Diabetes mellitus and limb loss: an analysis from a tertiary care center

ABSTRACT

To compare the frequency and determinants of prosthesis fitting [artificial limbs] in diabetic and non-diabetic amputees at a tertiary care center. Cross Sectional Comparative Study This study was conducted at Institute of Physical Medicine and Rehabilitation [IPM and R] at Dow University of Health Sciences, Karachi during Oct 2007- Sep 2010. Data was collected from amputee records files seeking carefor prosthetic fitting. There were 1469 prosthesis fitted in both diabetic and non-diabetics patients. The data from both groups were compared for frequency of amputation in diabetic and non-diabetics. The data was entered and analysis was performed on SPSS windows version 16. The analysis of data was performed for patients who were provided prosthesis fitting at IPM and R. Diabetic males were 327[73.6%] female were 117 [26.4%].About a third of amputees had primary, secondary and tertiary health care services for control of diabetes. About 60% of all diabetics were not able to seek medical care for control of diabetes. The use of primary, secondary and tertiary health care services to control diabetes were also recorded to correlate with health seeking facilities among diabetics. The prosthesis fitting was given to one third of diabetic patients after lower limb amputation. The major determinants of diabetic amputees were old age, man uneducated, low socioeconomic status. The facilities for primary, secondary and tertiary health care services to control diabetes are available only to one third of diabetic patients. Diabetic control, education of foot care and accessibility to diabetic and prosthesis centre can markedly improve functional integration of diabetic amputees in community