Data & Trends

Diabetes Surveillance System

1999 Surveillance Report

Chapter 6: Lower Extremity Amputation

Lower 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 for 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 > 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 discharges 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 > 75 years were more than twice those of persons aged < 65. LEA rates were higher among males than among females (Figure 6.5; Table 6.5) and among blacks than whites (Figure 6.6; Table 6.6).

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This page last reviewed January 18, 2005.

United States Department of Health and Human Services
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Division of Diabetes Translation