Diabetes Care
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
QUICK SEARCH:   [advanced]


     

Diabetes Care Publish Ahead of Print published online ahead of print April 28, 2008
DOI: 10.2337/dc08-0344
This Article
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Google Scholar
Right arrow Articles by Jonasson, J. M.
Right arrow Articles by Brismar, K.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Jonasson, J. M.
Right arrow Articles by Brismar, K.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Original Research

The risks of non-traumatic lower extremity amputations in patients with type 1 diabetes – a population-based cohort study in Sweden

Junmei Miao Jonasson, MD, PHD1,,2, Weimin Ye, MD, PHD1, Pär Sparén, PHD1, Jan Apelqvist, MD, PHD3, Olof Nyrén, MD, PHD1 and Kerstin Brismar, MD, PHD2

1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
2Department of Molecular Medicine and Surgery, Karolinska Institutet, Sweden
3Department of Internal Medicine, University Hospital, Lund, Sweden

junmei.miao.jonasson{at}ki.se

kerstin.brismar{at}ki.se

ABSTRACT

Objective: To estimate the risks of non-traumatic lower extremity amputations (LEAs) in patients with type 1 diabetes mellitus (T1DM).

Research Design and Method: We identified 31,354 patients with T1DM (15,001 women and 16,353 men) in the Swedish Inpatient Register between 1975 and 2004. The incidence of non-traumatic LEAs was followed up until December 31, 2004, by cross-linkage in the Inpatient Register and linkage to the Death and Migration registers. Poisson regression modeling was used to compare the risks of non-traumatic LEAs during different calendar periods of follow-up, with adjustment both for gender and attained age at follow-up. Standardized incidence ratios (SIRs) was used to estimate the relative risks with the age-, sex-, and calendar-period-matched general Swedish population as reference. The cumulative probability of non-traumatic LEAs was calculated by the Kaplan-Meier method.

Results: In total, 465 patients with T1DM underwent non-traumatic LEAs. The risk was lower during the most recent calendar period (2000-2004) than the period prior to 2000 (relative risk = 0.6, 95% confidence interval [CI] 0.5-0.8). However, even in this most recent period, the risk for non-traumatic LEAs among these relatively young patients was 86-fold higher than that in the matched general population (SIR =85.8, 95% CI 72.9-100.3). By the age of 65, the cumulative probability of having a non-traumatic LEA was 11.0% for women with T1DM, and 20.7% for men with T1DM.

Conclusion: Although the risks appeared to have declined in recent years, patients with type 1 diabetes still run a very high risk for non-traumatic LEAs.


Add to CiteULike CiteULike   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Diabetes Diabetes Care Clinical Diabetes Diabetes Spectrum
Copyright © 2008 by the American Diabetes Association.