Medical strategies to reduce amputation in patients with Type 2 diabetes. Issue 8 (16th July 2013)

• Record Type: Journal Article
• Authors: Malik, R. A.; Tesfaye, S.; Ziegler, D.
• Is Part Of: Diabetic medicine. Volume 30:Issue 8(2013:Aug.)
• Page Start: 893
• Page End: 900
• Publication Date: 2013-07-16
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.12169
• Languages: English
• ISSNs: 0742-3071

Abstract

<abstract abstract-type="main" id="dme12169-abs-0001"> <title>Abstract</title> <p>Lower extremity amputation is a common and disabling complication of Type 2 diabetes. Whilst the introduction of specialist multidisciplinary teams has led to a reduction in the incidence of lower extremity amputation in some centres, the overall prevalence of diabetes‐related amputation has actually increased in recent decades. The aetiology of diabetes‐related amputation is complex, with neuropathy, macrovascular and microvascular disease contributing significantly. Ulceration, previous amputation, increasing diabetes duration and poor long‐term control of glycaemia and lipids are important risk factors for amputation in populations with diabetes. Major randomized intervention trials of blood glucose‐lowering or anti‐hypertensive therapies in populations with diabetes have shown limited reductions in neuropathy and/or macrovascular disease, and no benefit on amputation rates. In contrast, a recent analysis from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study showed a significantly reduced rate of minor, but not major amputations in patients with Type 2 diabetes treated with fenofibrate. Mechanistic studies are clearly needed to understand the basis of this benefit.</p> </abstract>