London: There has been a significant reduction in diabetes-related amputations since the mid-1990s thanks to improvements in diabetes care over this period, researchers report.


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Amputations of the lower limbs are one of the most serious and disabling complications of diabetes.


It becomes necessary when the nerve and blood vessel damage caused by the condition affects the blood supply to the lower limbs, especially the feet.


Serious problems with the feet, including ulceration, are a frequent reason for hospitalisation among patients who have diabetes.


This new study analysed amputation rates in Denmark (with five lakh residents and regarded as representative of both the population of Denmark and other high-income countries of Europe and the world) during the period 1996-2011.


The analysis showed major reductions in diabetes-related amputations of various types.


The researchers found an annual reduction in below-ankle amputation (BAA) rates among diabetes patients of 10 percent and the annual reduction in below-knee amputation (BKA) rates for patients with diabetes was 15 percent.


For above-knee amputations (AKA), the annual rate of reduction for those with diabetes was around three percent but not statistically significant.


Amputation rates unrelated to diabetes (for example, those caused by vascular diseases and ischaemia) remained unchanged over this period.


The authors believe that better care related to diabetes and its complications are the central cause of the reduced amputation rates.


"Our study suggests that the reduction in amputation rates among diabetes patients most likely is due to improvement in the care of individuals with diabetes," they noted.


"The findings can be explained by improved diabetes care or changes in how care is delivered, including better screening," they added.


The reduction of amputations among diabetics is a good news. "It is encouraging that the overall amputation rate is declining in most parts of the world," the authors wrote.


To reduce the amputation rate further, the authors suggest focus on establishing multidisciplinary diabetic clinics highly specialised in the diagnosis and treatment of the underlying diseases.


The research is published in Diabetologia - the journal of the European Association for the Study of Diabetes.