Background: Diabetic foot ulceration is receiving more attention because of its high amputation and mortality\nrate. It is essential to establish the frequency of amputations in people with diabetes after any change to the\nmanagement of diabetic foot care. The present study aim to compare the frequency of lower-extremity\namputations in patients with diabetes foot ulcer over a ten-year period.\nMethods: Six hundred forty eight patients with diabetes foot ulcer were retrospectively studied from 2004 to 2013.\nThe clinical features, laboratory results and the lower-extremity amputations were recorded. Major amputation was\ndefined as amputations above the ankle while minor amputation was amputations below the ankle in the present study.\nResults: Patients with diabetic foot ulcer were old (age 66.96 �± 11.96 years), with a long duration of diabetes\n(10.30 �± 6.94 years), high HbA1c (9.19 �± 2.62 %), SBP (144.05 �± 24.18 mmHg), DBP (79.53 �± 11.88 mmHg), LDL-C\n(2.71 �± 0.93 mmol/L) and had great frequency of neuropathy (62.7 %), retinopathy (45.0 %), nephropathy (39.5 %) and\nPAD (33.2 %). From 2004 to 2013, the frequency of all lower-extremity amputations is 12.0 % (5.2 % major amputation,\n6.8 % minor amputation). The frequency of major amputations decreased from 9.5 % in 2004 and 14.5 % in 2005 to less\nthan 5.0 % after 2006. In particular, there was a significant decline in major amputations of diabetic foot patient with\nWagner 3 to 4 wounds. The frequency rate of major amputations in diabetic foot patient with Wagner 3 to 4 wounds\nfell from 35.7 % in 2004 to 4.4 % after 2007. The change in frequency of minor amputations was fluctuation.\nConclusion: This study demonstrates that the introduction of a multidisciplinary team, coordinated by an\nendocrinologist and a podiatrist, for managing diabetic foot disease is associated with a reduction in the\nfrequency of major amputations in patients with diabetes.
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