Limb loss awareness month
Losing a leg or part of a leg or foot is a real possibility for many persons with diabetes, or a result of trauma. April is Limb Loss Awareness Month and it provides an opportunity to discuss this often taboo or ignored topic.
We have little statistics on amputations here in The Bahamas. We do know that most of the lower leg or foot amputations are a result of diabetes and trauma. The vast majority is due to diabetes. A small research study showed that below knee amputation was the most common amputation performed at Princess Margaret Hospital (PMH) for persons with diabetes (35 percent), toe (digital) amputation 21 percent, followed by a trans-metatarsal (foot) amputations 14 percent. In 2010, the average age for an amputation was 57 years and there were just as many women and men having amputations.
In the United States nearly two million people are living with limb loss. The main causes are vascular disease (54 percent) — including diabetes and peripheral arterial disease — trauma (45 percent) and cancer (less than two percent). Approximately 185,000 amputations occur each year. African Americans are four times more likely to have an amputation than white Americans.
More than half of the individuals who have an amputation due to vascular disease including diabetes will die within five years. This is higher than the five year death rate for people who had breast cancer, colon cancer, and prostate cancer. Of persons with diabetes who had a lower extremity amputation, 55 percent will require another amputation on the second leg within two to three years.
In the United States, below-knee amputations are also the most common amputations, representing 71 percent of amputations. Amputations were more common in men 69 percent to 31 percent in women and the age was 45 to 64 years. The Amputee Coalition of America estimates that there are 185,000 new lower extremity amputations each year in the United States and an estimated population of two million American amputees.
Globally, there are more than one million limb amputations annually — one every 20 seconds. This is even more troubling, since the International Diabetes Federation (IDF) predicts that current global prevalence of diabetes will continue to increase. They also revealed that 85 percent of these amputations can be prevented.
Limb loss prevention
Introducing a comprehensive foot care program is the best way to prevent amputations.
The three most important factors for reducing the rate of diabetes related amputation are:
- Patient education to make sure patients know how to care for their feet, identifies a problem with the feet, prevent injury and seek medical care as soon as possible. Diabetics are encouraged to look at their feet every day and see a podiatrist at least once per year.
- Regular visits with the podiatrist have been proven to reduce diabetes related amputations. Seeing a podiatrist regularly prevents ulcers which can lead to amputations and admissions to the hospital by treating potential problems early.
- Appropriate footwear, as wearing shoes that do not fit is the most common cause of injury to the foot. Wearing diabetic shoes help protect the foot and prevent injury and amputations.
Not smoking is a critical habit in preventing amputations. Smoking cigarettes increases the risk of an amputation 25 more times than non-smokers.
- For more information email firstname.lastname@example.org or visit www.apma.org. To see a podiatrist visit Bahamas Foot Centre on Rosetta Street, telephone 325-2996, or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820, or Lucayan Medical Centre on East Sunrise Highway, Freeport, Grand Bahama, telephone 373-7400.