THE MANAGEMENT AND OUTCOME OF CRITICAL LIMB ISCHEMIA IN DIABETIC-PATIENTS - RESULTS OF A NATIONAL SURVEY

It is generally considered that the outcome from critical limb ischaem ia (CLI) in people with diabetes is inferior to that in non-diabetic p atients. However, excellent results have been reported in diabetic peo ple with the use of bypass surgery to pedal arteries. Data from a pros pective national survey on CLI have been analysed to compare surgical practice and outcome from CLI in diabetic and non-diabetic populations . Of 679 limbs included in the survey, 204 (30 %) were in diabetic pat ients. Thirty-seven (18 %) of diabetic limbs were treated by primary a mputation compared to 43 (9 %) in non-diabetics (p = 0.0013). Revascul arization was the primary treatment intention in 127 (62.3 %) of diabe tic limbs compared to 342 (72 %) in non-diabetics (p = 0.01). Bypass t o pedal arteries was reported in only 2 (1 %) diabetic patients. The l imb salvage rate in diabetic patients was 60 %, compared to 72.5 % for non-diabetic patients (p = 0.0013). The mortality rates were 15 % and 12 % in diabetic and non-diabetic patients, respectively (NS). These results confirm that in the UK and Ireland diabetic patients with CLI fare considerably worse than do people without diabetes. The results m ay be improved if more pedal artery reconstructions were performed.