Geographic and Ethnic Inequalities in Diabetes-Related Amputations
Individuals with diabetes mellitus are at increasing risk for major lower-extremity amputations (LEAs). Poor quality of life and remarkable disabilities are associated with LEAs, determining a high economic burden for the healthcare systems. Reducing LEAs is therefore a primary marker of quality of...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Clinical Diabetes and Healthcare |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcdhc.2022.855168/full |
| _version_ | 1818319134053629952 |
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| author | Alfonso Bellia Alfonso Bellia Marco Meloni Marco Meloni Aikaterini Andreadi Aikaterini Andreadi Luigi Uccioli Luigi Uccioli Davide Lauro Davide Lauro |
| author_facet | Alfonso Bellia Alfonso Bellia Marco Meloni Marco Meloni Aikaterini Andreadi Aikaterini Andreadi Luigi Uccioli Luigi Uccioli Davide Lauro Davide Lauro |
| author_sort | Alfonso Bellia |
| collection | DOAJ |
| description | Individuals with diabetes mellitus are at increasing risk for major lower-extremity amputations (LEAs). Poor quality of life and remarkable disabilities are associated with LEAs, determining a high economic burden for the healthcare systems. Reducing LEAs is therefore a primary marker of quality of care of the diabetic foot. At global level, between-countries comparisons of LEAs rates are basically hampered by differences in criteria used for data collection and analysis among studies. Significant variability in amputation rates exists between geographic areas, and also within specific regions of a country. Overall 5-year mortality rate after major amputations is reported to vary substantially across countries, from 50 to 80%. The odds of LEAs are substantially higher for Black, Native American and Hispanic ethnicities compared with White groups, with similar figures observed in the economically disadvantaged areas compared to more developed ones. Such discrepancies may reflect differences in diabetes prevalence as well as in financial resources, health-care system organization and management strategies of patients with diabetic foot ulcers. Looking at the experience of countries with lower rates of hospitalization and LEAs worldwide, a number of initiatives should be introduced to overcome these barriers. These include education and prevention programs for the early detection of diabetic foot at primary care levels, and the multidisciplinary team approach with established expertise in the treatment of the more advanced stage of disease. Such a coordinated system of support for both patients and physicians is highly required to reduce inequalities in the odd of diabetes-related amputations worldwide. |
| first_indexed | 2024-12-13T10:04:17Z |
| format | Article |
| id | doaj.art-2bb058f948194eef81ad5f09c239a572 |
| institution | Directory Open Access Journal |
| issn | 2673-6616 |
| language | English |
| last_indexed | 2024-12-13T10:04:17Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Clinical Diabetes and Healthcare |
| spelling | doaj.art-2bb058f948194eef81ad5f09c239a5722022-12-21T23:51:34ZengFrontiers Media S.A.Frontiers in Clinical Diabetes and Healthcare2673-66162022-03-01310.3389/fcdhc.2022.855168855168Geographic and Ethnic Inequalities in Diabetes-Related AmputationsAlfonso Bellia0Alfonso Bellia1Marco Meloni2Marco Meloni3Aikaterini Andreadi4Aikaterini Andreadi5Luigi Uccioli6Luigi Uccioli7Davide Lauro8Davide Lauro9Department of Systems Medicine, University of Rome Tor Vergata, Rome, ItalyUnit of Endocrinology and Diabetes, University Hospital Policlinico Tor Vergata, Rome, ItalyDepartment of Systems Medicine, University of Rome Tor Vergata, Rome, ItalyUnit of Endocrinology and Diabetes, University Hospital Policlinico Tor Vergata, Rome, ItalyDepartment of Systems Medicine, University of Rome Tor Vergata, Rome, ItalyUnit of Endocrinology and Diabetes, University Hospital Policlinico Tor Vergata, Rome, ItalyDepartment of Systems Medicine, University of Rome Tor Vergata, Rome, ItalyUnit of Endocrinology and Diabetes, University Hospital Policlinico Tor Vergata, Rome, ItalyDepartment of Systems Medicine, University of Rome Tor Vergata, Rome, ItalyUnit of Endocrinology and Diabetes, University Hospital Policlinico Tor Vergata, Rome, ItalyIndividuals with diabetes mellitus are at increasing risk for major lower-extremity amputations (LEAs). Poor quality of life and remarkable disabilities are associated with LEAs, determining a high economic burden for the healthcare systems. Reducing LEAs is therefore a primary marker of quality of care of the diabetic foot. At global level, between-countries comparisons of LEAs rates are basically hampered by differences in criteria used for data collection and analysis among studies. Significant variability in amputation rates exists between geographic areas, and also within specific regions of a country. Overall 5-year mortality rate after major amputations is reported to vary substantially across countries, from 50 to 80%. The odds of LEAs are substantially higher for Black, Native American and Hispanic ethnicities compared with White groups, with similar figures observed in the economically disadvantaged areas compared to more developed ones. Such discrepancies may reflect differences in diabetes prevalence as well as in financial resources, health-care system organization and management strategies of patients with diabetic foot ulcers. Looking at the experience of countries with lower rates of hospitalization and LEAs worldwide, a number of initiatives should be introduced to overcome these barriers. These include education and prevention programs for the early detection of diabetic foot at primary care levels, and the multidisciplinary team approach with established expertise in the treatment of the more advanced stage of disease. Such a coordinated system of support for both patients and physicians is highly required to reduce inequalities in the odd of diabetes-related amputations worldwide.https://www.frontiersin.org/articles/10.3389/fcdhc.2022.855168/fulllower limb amputationdiabetesQuality of Lifehealth care organization and managementgeographical disparities |
| spellingShingle | Alfonso Bellia Alfonso Bellia Marco Meloni Marco Meloni Aikaterini Andreadi Aikaterini Andreadi Luigi Uccioli Luigi Uccioli Davide Lauro Davide Lauro Geographic and Ethnic Inequalities in Diabetes-Related Amputations Frontiers in Clinical Diabetes and Healthcare lower limb amputation diabetes Quality of Life health care organization and management geographical disparities |
| title | Geographic and Ethnic Inequalities in Diabetes-Related Amputations |
| title_full | Geographic and Ethnic Inequalities in Diabetes-Related Amputations |
| title_fullStr | Geographic and Ethnic Inequalities in Diabetes-Related Amputations |
| title_full_unstemmed | Geographic and Ethnic Inequalities in Diabetes-Related Amputations |
| title_short | Geographic and Ethnic Inequalities in Diabetes-Related Amputations |
| title_sort | geographic and ethnic inequalities in diabetes related amputations |
| topic | lower limb amputation diabetes Quality of Life health care organization and management geographical disparities |
| url | https://www.frontiersin.org/articles/10.3389/fcdhc.2022.855168/full |
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