ArticleDiabetes care2020
National and State-Level Trends in Nontraumatic Lower-Extremity Amputation Among U.S. Medicare Beneficiaries With Diabetes, 2000-2017.
Article in Diabetes care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.
- Tibial Osteodistraction Angiogenesis for Diabetic Foot Ischemia: A Systematic Review and Meta-Analysis.Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair SocietyPooled it
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- Bibliometric analysis highlights racial diversity of type 2 diabetes research: Global trends from 2010 to 2024.AIMS public health · 2026Article
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- Intravitreal anti-VEGF therapy and risk of limb complications in individuals with diabetic eye disease.Diabetes research and clinical practice · 2025Article
- Primary Care Providers Describe Barriers and Facilitators to Amputation Prevention in Oklahoma.Journal of clinical medicine · 2025Article
- Comparative effectiveness of porcine placental extracellular matrix against other cellular, acellular and matrix-like products in diabetic foot ulcers from the Medicare database.Journal of comparative effectiveness research · 2025Article
- Trends of lower-limb complications in patients with type 2 diabetes mellitus during the COVID-19 pandemic.Diabetes research and clinical practice · 2025Article
- 2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2025Review
- Outcomes for Patients with Diabetic Foot Ulcers Following Transition from Medicaid to Commercial Insurance.Diabetology · 2024Article
- Review
- Experiences of middle-aged individuals with lower extremity amputation caused by diabetic foot ulcer after disability in China: A qualitative study.Nursing open · 2024Article
- Validating a fear-of-falling-related activity avoidance scale in lower limb prosthesis users.PM & R : the journal of injury, function, and rehabilitation · 2024Article
- 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2024Review
- Vascular surgeons are positioned to fight healthcare disparities.Journal of vascular surgery. Venous and lymphatic disorders · 2024Review
- A Pneumatically Controlled Prosthetic Socket for Transfemoral Amputees.Sensors (Basel, Switzerland) · 2023Article
- Examining health care access disparities in Hispanic populations with peripheral artery disease and diabetes.Vascular medicine (London, England) · 2023Article
- Article
- Impact of Diabetic Foot Multidisciplinary Unit on Incidence of Lower-Extremity Amputations by Diabetic Foot.Journal of clinical medicine · 2023Article
- Trends and Race/Ethnic Disparities in Diabetes-Related Hospital Use in Medicaid Enrollees: Analyses of Serial Cross-sectional State Data, 2008-2017.Journal of general internal medicine · 2023Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveDiabetes is a leading cause of nontraumatic lower-extremity amputation (NLEA) in the U.S. After a period of decline, some national U.S. data have shown that diabetes-related NLEAs have recently increased, particularly among young and middle-aged adults. However, the trend for older adults is less clear. RESEARCH DESIGN AND
methodsTo examine NLEA trends among older adults with diabetes (≥67 years), we used 100% Medicare claims for beneficiaries enrolled in Parts A and B, also known as fee for service (FFS). NLEA was defined as the highest-level amputation per patient per calendar year. Annual NLEA rates were estimated from 2000 to 2017 and stratified by age-group, sex, race/ethnicity, NLEA level (toe, foot, below-the-knee amputation [BKA], or above-the-knee amputation [AKA]), and state. All rates were age and sex standardized to the 2000 Medicare population. Trends over time were assessed using Joinpoint regression and annual percent change (APC) reported.
resultsNLEA rates (per 1,000 people with diabetes) decreased by half from 8.5 in 2000 to 4.4 in 2009 (APC -7.9,
conclusionsThis study of the U.S. Medicare FFS population shows that recent increases in diabetes-related NLEAs are also occurring in older populations but at a less severe rate than among younger adults (<65 years) in the general population. Preventive foot care has been shown to reduce rates of NLEA among adults with diabetes, and the findings of the study suggest that those with diabetes-across the age spectrum-could benefit from increased attention to this strategy.
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