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Data & TrendsDiabetes Surveillance System1999 Surveillance Report
Chapter 1: The Public Health Burden of Diabetes Mellitus in the United States Nontraumatic Lower Extremity AmputationLower extremity disease is more common among persons with diabetes than among persons without the disease (21,22). More than half of all nontraumatic lower extremity amputations (LEAs) occur in persons with diagnosed diabetes, who represent only 3% of the U.S. population (23). This report shows that LEA remains a significant complication among persons with diabetes and that blacks and the elderly are disproportionately affected. Between 1980 and 1996, the number of diabetes-related hospital discharges with LEA as a reported procedure increased from 36,000 to 86,000 per year (Figure 6.1, Table 6.1). Almost 60% of diabetes-related LEAs occurred among persons aged greater than or equal to 65 years. In 1996, LEA discharges accounted for 1,168,000 days of hospital stay, for an average length of stay of 13.7 days (Figure 6.2, Table 6.1). Between 1980 and 1996, the average length of stay for LEA discharges decreased by about 22 days (from 35.8 days to 13.7 days). The age-adjusted rate of LEA hospital discharge among persons with diabetes was relatively stable from 1980 to 1982, increased 46% in 1983 (the year Medicare's prospective reimbursement system was implemented), leveled off, and then began increasing in the mid 1990s (Figure 6.3, Table 6.4). Between 1983 and 1996, LEA rates increased 24%. LEA rates per 1,000 diabetic population increased with age (Figure 6.4, Table 6.4). In 1996, rates among persons aged greater than or equal to 75 years were more than twice those among persons aged <65 years. LEA rates were higher among men than among women (Figure 6.5, Table 6.5) and among blacks than whites (Figure 6.6, Table 6.6). Return to Chapter 1 Contents
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Diabetes & Me