Amputation prevention and rehabilitation in diabetes.

Abstract

Diabetes is a multi-system disease which can lead to complications such as peripheral neuropathy and peripheral vascular disease. These two complications can synergistically lead to the formation of ulcerations in the feet and lower extremities of persons with diabetes (PWD). Should an ulceration develop, it may be a self limited process healing spontaneously or it may lead to more serious complications such as infection of the skin, soft tissue, bone, sepsis, and possibly amputation of toes, foot, or lower extremity. For the year 1991, 57% of all amputations involving lower extremities in Manitoba were in PWD. Lower extremity amputations were 10 times higher amongst PWD than those without diabetes. In 1991, the prevalence of diabetes in adult Manitobans was as follows: First Nations individuals - 12% males, 20% females, non-First Nations individuals - 7% male, 6.4% females. The Manitoba Health Services Commission records for 1993-1994 show 16% of lower extremity amputations in Manitoba were amongst First Nations individuals, and 84% in non-First Nations individuals.1