Positive associations seen for higher age, being divorced, male sex; risk higher with increased foot risk versus healthy feet at baseline
By Elana Gotkine HealthDay Reporter
WEDNESDAY, Aug. 23, 2023 (HealthDay News) — For people with newly diagnosed diabetes, the risk for lower-limb amputation (LLA) is increased for those with older age, males, and divorced individuals, according to a study to be presented at the annual meeting of the European Association for the Study of Diabetes, being held Oct. 2 to 6 in Hamburg, Germany.
Stefan Jansson, Ph.D., from Örebro University in Sweden, and colleagues examined the association of demographic, socioeconomic, medical, and lifestyle risk factors with LLA in people with newly diagnosed diabetes using Swedish national register-linked data. The cohort consisted of 66,569 individuals aged 18 years or older with an incident diabetes diagnosis.
There were 133 LLAs during the median follow-up of four years. The researchers found that in a model mutually adjusting for all variables, positive associations were seen for higher age (hazard ratio [HR], 1.08 per year), being divorced versus married (HR, 1.67), and male sex (HR, 1.57). Compared with those with healthy feet, those with an increased foot risk at baseline had an increased risk for LLA (HR, 4.12, 8.26, and 11.24 for neuropathy/angiopathy, previous wounds, and ongoing severe foot disease, respectively). Compared with diet-only treatment, insulin treatment had an HR of 2.03. A significantly lower risk was seen for people with obesity versus those with normal weight (HR, 0.46). Compared with no smoking, smoking was associated with increased risk (HR, 1.99). Relative to daily physical activity, low physical activity (less than one time/week) was associated with increased risk (HR, 2.05).
“Lifestyle variables have a strong association with LLA, and an increase in physical activity, avoidance of being underweight, and smoking cessation may be impactful interventions to reduce the risk of LLA,” the authors said in a statement.
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