REGIONAL VARIATION IN THE INCIDENCE OF DIABETES-RELATED AMPUTATIONS IN THE NETHERLANDS

The purpose of this study is to identify the incidence of diabetes-rel ated lower extremity amputations in 27 health regions in the Netherlan ds. A secondary database was used that contains all hospitalizations f or a lower extremity amputation in the Netherlands in 1991 and 1992, r ecorded seperately for 27 health regions. The age-adjusted incidence l ower extremity amputations per 10 000 diabetic patients in the Netherl ands was 25.05, and among the regions it ranged from 10.15 to 44.64. I n the non-diabetic population, the age-adjusted incidence in the Nethe rlands was 1.24 and ranged by region from 0.77 to 1.77. Overall, diabe tic males had higher age-adjusted incidence rates than diabetic female s, although in four health regions the situation was reversed. In the Netherlands, there was an increasing incidence of diabetes-related low er extremity amputation as age increased: < 45 years, 11.15; 45-64 yea rs, 33.84; 65-74 years, 61.22: and 75 + years. 107.92 (P < 0.001). Thi s continued to be a significant phenomenon for every health region (P < 0.001). This study found a wide range in the incidence oi diabetes r elated lower extremity amputations in the 27 health regions in the Net herlands. A possible explanation could be differences in the severity of diabetes, in local treatment philosophies or the availability of su bspecialties.