Functional status of persons with diabetes-related lower-extremity amputations

OBJECTIVE - It is reasonable to predict that diabetes-related lower-extremi ty amputations have a detrimental impact on quality of life. However, we ar e unaware of any study in the medical literature describing the functional level of diabetic patients with amputations. The objective of this study wa s to evaluate amputations among diabetic patients and to determine the func tional level of these patients with the Sickness Impact Profile (SIP). RESEARCH DESIGN AND METHODS - We enrolled 124 patients with diabetes. Case subjects (n = 35) were defined as patients who had undergone amputation of the lower-extremity, and control subjects (n = 89) were defined as patients who had not undergone amputation. Study participants received a standard h istory and physical examination. RESULTS - Both the physical dimension scores (33.5 +/- 14.9 vs. 22-3 +/- 14 .7, P < 0.001) and the total SIP scores (27.6 +/- 9.9 vs, 22.5 +/- 10.3, P = 0.013) were significantly higher for amputees. However, the psychosocial dimension scores were not significantly different between case and control subjects (14.9 +/- 8.9 vs 15.2 +/- 10.0, P > 0.05). Post hoe analysis showe d that the group of patients who had undergone transtibial amputation had a significantly higher total impairment score than patients who had not unde rgone amputation (P = 0.039). This is in contrast to patients with toe or m idfoot amputations, for whom total impairment scores were not significantly higher than those for the control subjects. Interestingly, bilateral amput ees did not have significantly higher scores on either SIP dimension compar ed with unilateral amputees. CONCLUSIONS - These findings exemplify the detrimental physical and psychos ocial health status of patients with diabetes-related lower-extremity amput ation.