Black Diabetics More Likely to Need Amputation:
This from our SALSAmigo Dartmouth’s Phil Goodney via Kristina Fiore and MedPage Today.
Older blacks with type 2 diabetes were nearly three times more likely than other Medicare beneficiaries to undergo disease-related leg amputation, researchers found.
Data analyzed by the Dartmouth Atlas Project showed that the leg amputation rate among black Medicare patients with diabetes and peripheral arterial disease (PAD) was 5.6 per 1,000 population compared with 2.0 per 1,000 among non-black diabetes and PAD patients.
“This report leaves little doubt where the focus of amputation prevention needs to be directed,” Philip Goodney, MD, of Dartmouth Hitchcock Medical Center in Lebanon, N.H., said in a statement. “While a comprehensive approach is necessary, focusing on black patients in poor, rural regions of the United States is likely to be the best place to start.”
He called for more opportunities to “expand education and preventive care for all patients at risk for amputation. However, initiating broader efforts in these high-risk communities will be essential to have the greatest impact.”
Amputation rates also varied by region, with the highest rates in the rural Southeast, Goodney and colleagues reported. And racial disparities were wider in some states than others.
The worst instances were in Mississippi, they reported, with 14.2 per 1,000 in Meridian and 16.1 per 1,000 in Tupelo, compared with 3.8 and 4.7 in non-black patients in those cities, respectively.
The study also showed that blacks were less likely to get routine preventive care than other patients. Only 75% of black diabetic beneficiaries had a blood lipid test in 2010, compared with almost 82% of non-black patients.
The report was based on Medicare claims from 2007 to 2011.
A report from last spring in the New England Journal of Medicine noted that diabetes complications have plummeted over a 20-year span. Specifically, amputation rates were halved between 1990 and 2010.
However, those researchers noted that a large burden of disease persists because of the continued increase in prevalence of diabetes, and that major diabetes complications will continue to put a heavy burden on the healthcare system.