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Poor People With Diabetes More Likely to Lose Limb

Most amputations are preventable with earlier treatment, researchers note
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WebMD News from HealthDay

By Mary Elizabeth Dallas

HealthDay Reporter

MONDAY, Aug. 4, 2014 (HealthDay News) -- Poor people with diabetes are much more likely to lose a limb to the disease than affluent patients are, new research suggests.

Researchers from the University of California, Los Angeles, found the odds of having a toe, foot or leg amputated was up to 10 times higher for diabetics who live in low-income neighborhoods.

Most of these amputations are preventable if patients are diagnosed and get proper medical care sooner, the study authors noted. They added that their findings should prompt public officials to implement laws that help reduce barriers to health care.

"When you have diabetes, where you live directly relates to whether you'll lose a limb to the disease. Millions of Californians have undergone preventable amputations due to poorly managed diabetes," lead author Dr. Carl Stevens, a clinical professor of medicine at the David Geffen School of Medicine at UCLA, said in a university news release.

"We hope our findings spur policymakers nationwide to improve access to treatment by expanding Medicaid and other programs targeting low-income residents, as we did in California in 2014," Stevens added.

Uncontrolled diabetes can weaken the immune system and cause neuropathy -- nerve death or damage. As a result, a small cut could go undetected and quickly progress to a life-threatening infection. The early diagnosis of diabetes, proper management of the disease and expert wound care can help prevent complications that could lead to amputation.

"I've stood at the bedsides of diabetic patients and listened to the surgical residents say, 'We have to cut your foot off to save your life.' These patients are often the family breadwinners and parents of young children -- people with many productive years ahead of them," noted Stevens, who has worked as an emergency physician for 30 years at Harbor-UCLA Medical Center.

In conducting the study, the researchers analyzed U.S. Census Bureau data on household incomes and state hospital discharge data that tracked amputations due to diabetes by California ZIP code. This information was cross-referenced with information from a UCLA survey, which estimated the number of people who had diabetes in various low-income areas in California to create a map that revealed diabetes-related amputation rates by neighborhood for patients aged 45 and older.

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