Background
Lower extremity amputations (LEA) are a life-threatening chronic complication of diabetes mellitus and an important indicator of the quality of diabetic foot care. Epidemiological studies show large differences in the incidence of LEA among people with diabetes mellitus.
Objective
Description of relevant methodological aspects when comparing studies on the incidence of amputations in people with diabetes mellitus.
Materials and methods
Characteristics of the study population, estimation of a population at risk, definition and recording of LEA as well as statistical approaches are the important methodological aspects and should, therefore, be considered in the interpretation of study results.
Results
The published results demonstrated considerable variation in the incidence of LEA among people with diabetes mellitus: the incidence rate of any LEA ranged between 78 (minimum) and 704 (maximum) per 100,000 person–years. The incidence rate of major LEA ranged between 33 and 383 per 100,000 person–years and the incidence rate of minor LEA ranged between 86 and 363 per 100,000 person–years. The epidemiological studies showed a reduction concerning the incidence of a major LEA among people with diabetes over time. The current study results regarding time trends for any LEA and minor LEA are contradictory.
Conclusions
The marked variations concerning the incidence of LEA among people with diabetes are often due to methodological differences. It is therefore desirable to establish uniform standards for study designs and reporting of the results.