Diabetes-Related Lower-Extremity Amputations Disproportionately Affect Blacks and Mexican Americans
Lawrence A. Lavery, William H. van Houtum, Hisham R. Ashry, David G. Armstrong, and Jacqueline A. Pugh

ABSTRACT Background. We sought to identify the age-adjusted incidence of lower-extremity amputation (LEA) in Mexican Americans, blacks, and non-Hispanic whites with diabetes in south Texas. Methods. We summarized medical records for hospitalizations for LEAs for 1993 in six metropolitan statistical areas in south Texas. Results. Age-adjusted incidence per 10,000 patients with diabetes was 146.59 in blacks, 60.68 in non-Hispanic whites, and 94.08 in Mexican Americans. Of the patients, 47% of amputees had a history of amputation, and 17.7% were hospitalized more than once during 1993. Mexican Americans had more diabetes-related amputations (85.9%) than blacks (74.7%) or non-Hispanic whites (56.3%). Conclusions. This study is the first to identify the incidence of diabetes-related lower-extremity amputations in minorities using primary data. Minorities had both a higher incidence and proportion of diabetes-related, LEAs compared with non-Hispanic whites. Public health initiatives and national strategies, such as Healthy People 2000 and 2010, need to specifically focus on high-risk populations and high-risk geographic areas to decrease the frequency of amputation and reamputation.

Surgical Morbidity and the Risk of Amputation Due to Infected Puncture Wounds in Diabetic Versus Nondiabetic Adults

DAVID G. ARMSTRONG, DPM, LAWRENCE A. LAVERY, DPM, MPH, TERRI L. QUEBEDEAUX, DPM, and STEVEN C. WALKER, MD, PhD, San Antonio, Tex

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