title: Trends in lower extremity amputations in people with and without diabetes in England, 1996-2005.
abstract: OBJECTIVE
  To examine trends in non-traumatic lower extremity amputations over a 10-year-period in people with and without diabetes (DM) in England.
  
  
  METHODS
  All individuals admitted to NHS hospitals for non-traumatic amputations between 1996 and 2005 in England were identified using hospital activity data. Postoperative and 1-year mortality were examined between 2000 and 2004.
  
  
  RESULTS
  There was a reduction in minor and major amputations during the study period. The number of type 1 DM- and non-DM-related minor amputations decreased by 11.4% and 32.4%, respectively, while the number of type 2 DM-related minor amputations almost doubled. The incidence of type 1- and non-DM-related minor amputations decreased from 1.5 to 1.2 and from 8.1 to 5.1/100,000 population, respectively, while type 2 DM-related amputations increased from 2.4 to 4.1/100,000 population. The number of type 1- and non-DM-related major amputations declined by 41% and 22%, respectively, whereas type 2 DM-related amputations increased by 43%. The incidence of type 2 DM-related amputations increased from 2.0 to 2.7/100,000 population. Overall perioperative and 1-year mortality did not significantly change between 2000 and 2004.
  
  
  CONCLUSIONS
  While several factors may explain the increase in type 2 DM-related LEAs, these findings highlight the importance of diabetes prevention strategies and controlling risk factors for LEAs in people with diabetes.
authors.affiliation: Department of Primary Care and Public Health, Imperial College London, UK. e.vamos@imperial.ac.uk
authors.forename: Eszter Panna
authors.initials: EP
authors.lastname: Vamos
authors.forename: Alex
authors.initials: A
authors.lastname: Bottle
authors.forename: Azeem
authors.initials: A
authors.lastname: Majeed
authors.forename: Christopher
authors.initials: C
authors.lastname: Millett
mesh_terms: D000289:Admitting Department, Hospital / Q000706:statistics & numerical data; D000368:Aged; D000671:Amputation, Surgical / Q000401:mortality / Q000706:statistics & numerical data*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D017719:Diabetic Foot / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011203:Poverty; D012086:Reoperation / Q000706:statistics & numerical data