Medical strategies to reduce amputation in patients with type 2 diabetes Review uri icon

Overview

MeSH Major

  • Antihypertensive Agents
  • Diabetes Mellitus, Type 2
  • Diabetic Angiopathies
  • Diabetic Neuropathies
  • Hypoglycemic Agents
  • Hypolipidemic Agents

abstract

  • Lower extremity amputation is a common and disabling complication of Type 2 diabetes. Whilst the introduction of specialist multidisciplinary teams has led to a reduction in the incidence of lower extremity amputation in some centres, the overall prevalence of diabetes-related amputation has actually increased in recent decades. The aetiology of diabetes-related amputation is complex, with neuropathy, macrovascular and microvascular disease contributing significantly. Ulceration, previous amputation, increasing diabetes duration and poor long-term control of glycaemia and lipids are important risk factors for amputation in populations with diabetes. Major randomized intervention trials of blood glucose-lowering or anti-hypertensive therapies in populations with diabetes have shown limited reductions in neuropathy and/or macrovascular disease, and no benefit on amputation rates. In contrast, a recent analysis from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study showed a significantly reduced rate of minor, but not major amputations in patients with Type 2 diabetes treated with fenofibrate. Mechanistic studies are clearly needed to understand the basis of this benefit.

publication date

  • August 2013

Research

keywords

  • Review

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.1111/dme.12169

PubMed ID

  • 23445087

Additional Document Info

start page

  • 893

end page

  • 900

volume

  • 30

number

  • 8