The contribution of diabetes mellitus to lower extremity amputations in four public sector hospitals in Cape Town for 2009 and 2010

Abstract

Diabetes is the most common non-communicable disease worldwide and contributes to substantial morbidity and mortality. The prevalence of diabetes is increasing and reaching epidemic proportions, with the largest increase being seen in developing countries, including South Africa. Among the many complications of diabetes, lower extremity amputations are common, with a leg being lost to diabetes somewhere in the world every thirty seconds. The vast majority of these amputations is preventable and is a reflection of inadequate care of diabetic patients. Studies done in South Africa have shown that the care of diabetes in the public sector is suboptimal. A study in the private sector in South Africa showed that by ensuring optimal care of diabetic patients, long term glycaemic control and a decrease in complications and hospital admissions can be achieved. Lower extremity amputations can be the result of complications due to poor glycaemic control. There are, however, few studies that have been done in South Africa assessing the contribution that diabetes makes to the performance of lower extremity amputations. This study will attempt to begin to fill in this gap in South African data and the results will be compared to a previous unpublished South African study in the Cape Town Metropole from 1999.