Ethnic and health correlates of diabetes-related amputations at the Texas-Mexico border

Rev Panam Salud Publica. 2010 Sep;28(3):214-20. doi: 10.1590/s1020-49892010000900012.

Abstract

Objective: To examine the association between diabetes-related lower-extremity amputation (LEA) and ethnicity, age, source of payment, geographic location, diabetes severity, and health condition in adults with diabetes mellitus type 2 living in border and non-border counties in Texas, United States of America, and to assess intra-border region geographic differences in post-LEA treatment.

Methods: This correlational study was based on secondary data from the 2003 Texas Inpatient Hospital Discharge Data. The sample consisted of individuals 45 years of age and older with type 2 diabetes who had undergone a nontraumatic LEA (n = 5,865). Descriptive statistics and logistic regression analyses were applied.

Results: The following characteristics were predictors of LEA: being Hispanic or African American, male, ≥ 55 years old, and a Medicare or Medicaid user, and living in a border county. Persons with moderate diabetes and those who suffered from cardiovascular disease or stroke also had higher odds of undergoing an LEA. Post-LEA occupational therapy was significantly less prevalent among border residents (9.5%) than non-border residents (15.3%) (P < 0.001).

Conclusion: Understanding the factors that influence diabetes-related LEA may lead to early detection and effective treatment of this disabling consequence of diabetes along the U.S.-Mexico border.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amputation, Surgical / statistics & numerical data*
  • Black or African American / statistics & numerical data
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / ethnology
  • Comorbidity
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetic Foot / epidemiology
  • Diabetic Foot / ethnology
  • Diabetic Foot / surgery*
  • Ethnicity / statistics & numerical data*
  • Female
  • Foot / blood supply
  • Foot / surgery
  • Humans
  • Ischemia / epidemiology
  • Ischemia / ethnology
  • Ischemia / surgery*
  • Leg / blood supply*
  • Leg / surgery
  • Male
  • Mexican Americans / statistics & numerical data
  • Mexico / epidemiology
  • Mexico / ethnology
  • Middle Aged
  • Risk Factors
  • Stroke / epidemiology
  • Stroke / ethnology
  • Texas / epidemiology
  • White People / statistics & numerical data