Four-fold increase in foot ulcers in type 2 diabetic subjects without an increase in major amputations by a multidisciplinary setting.
OBJECTIVE
We observed a large increase in type 2 diabetic subjects with foot ulcers in our diabetic outpatient foot clinic and wanted to identify the amputations rate and individuals at risk of amputations by comparing those who had had a regular control in the multidisciplinary foot clinic prior to the amputations and those who had not.


METHODS
We examined all clinical records from the orthopaedic surgery department and the diabetic outpatient foot clinic of diabetic patients who underwent amputations for 6 years.


RESULTS
Eighty-eight patients with type 2 diabetes underwent 142 amputations; 42 major and 100 minor amputations. There was no increase in the number of major amputations in this period. In the group not followed in the foot clinic prior to amputations we showed a greater major amputations rate (p<0.05), although this group had a shorter duration of diabetes and less retinopathy, nephropathy and AMI/stroke. Everyone in both groups had severe neuropathy and ischemia.


CONCLUSIONS
A multidisciplinary diabetic foot clinic may decrease the risk of major amputations in type 2 diabetic subjects with foot ulcers. Severe neuropathy and ischemia were the most important risk factors.
Hedetoft
Christoffer
C
Department of Endocrinology, Koege University Hospital, University of Copenhagen, Denmark. Hedetoft@dadlnet.dk
Rasmussen
Anne
A
Fabrin
Jesper
J
Kølendorf
Klaus
K
D000368:Aged; D000671:Amputation, Surgical / Q000145:classification / Q000706:statistics & numerical data*; D003718:Denmark; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D017719:Diabetic Foot / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D016523:Foot Ulcer / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team