Lower-Extremity Amputation Trends Among People With Diabetes In A Large Urban Environment

Non-traumatic lower extremity amputations (NLEAs) are a major complication for individuals with poorly controlled diabetes. We sought to identify trends for diabetic NLEAs in Dallas County between 2015 (4th quarter) to 2019 (3rdquarter) by using hospitalization data available from Dallas-Fort Worth Hospital Council Educational and Research Foundation and the CDC’s Behavioral Risk Factor Surveillance System (BRFSS). Per BRFSS, the prevalence of diabetes in Dallas County is 11.7% with a mean (±SD) age of 53±19.1 years, and 56% male, 27% Hispanic, 35% black and 30% non-Hispanic white. The age-adjusted NLEA rates per 1,000 in this population of adults with diabetes increased 18.1% between 2015 and 2019 (incomplete years annualized), with men experiencing higher NLEA rates than women. There was a significant decrease in age-adjusted rates of all NLEAs in women from 2017 and 2018, reflecting prior reports at the national level. The age-adjusted rates for major NLEAs decreased in all age groups except ages 75+ between 2018 and 2019 with a concomitant increase in minor NLEAs; this had been preceded by a steady increase in rates of all NLEAs up to 2018. Of relevance is that starting in 2018 the proportion of major to minor NLEAs has been decreasing steadily. In conclusion, we note a fall in NLEA rates in the last year of observation with the added benefit of a relative fall in major compared to minor NLEAs in patients with diabetes. Disclosure K.K. Chatha: None. B. Walsh: None. J. La Fontaine: None. M.E. Bowen: None. L. Meneghini: Advisory Panel; Self; Novo Nordisk Inc., Sanofi US. Consultant; Self; Applied Therapeutics, Sanofi US.