title: Thailand diabetes registry project: prevalence and risk factors associated with lower extremity amputation in Thai diabetics.
abstract: OBJECTIVE
  To determine the prevalence and risk factors associated with lower extremity amputation (LEA) in Thai diabetics.
  
  
  METHODS
  A cross-sectional, multicenter hospital-based diabetes registry was carried out from April to December 2003. Baseline characteristics and risk factors were analysed from 9419 diabetic patients. peripheral vascular disease (PVD) was defined as absent or diminished dorsalis pedis (DP) and posterior tibialis (PT) pulses to palpation in the same limb. LEA was defined as surgical removal of part of a lower extremity.
  
  
  RESULTS
  The prevalence of LEA was 1.5% (142). Mean diabetes duration was 10 years (SD = 7.6). Out of 556 patients with a history of foot ulcer 123 (22.1%) underwent amputation. PVD was present in 370 patients. Most ofLEAs were toe amputations (64.1%). Multiple logistic regression analysis of risk factors (adjusted OR, [95% confidence interval], p value) revealed a high risk of LEA in patients with a history of ulcer (59.2, [32.8-106.8], p < 0.001), peripheral vascular disease (5.3, [3.1-9.2], p < 0.001), diabetic retinopathy (2.2, [1.3-3.8], p = 0.004), and insulin injection (1.9, [1.1-3.2], p < 0.023).
  
  
  CONCLUSIONS
  Patients at risk for LEA were those with a history of foot ulcer, absence of peripheral pulse, diabetic retinopathy and insulin injection. Preventive strategies should be considered in these groups of patients. Data should be interpreted with caution as the number of patients with amputation was few and information on neuropathy was not available.
authors: Theptarin General Hospital, 3850 Rama 4 Rd, Bangkok 10110, Thailand. Sirinate@Theptarin.com
authors: Sirinate
authors: S
authors: Krittiyawong
authors: Chardpraom
authors: C
authors: Ngarmukos
authors: Yupin
authors: Y
authors: Benjasuratwong
authors: Petch
authors: P
authors: Rawdaree
authors: Rattana
authors: R
authors: Leelawatana
authors: Natapong
authors: N
authors: Kosachunhanun
authors: Nattachet
authors: N
authors: Plengvidhya
authors: Chaicharn
authors: C
authors: Deerochanawong
authors: Sompongse
authors: S
authors: Suwanwalaikorn
authors: Thongchai
authors: T
authors: Pratipanawatr
authors: Thanya
authors: T
authors: Chetthakul
authors: Sirima
authors: S
authors: Mongkolsomlit
authors: Pongamorn
authors: P
authors: Bunnag
mesh_terms: D000671:Amputation, Surgical; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016730:Program Development; D015397:Program Evaluation; D012042:Registries; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology