Surprisingly, individuals with obesity have less than half the risk of lower limb amputation compared to those of normal weight.

A new study reveals risk factors for lower limb amputation (LLA) in people with diabetes

A recent study set to be unveiled at the European Association for the Study of Diabetes (EASD) Annual Meeting in Hamburg, Germany, between October 2-6, reveals intriguing associations between certain demographic factors and the risk of lower limb amputation (LLA) in diabetic individuals.

Conducted by Dr. Stefan Jansson from Örebro University in Sweden and his team, the study showcases that divorcees with diabetes face a 67% higher likelihood of undergoing LLA (amputations below the knee) in contrast to their married counterparts.

Similarly, diabetic men are found to have a 57% increased risk compared to diabetic women.

A common complication in diabetes patients is the degradation of both large and small blood vessels. This deterioration becomes pronounced among those who don’t consistently follow prescribed treatments for managing blood sugar, fats, and pressure. Fortunately, due to advancements in diabetes care, the frequency of LLA has been on the decline.

The study was motivated by the lack of extensive research into risk factors contributing to LLA among the diabetic population. The researchers aimed to understand how various demographic, medical, and lifestyle elements influence the likelihood of LLA among those newly diagnosed with diabetes.

Using Swedish national data, the researchers identified adults with newly diagnosed diabetes from 2007-2016 who hadn’t previously undergone amputation. Out of the 66,569 participants, 98% had type 2 diabetes, and 2% had type 1 diabetes. Throughout a median duration of four years, 133 participants underwent amputation. Advanced computational analysis was employed to discern the correlations between various risk factors and LLA incidents.

Lifestyle factors influencing diabetes complications

The findings illustrated a 67% increased LLA risk for divorced individuals compared to married ones. Each additional year of age increased the LLA risk by 8%.

The study suggests that the elevated risk among divorced individuals might stem from altered self-care and dietary habits post-divorce, particularly when they live alone.

For men, the risk could be exacerbated by increased social isolation and reduced physical activity.

Other factors influencing Lower Limb Amputation risk among diabetics

Certain conditions like neuropathy/angiopathy increased LLA risk by four times, while a history of foot ulcers upped the risk eightfold. Surprisingly, those with obesity exhibited a 46% reduced risk of LLA compared to individuals of normal weight. On the other hand, smokers and those with low physical activity faced double the risk of their non-smoking and more active counterparts, respectively.

This observational study raises questions about the lowered LLA risk among obese individuals.

The authors postulate that this anomaly might be attributed to either statistical randomness, superior wound healing capabilities in the obese, or weight loss due to illness in normal-weight individuals, elevating their relative LLA risk.

In summary, the research underscores the significant role of age, gender, marital status, foot health, treatment methods, physical activity levels, and smoking habits in influencing LLA risks in diabetics.

The team emphasizes the importance of lifestyle interventions, including heightened physical activity, avoiding being underweight and quitting smoking to mitigate LLA risks. They further stress the need for heightened vigilance for older diabetics, even if their disease’s tenure is brief.

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