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Endocrine Abstracts (2022) 81 EP444 | DOI: 10.1530/endoabs.81.EP444

1National Institute of Nutrition, Tunisia; 2University of Tunis El Manar, Tunisia


Introduction: The progressive increase in diabetes is likely to increase the incidence of amputations. Despite a wealth of research highlighting the importance of early detection and management, prevention practices remain poor, with inconsistent patient follow-up and compliance. The aim of our study was to assess the prevalence and risk factors for lower limb amputation in a third-line hospital among diabetics.

Methods: It was a retrospective study including patients aged 18 years and older with a confirmed diagnosis of type 1 and type 2 diabetes, hospitalized in nutrition department A between 1 September and 31 December 2021. Subjects under 18 years of age and those with non-diabetic foot amputations (e.g. traumatic or neoplastic) were excluded from the study. Subjects hospitalized for conditions other than diabetes were also excluded.

Results: The study enrolled 209 patients comprising 88 males and 121 females. The average age of the cohort was 51.8 years ± 18.3 years. Lower limb amputation was twice as common in type 2 diabetics. It occurred in 4.4%, more commonly amongst men (9% versus 0.8%; P = 0.004). Of them, 78% had dyslipidemia, 85% were overweight or obese and 65% had high blood pressure. Risk factors most closely associated with amputation included diabetic retinopathy (P = 0.001), diabetic nephropathy (P = 0.005), diabetic peripheral neuropathy (P = 0.002) and chronic peripheral artery occlusive disease (PAOD) (P = 0.01). Although average glycosylated hemoglobin A1C (Hba1c) levels was higher amongst amputees, it was statistically insignificant.

Conclusion: Considering the correlation between amputation and other microvascular complications of diabetes, it would be justifiable to detect and manage these complications early in order to limit their aggravation and prevent the occurrence of other complications. Several factors offer potential for modification for the prevention of amputations but require further study. These include blood pressure, glycosylated hemoglobin, and smoking.

Volume 81

European Congress of Endocrinology 2022

Milan, Italy
21 May 2022 - 24 May 2022

European Society of Endocrinology 

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