Ethnic and health correlates of diabetes-related amputations at the Texas-Mexico border.
OBJECTIVE
To examine the association between diabetes-related lower-extremity amputation (LEA) and ethnicity, age, source of payment, geographic location, diabetes severity, and health condition in adults with diabetes mellitus type 2 living in border and non-border counties in Texas, United States of America, and to assess intra-border region geographic differences in post-LEA treatment.


METHODS
This correlational study was based on secondary data from the 2003 Texas Inpatient Hospital Discharge Data. The sample consisted of individuals 45 years of age and older with type 2 diabetes who had undergone a nontraumatic LEA (n = 5,865). Descriptive statistics and logistic regression analyses were applied.


RESULTS
The following characteristics were predictors of LEA: being Hispanic or African American, male, ≥ 55 years old, and a Medicare or Medicaid user, and living in a border county. Persons with moderate diabetes and those who suffered from cardiovascular disease or stroke also had higher odds of undergoing an LEA. Post-LEA occupational therapy was significantly less prevalent among border residents (9.5%) than non-border residents (15.3%) (P < 0.001).


CONCLUSIONS
Understanding the factors that influence diabetes-related LEA may lead to early detection and effective treatment of this disabling consequence of diabetes along the U.S.-Mexico border.
Department of Social and Behavioral Health, Texas A& M School of Rural Public Health, McAllen, Texas, USA. nmier@srph.tamhsc.edu
Nelda
N
Mier
Marcia
M
Ory
Dongling
D
Zhan
Edna
E
Villarreal
Maria
M
Alen
Jane
J
Bolin
D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000208:ethnology; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology; D017719:Diabetic Foot / Q000453:epidemiology / Q000208:ethnology / Q000601:surgery*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005528:Foot / Q000098:blood supply / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000453:epidemiology / Q000208:ethnology / Q000601:surgery*; D007866:Leg / Q000098:blood supply* / Q000601:surgery; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data; D008800:Mexico / Q000453:epidemiology / Q000208:ethnology; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000208:ethnology; D013781:Texas / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data