US report on regional diabetes care raises amputation concerns
Black patients with type 2 diabetes in the United States are three times more likely than non-black patients to have a leg amputated, according to a report from the Dartmouth Atlas Project.
The research analysed Medicare data from 2007-2011, to assess how the healthcare system was treating patients diagnosed with diabetes and peripheral arterial disease.
Disparities in diabetes care
The results showed that there were racial and regional disparities, where certain diabetes patients were less likely to receive preventative care such as blood sugar testing, cholesterol testing and foot exams.
These tests can reduce the risk of amputation, an extreme measure relating to extreme poor diabetes control. However, only 75 per cent of black patients with diabetes received a blood lipids (cholesterol and triglycerides) test, compared to 82 per cent of non-black patients.
Mississippi has highest amputation rate
Mississippi, which is tied with West Virginia for the most obese state in the US, had an amputation rate of 6.2 per 1,000 patients in the city of Tupelo. For every 1,000 black Medicare patients with diabetes, 14.2 amputations occurred in Mississippi’s city of Meridian, with only 2.1 occurring among black patients in San Diego.
Co-author Philip Goodney, MD, Director of the Center for the Evaluation of Surgical Care at Dartmouth Hitchcock Medical Center, concluded: “We must look for opportunities to expand education and preventive care for all patients at risk for amputation.
“It seems clear to us that we can make the greatest gains by focusing on African-American patients in the highest risk regions, typically in the poor rural regions of the Southern United States”.
Receive the best diabetes care
Patients with type one or type two diabetes are urged to vigilantly ensure you receive all necessary tests to help monitor your diabetes when you visit your doctor.
Amputation is a worst case scenario for patients with diabetes and can be prevented with regular check-ups with health care professionals and by retaining good personal control of diabetes.
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