caa a22 4500 475771524 CHVBK 20180406123618.0 cr unu---uuuuu 170329e20000701xx s 000 0 eng 10.1007/s001250051459 doi (NATIONALLICENCE)springer-10.1007/s001250051459 Decreasing incidence of major amputations in people with diabetes [Elektronische Daten] [P. Holstein, N. Ellitsgaard, B. Bornefeldt Olsen, V. Ellitsgaard] Aims/hypothesis.: To assess the results of the strategy used in avoiding major amputations in patients with diabetes mellitus. Methods. A retrospective study for the years 1981 to 1995 in a central district hospital in Copenhagen with a catchment area population of about 178,000. Results. There were 463 major leg amputations and the incidence decreased from 27.2 to 6.9/100,000 population (75 %). The decrease in patients with Type I (insulin-dependent) diabetes mellitus was from 10.0 to 4.1 (59 %) and in Type II (non-insulin-dependent) diabetes mellitus from 17.2 to 2.8/100,000 people (84 %). Analysis showed that the diabetic population remained constant despite a considerable fall in the number of older people. During the study period infra-popliteal arterial bypass was introduced for the treatment of critical lower limb ischaemia and in diabetic patients the number of bypasses increased from zero to 13/100,000 population. The total number of revascularisation procedures in people with diabetes increased from 2.6 to 19.2/ 100,000 population. Moreover, a multidisciplinary diabetic foot clinic was established. Conclusion/interpretation. A 75 % reduction in the incidence of major amputations coincided with a sevenfold increase in revascularization procedures and the establishment of a multidisciplinary diabetic foot clinic suggesting these measures are important in the prevention of diabetic leg amputations. [Diabetologia (2000) 43: 844-847] Springer-Verlag Berlin Heidelberg, 2000 Keywords Amputation, diabetes, diabetic foot, diabetic gangrene, arterial reconstruction, multidisciplinary team nationallicence Holstein P. Copenhagen Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark, DK aut Ellitsgaard N. Department of Thoracic and Vascular Surgery L, Bispebjerg Hospital, Copenhagen, Denmark, DK aut Bornefeldt Olsen B. Department of Orthopaedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark, DK aut Ellitsgaard V. Department of Thoracic and Vascular Surgery L, Bispebjerg Hospital, Copenhagen, Denmark, DK aut https://doi.org/10.1007/s001250051459 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s001250051459 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Holstein P. Copenhagen Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark, DK aut NATIONALLICENCE 700 1- Ellitsgaard N. Department of Thoracic and Vascular Surgery L, Bispebjerg Hospital, Copenhagen, Denmark, DK aut NATIONALLICENCE 700 1- Bornefeldt Olsen B. Department of Orthopaedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark, DK aut NATIONALLICENCE 700 1- Ellitsgaard V. Department of Thoracic and Vascular Surgery L, Bispebjerg Hospital, Copenhagen, Denmark, DK aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer