Regional variation in the incidence of diabetes-related amputations in The Netherlands

Diabetes Res Clin Pract. 1996 Mar;31(1-3):125-32. doi: 10.1016/0168-8227(96)01199-0.


The purpose of this study is to identify the incidence of diabetes-related lower extremity amputations in 27 health regions in the Netherlands. A secondary database was used that contains all hospitalizations for a lower extremity amputation in the Netherlands in 1991 and 1992, recorded separately for 27 health regions. The age-adjusted incidence lower extremity amputations per 10,000 diabetic patients in the Netherlands was 25.05, and among the regions it ranged from 10.15 to 44.64. In the non-diabetic population, the age-adjusted incidence in the Netherlands was 1.24 and ranged by region from 0.77 to 1.77. Overall, diabetic males had higher age-adjusted incidence rates than diabetic females, although in four health regions the situation was reversed. In the Netherlands, there was an increasing incidence of diabetes-related lower extremity amputation as age increased: < 45 years, 11.15; 45-64 years, 33.84; 65-74 years, 61.22; and 75 + years, 107.92 (P < 0.001). This continued to be a significant phenomenon for every health region (P < 0.001). This study found a wide range in the incidence of diabetes related lower extremity amputations in the 27 health regions in the Netherlands. A possible explanation could be differences in the severity of diabetes, in local treatment philosophies or the availability of subspecialties.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Amputation / statistics & numerical data*
  • Demography
  • Diabetic Foot / surgery*
  • Female
  • Geography
  • Humans
  • Incidence
  • Information Systems
  • Male
  • Middle Aged
  • Netherlands
  • Risk Factors
  • Sex Factors