title: [Lower extremity amputations in diabetic patients: a case-control study].
abstract: OBJECTIVE
  Lower extremity amputation is an increasing problem among diabetic patients and an important public health problem. The study purpose was to identify factors associated with lower extremity amputation.
  
  
  METHODS
  A matched case-control study was carried out among diabetic patients. Cases were selected in public health programs of the city of São Paulo, Brazil. One hundred and seventeen cases of diabetics with lower extremity amputation were compared to 234 controls of diabetics without amputation, matched by sex, age, and duration of disease. Sociodemographic variables, life habits (smoking and alcohol drinking), clinical aspects, and health education in diabetes were included. Univariate analyses and conditional logistic regression method were applied to data.
  
  
  RESULTS
  Data showed evidence of association for: smoking, last glucose test > or = 200 mg/dl, presence of peripheral somatic neuropathy and vibratory perception (tuning fork 128 Hz), and peripheral vascular disease. Diabetes treatment and attending nursing appointments for diabetes education were important factors for preventing lower extremity amputation in diabetic patients.
  
  
  CONCLUSIONS
  The knowledge of determinants and intervening factors for this condition will lead to cost reduction and better quality of care delivered in public health services.
authors.affiliation: Departamento de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil. monica@denf.epm.br
authors.forename: Mônica Antar
authors.initials: MA
authors.lastname: Gamba
authors.forename: Sabina Léa Davidson
authors.initials: SL
authors.lastname: Gotlieb
authors.forename: Denise Pimentel
authors.initials: DP
authors.lastname: Bergamaschi
authors.forename: Lucila A C
authors.initials: LA
authors.lastname: Vianna
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D001938:Brazil / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D035002:Lower Extremity; D008297:Male