Amputation Rates Climb Among Diabetics Who Delay Care

Researchers at the University of Campania in Italy identified troubling trends when they evaluated clinical features and amputation risk among individuals with diabetes and diabetic foot ulcers who had been admitted to a tertiary care center during the COVID-19 lockdown.

The research team, led by Paola Caruso, MD, launched the study to determine how this patient population fared during the height of the pandemic in Italy. They compared the medical records of 25 patients who were admitted to the Teaching Hospital at the University of Campania between March 9th and May 18th, 2020, to the medical records of 38 comparable patients admitted between January and May 2019.

The results reveal high numbers of emergent and serious cases during the pandemic. The 2020 group experienced higher numbers of emergency patients, few outpatients, and higher likelihood of gangrene. Amputation was more than three times more likely in the 2020 versus the 2019 groups.

“The COVID-19 lockdown may have had a detrimental impact on amputation risk because of the sudden interruption of diabetic foot ulcer care and lower-limb preservation pathways, resulting in delayed diagnosis and treatment,” the researchers wrote in their study, which was published in Diabetes Care in July. “Diabetic foot ulceration is often characterized by progressive clinical course, which can rapidly lead patients to critical worsening on their ulcers.”

The increased likelihood of amputation among patients who delayed care confirms the need for proper timely management of patients with diabetic foot ulcers “to prevent dramatic outcomes responsible for a reduction of quality of life and increased morbidity and mortality,” the authors reported.

Sources: Diabetes Care, The O&P Almanac