in Spain.Cardiovascular diabetology · 2022Article
- Intralesional Infiltrations of Arteriosclerotic Tissue Cells-Free Filtrate Reproduce Vascular Pathology in Healthy Recipient Rats.International journal of molecular sciences · 2022Article
- Renal Complications and Duration of Diabetes: An International Comparison in Persons with Type 1 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2021Article
- Observational
- Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association.Circulation · 2021Article
- The Role of Lower Extremity Amputation in Chronic Limb-Threatening Ischemia.The International journal of angiology : official publication of the International College of Angiology, Inc · 2020Review
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: This study investigates how the excess risk of lower extremity amputations (amputations) in people with type 1 diabetes mellitus (DM) differs from the general population by diabetes duration, glycemic control, and renal complications. Research design and methods: We analyzed data from people with type 1 DM from the Swedish National Diabetes Register without prior amputation from January 1998 to December 2013. Each person (n=36 872) was randomly matched with five controls by sex, age, and county (n=184 360) from the population without diabetes. All were followed until first amputation, death or end of follow-up. Results: The overall adjusted HR for all amputation was 40.1 (95% CI 32.8 to 49.1) for type 1 DM versus controls. HR increased with longer diabetes duration. The incidence of amputation/1000 patient-years was 3.18 (95% CI 2.99 to 3.38) for type 1 DM and 0.07 (95% CI 0.05 to 0.08) for controls. The incidence decreased from 1998-2001 (3.09, 95% CI 2.56 to 3.62) to 2011-2013 (2.64, 95% CI 2.31 to 2.98). The HR for major amputations was lower than for minor amputations and decreased over the time period (p=0.0045). Worsening in glycemic control among patients with diabetes led to increased risk for amputation with an HR of 1.80 (95% CI 1.72 to 1.88) per 10 mmol/mol (1%) increase in hemoglobin A1c. Conclusions: Although the absolute risk of amputation is relatively low, the overall excess risk was 40 times that of controls. Excess risk was substantially lower for those with good glycemic control and without renal complications, but excess risk still existed and is greatest for minor amputations.
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