The impact of diabetes-related lower-extremity amputations in The Netherlands

J Diabetes Complications. Nov-Dec 1996;10(6):325-30. doi: 10.1016/1056-8727(95)00088-7.


The purpose of this study is to identify the incidence of diabetes-related lower-extremity amputations in the Netherlands. We used discharge records from SIG Health Care Information for every hospitalization for a lower-extremity amputation in all hospitals in the Netherlands in 1992. Age- and gender-specific population figures and diagnosed cases of diabetes were obtained from the Central Bureau of Statistics. Age- and gender-adjusted amputation incidences were identified at four different levels (toe, foot, leg, and thigh). Multiple amputations were analyzed by the highest level. Of all lower-extremity amputations, 1,575 (47%) were in persons with diabetes mellitus. Age- and gender-adjusted lower-extremity amputation rates per 10,000 persons with diabetes by level were the following: toe 12.39, foot 2.42, leg 7.82, thigh 2.54, and total 25.17. People with diabetes were 20.3 times more likely to experience a lower-extremity amputation than people without diabetes. Males were at a significantly higher risk of experiencing an amputation than females. There was a significant increase in the age-specific incidence of amputations as age increased. The most common amputation procedure performed was the toe amputation. There was a significant increase in thigh amputations as age increased, indicating that as people get older they suffer higher levels of amputations. Although the incidence of lower-extremity amputations was lower than previous reports, they still have a serious impact on the health-care system in the Netherlands.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Amputation / statistics & numerical data*
  • Diabetic Foot / epidemiology
  • Diabetic Foot / surgery*
  • Female
  • Foot
  • Humans
  • Incidence
  • Leg
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Risk Assessment
  • Sex Characteristics
  • Sex Factors
  • Thigh
  • Toes