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Diabetes Care, Vol 16, Issue 1 349-353, Copyright © 1993 by American Diabetes Association

ARTICLES

Epidemiology of lower-extremity amputations in the Indian Health Service, 1982-1987

SE Valway, RW Linkins and DM Gohdes
Indian Health Service Diabetes Program, Albuquerque, NM 87102.

OBJECTIVE--To describe the LEA experience among IHS diabetic patients. RESEARCH DESIGN AND METHODS--A cross-sectional study of hospital discharges for nontraumatic LEAs from 1982 to 1987 in four IHS areas was conducted. RESULTS--Incidence rates of first LEA in the study period increased with increasing age. Compared with nondiabetic subjects, diabetic patients had increased risks in each age-group, with those between the ages of 15 and 44 yr having a 158-fold increased risk. The average annual age-adjusted incidence rates of all LEAs among diabetic subjects in the Tucson (240.8/10,000) and Phoenix (203.1/10,000) IHS areas were substantially higher than the rates for the U.S. (73.1/10,000), Navajo (74.0/10,000), and the Oklahoma (87.3/10,000) IHS areas. CONCLUSIONS--LEA rates varied in different IHS areas. Reasons for these findings need to be evaluated, but may include IHS area differences in preventive health-care practices or risk factors for LEA.
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Copyright © 1993 by the American Diabetes Association.