title: Diabetes-related lower-extremity amputations disproportionately affect Blacks and Mexican Americans.
abstract: BACKGROUND
  We sought to identify the age-adjusted incidence of lower-extremity amputation (LEA) in Mexican Americans, blacks, and non-Hispanic whites with diabetes in south Texas.
  
  
  METHODS
  We summarized medical records for hospitalizations for LEAs for 1993 in six metropolitan statistical areas in south Texas.
  
  
  RESULTS
  Age-adjusted incidence per 10,000 patients with diabetes was 146.59 in blacks, 60.68 in non-Hispanic whites, and 94.08 in Mexican Americans. Of the patients, 47% of amputees had a history of amputation, and 17.7% were hospitalized more than once during 1993. Mexican Americans had more diabetes-related amputations (85.9%) than blacks (74.7%) or non-Hispanic whites (56.3%).
  
  
  CONCLUSIONS
  This study is the first to identify the incidence of diabetes-related lower-extremity amputations in minorities using primary data. Minorities had both a higher incidence and proportion of diabetes-related, LEAs compared with non-Hispanic whites. Public health initiatives and national strategies, such as Healthy People 2000 and 2010, need to specifically focus on high-risk populations and high-risk geographic areas to decrease the frequency of amputation and reamputation.
authors.affiliation: Department of Orthopaedics, University of Texas Health Science Center, San Antonio, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Lavery
authors.forename: W H
authors.initials: WH
authors.lastname: van Houtum
authors.forename: H R
authors.initials: HR
authors.lastname: Ashry
authors.forename: D G
authors.initials: DG
authors.lastname: Armstrong
authors.forename: J A
authors.initials: JA
authors.lastname: Pugh
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D003925:Diabetic Angiopathies / Q000208:ethnology* / Q000601:surgery; D003929:Diabetic Neuropathies / Q000208:ethnology* / Q000601:surgery; D005260:Female; D006801:Humans; D007866:Leg / Q000601:surgery*; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data*; D008875:Middle Aged; D013781:Texas