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Risks of nontraumatic lower-extremity amputations in patients with type 1 diabetes - A population-based cohort study in Sweden

Jonasson, Junmei Miao; Ye, Weimin; Sparen, Par; Apelqvist, Jan LU ; Nyren, Olof and Brismar, Kerstin (2008) In Diabetes Care 31(8). p.1536-1540
Abstract
OBJECTIVE - The purpose of this study was to estimate the risks of nontraumatic lower-extremity amputations (LEAS) in patients With type 1 diabetes. RESEARCH DESIGN AND METHODS - We identified 31,354 patients with type 1 diabetes (15,001 women and 16,353 men) in the Swedish Inpatient Register between 1975 and 2004. The incidence of nontraumatic LEAs was followed up until 31 December 2004 by cross-linkage in the Inpatient Register and linkage to the Death and Migration registers. Poisson regression modeling was used to compare the risks of nontraumatic LEAs during different calendar periods of follow-up, with adjustment for both sex and attained age at follow-up. Standardized incidence ratios (SIRs) were used to estimate the relative risks... (More)
OBJECTIVE - The purpose of this study was to estimate the risks of nontraumatic lower-extremity amputations (LEAS) in patients With type 1 diabetes. RESEARCH DESIGN AND METHODS - We identified 31,354 patients with type 1 diabetes (15,001 women and 16,353 men) in the Swedish Inpatient Register between 1975 and 2004. The incidence of nontraumatic LEAs was followed up until 31 December 2004 by cross-linkage in the Inpatient Register and linkage to the Death and Migration registers. Poisson regression modeling was used to compare the risks of nontraumatic LEAs during different calendar periods of follow-up, with adjustment for both sex and attained age at follow-up. Standardized incidence ratios (SIRs) were used to estimate the relative risks (RRs) with the age-, sex-, and calendar period-matched general Swedish population as reference. The cumulative probability of nontraumatic LEAs was calculated by the Kaplan-Meier method. RESULTS - In total, 465 patients with type 1 diabetes undenwent nontraumatic LEAS. The risk was lower during the most recent calendar period (2000-2004) than during the period before 2000 (RR 0.6 [95% CI 0.5-0.8]). However, even in this most recent period, the risk for nontraumatic LEAs among these relatively young patients was 86-fold higher than that in the matched general population (SIR 85.8 [72.9-100.3]). By age 65 years, the cumulative probability of having a nontraumatic LEA was 11.0% for women with type 1 diabetes and 20.7% for men with type 1 diabetes. CONCLUSIONS - Although the risks appeared to have declined in recent years, patients with type 1 diabetes still have a very high risk for nontraumatic LEAs. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Diabetes Care
volume
31
issue
8
pages
1536 - 1540
publisher
American Diabetes Association
external identifiers
  • wos:000258482000014
  • scopus:49649118042
ISSN
1935-5548
DOI
10.2337/dc08-0344
language
English
LU publication?
yes
id
95b45554-08ab-4796-a1fb-2f428e32acf2 (old id 1251967)
date added to LUP
2008-11-03 16:19:46
date last changed
2017-07-30 04:24:29
@article{95b45554-08ab-4796-a1fb-2f428e32acf2,
  abstract     = {OBJECTIVE - The purpose of this study was to estimate the risks of nontraumatic lower-extremity amputations (LEAS) in patients With type 1 diabetes. RESEARCH DESIGN AND METHODS - We identified 31,354 patients with type 1 diabetes (15,001 women and 16,353 men) in the Swedish Inpatient Register between 1975 and 2004. The incidence of nontraumatic LEAs was followed up until 31 December 2004 by cross-linkage in the Inpatient Register and linkage to the Death and Migration registers. Poisson regression modeling was used to compare the risks of nontraumatic LEAs during different calendar periods of follow-up, with adjustment for both sex and attained age at follow-up. Standardized incidence ratios (SIRs) were used to estimate the relative risks (RRs) with the age-, sex-, and calendar period-matched general Swedish population as reference. The cumulative probability of nontraumatic LEAs was calculated by the Kaplan-Meier method. RESULTS - In total, 465 patients with type 1 diabetes undenwent nontraumatic LEAS. The risk was lower during the most recent calendar period (2000-2004) than during the period before 2000 (RR 0.6 [95% CI 0.5-0.8]). However, even in this most recent period, the risk for nontraumatic LEAs among these relatively young patients was 86-fold higher than that in the matched general population (SIR 85.8 [72.9-100.3]). By age 65 years, the cumulative probability of having a nontraumatic LEA was 11.0% for women with type 1 diabetes and 20.7% for men with type 1 diabetes. CONCLUSIONS - Although the risks appeared to have declined in recent years, patients with type 1 diabetes still have a very high risk for nontraumatic LEAs.},
  author       = {Jonasson, Junmei Miao and Ye, Weimin and Sparen, Par and Apelqvist, Jan and Nyren, Olof and Brismar, Kerstin},
  issn         = {1935-5548},
  language     = {eng},
  number       = {8},
  pages        = {1536--1540},
  publisher    = {American Diabetes Association},
  series       = {Diabetes Care},
  title        = {Risks of nontraumatic lower-extremity amputations in patients with type 1 diabetes - A population-based cohort study in Sweden},
  url          = {http://dx.doi.org/10.2337/dc08-0344},
  volume       = {31},
  year         = {2008},
}