Abstract
Background and objectives: Diabetes mellitus (DM) stands out among the most important public health problems worldwide since it represents a high burden on health systems and is associated with higher hospitalization rates, and a higher incidence of cardiovascular diseases. Amputations are among the most common complications, leading to disability and increasing care costs. This research aims to analyze the prevalence of DM-related amputations, comorbidities and associated risk factors in the diabetic population residing in the State of Espírito Santo, Brazil. Materials and Methods: This is a quantitative, exploratory, cross-sectional study with a time series design and the use of secondary data registered and followed by the system of Registration and Monitoring of Hypertension and Diabetes—SisHiperdia. Results: The sample consisted of 64,196 diabetic patients, out of them, 3.9% had type 1 DM, 10.9% with type 2 DM, and 85.2% with DM coexisting with hypertension. Most were female (66.6%), aged 40 to 59 years (45.6%), and 60 years and older (45.2%). The prevalence of DM-related amputations in the analyzed sample was 1.2% in type 1 DM, 1.5% in type 2 DM, and 2.2% in concomitant DM and hypertension. Higher amputation rates were observed in males in the age group above 60 years in type 1 DM and type 2 DM and were slightly higher in the age groups up to 29 years in DM with hypertension. A higher prevalence of amputation was related to smoking, physical inactivity, acute myocardial infarction (AMI), stroke, chronic kidney disease (CKD), and diabetic foot (DF) in all types of DM. Conclusions: The present study showed a significant prevalence of DM-related amputations. An increased prevalence was evidenced when correlated with smoking, physical inactivity, AMI, stroke, CKD, and DF with significant statistical associations, except for a sedentary lifestyle in type 1 DM.
Highlights
Diabetes mellitus (DM) stands out among the most important public health problems
The present study aims to analyze the prevalence of DM-related amputations, comorbidities, and related risk factors in the diabetic population living in the state of Espírito Santo, Brazil
The results show that the prevalence of amputations related to DM in the state of Espírito Santo is still high, requiring constant monitoring and periodic review of strategies to implement public policies for managing this disease, and likewise, the development of new studies that separately analyze major and minor amputations, and identify the main difficulties encountered by the government, health professionals, patients and family members in coping with DM and its complications is required
Summary
Diabetes mellitus (DM) stands out among the most important public health problems. It is among the top ten causes of death worldwide, reaching approximately four million deaths of people aged 20 to 79 years in 2017. DM imposes high burden on health systems and is associated with higher hospitalization rates, higher utilization of health services, as well as a higher incidence of cardiovascular and cerebrovascular diseases, blindness, renal insufficiency, and non-traumatic lower-limb amputations. Diabetic foot ulcers and associated amputations are among the most common complications, leading to disability and increasing care costs [2,3]. Diabetes mellitus (DM) stands out among the most important public health problems worldwide since it represents a high burden on health systems and is associated with higher hospitalization rates, and a higher incidence of cardiovascular diseases. A higher prevalence of amputation was related to smoking, physical inactivity, acute myocardial infarction (AMI), stroke, chronic kidney disease (CKD), and diabetic foot (DF) in all types of DM. An increased prevalence was evidenced when correlated with smoking, physical inactivity, AMI, stroke, CKD, and DF with significant statistical associations, except for a sedentary lifestyle in type 1 DM
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