Variation in the recorded incidence of amputation of the lower limb in England

Holman, N.; Young, R. J.; Jeffcoate, W. J.

doi:10.1007/s00125-012-2468-6

Cited by 228Diabetic Foot Ulcer Assessment and ManagementPeripheral Artery Disease ManagementDiabetes, Cardiovascular Risks, and Lipoproteins

Variation in the recorded incidence of amputation of the lower limb in England

Open access

Holman, N., Young, R. J., Jeffcoate, W. J.·2012·Diabetologia

DOI 10.1007/s00125-012-2468-6

Open this paper in CoChat — free account Open PDF

Abstract

Aims/hypothesis The study aimed to explore the variation in recorded incidence of lower limb amputation in England.Methods The incidences of amputations in adults with and without diabetes were determined from hospital episode statistics over 3 years to 31 March 2010 and compared between the 151 Primary Care Trusts (PCTs) in England.Results There were 34,109 amputations, including 16,693 (48.9%) in people with diabetes. The incidence was 2.51 per 1,000 person-years in people with diabetes and 0.11 per 1,000 person-years in people without (relative diabetes risk 23.3). Incidence varied eightfold across PCTs in people both with diabetes (range 0.64-5.25 per 1,000 person-years) and without (0.03-0.24 per 1,000 person-years). Amputations in people with diabetes varied tenfold--both major (range 0.22-2.20 per 1,000 person-years) and minor (range 0.30-3.25 per 1,000 person-years). The incidences of minor and major amputations were positively correlated both in those with (r = 0.537, p < 0.0005) and without (r = 0.611, p < 0.0005) diabetes. Incidences of amputations were also correlated between people with and without diabetes (total amputations r = 0.433, p < 0.0005; major amputations r = 0.528, p < 0.0005). There was a negative correlation between the incidence of amputation and estimated prevalence of ethnic Asians. No association was found between the PCT incidence of either total amputations and general population prevalence of social deprivation (r = -0.138, p = 0.092) or smoking (r = 0.137, p = 0.096).Conclusions/interpretation Variation in amputation incidence occurs across England. Because of the similarity in amputation variation between people with and without diabetes the variation may reflect generic differences in local healthcare delivery, although racial factors may also contribute.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1007/s00125-012-2468-6

Cites

18 of 18 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

One study in the UK found that 48.9% of amputations from 2007 to 2010 were carried out on people with diabetes and diabetes conferred a 23.3x risk for amputations.
“One study in the UK found that 48.9% of amputations from 2007 to 2010 were carried out on people with diabetes and diabetes conferred a 23.3x risk for amputations.41”
From A review of current trends with type 2 diabetes epidemiology, aetiology, pathogenesis, treatments and future perspectives (2021) · cites this paper as [41]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

The global burden of diabetic foot disease
Boulton, A. J. M., Vileikytė, L., Tennvall, G. R., & Apelqvist, J. (2005) · The Lancet · doi:10.1016/s0140-6736(05)67698-2 · Cited by 2,578 · see citing works
The English indices of deprivation 2004
Noble, M., Wright, G., Dibben, C., Smith, G., McLennan, D., Anttila, C., Barnes, H., Mokhtar, C., Noble, S., & Gardner, J. (2004) · Cited by 1,494 · see citing works
Lower extremity amputations - a review of global variability in incidence
Moxey, P. W., Gogălniceanu, P., Hinchliffe, R. J., Loftus, I. M., Jones, K., THOMPSON, M. M., & Holt, P. (2011) · Diabetic Medicine · doi:10.1111/j.1464-5491.2011.03279.x · Cited by 590 · see citing works
Reduction in Diabetic Amputations Over 11 Years in a Defined U.K. Population
Krishnan, S. T. M., Nash, F., Baker, N., Fowler, D., & Rayman, G. A. (2007) · Diabetes Care · doi:10.2337/dc07-1178 · Cited by 366 · see citing works
Diabetic Neuropathic Foot Ulcers
Margolis, D. J., Allen‐Taylor, L., Hoffstad, O., & Berlin, J. A. (2002) · Diabetes Care · doi:10.2337/diacare.25.10.1835 · Cited by 262 · see citing works
Geographic Variation of Lower-Extremity Major Amputation in Individuals With and Without Diabetes in the Medicare Population
Wrobel, J. S., Mayfield, J. A., & Reiber, G. E. (2001) · Diabetes Care · doi:10.2337/diacare.24.5.860 · Cited by 248 · see citing works
Diabetes- and Nondiabetes-Related Lower Extremity Amputation Incidence Before and After the Introduction of Better Organized Diabetes Foot Care
Canavan, R. J., Unwin, N. C., Kelly, W. F., & Connolly, V. M. (2008) · Diabetes Care · doi:10.2337/dc07-1159 · Cited by 211 · see citing works
Amputation as a marker of the quality of foot care in diabetes
Jeffcoate, W. J., & van Houtum, W. H. (2004) · Diabetologia · doi:10.1007/s00125-004-1584-3 · Cited by 205 · see citing works
Self-citation
Variations in health care: the good, the bad and the inexplicable.
Appleby, J., Raleigh, V. S., Frosini, F., Bevan, G., Gao, H., & Lyscom, T. (2011) · Cited by 169 · see citing works
Incidence and characteristics of lower limb amputations in people with diabetes
Fosse‐Edorh, S., Hartemann, A., Jacqueminet, S., Van, G. H., Grimaldi, A., & Fagot‐Campagna, A. (2009) · Diabetic Medicine · doi:10.1111/j.1464-5491.2009.02698.x · Cited by 153 · see citing works
Risk factors, ethnic differences and mortality associated with lower-extremity gangrene and amputation in diabetes. The WHO multinational study of vascular disease in diabetes
and the WHO Multinational Study Group, Chaturvedi, N., Stevens, L. K., Fuller, J. H., Lee, E. T., & Lu, M. (2001) · Diabetologia · doi:10.1007/pl00002941 · Cited by 143 · see citing works
The association between baseline characteristics and the outcome of foot lesions in a UK population with diabetes
Ince, P. G., Kendrick, D., Game, F. L., & Jeffcoate, W. J. (2007) · Diabetic Medicine · doi:10.1111/j.1464-5491.2007.02189.x · Cited by 105 · see citing works
Self-citation
Risk of diabetes‐related amputation in South Asians vs. Europeans in the UK
Chaturvedi, N., Abbott, C. A., Whalley, A., Widdows, P., Leggetter, S., & Boulton, A. J. M. (2002) · Diabetic Medicine · doi:10.1046/j.1464-5491.2002.00583.x · Cited by 93 · see citing works
Ethnicity and Risk of Diabetes-Related Lower Extremity Amputation
Leggetter, S., Chaturvedi, N., Fuller, J., & Edmonds, M. E. (2002) · Archives of Internal Medicine · doi:10.1001/archinte.162.1.73 · Cited by 90 · see citing works
The personal cost of diabetic foot disease in the developing world—a study from Pakistan
Ali, S., Fareed, A., Humail, S. M., Basit, A., Ahmedani, M. Y., Fawwad, A., & Miyan, Z. (2008) · Diabetic Medicine · doi:10.1111/j.1464-5491.2008.02529.x · Cited by 72 · see citing works
Explanations for the Lower Rates of Diabetic Neuropathy in Indian Asians Versus Europeans
Abbott, C. A., Chaturvedi, N., Malik, R. A., Salgami, E. V., Yates, A. P., Pemberton, P. W., & Boulton, A. J. M. (2010) · Diabetes Care · doi:10.2337/dc09-2067 · Cited by 71 · see citing works
Variation in clinical decision making is a partial explanation for geographical variation in lower extremity amputation rates
Connelly, J., Airey, M., & Chell, S. (2001) · British journal of surgery · doi:10.1046/j.1365-2168.2001.01738.x · Cited by 54 · see citing works
The High-Low Amputation Ratio: A Deeper Insight into Diabetic Foot Care?
Wrobel, J. S., Robbins, J., & Armstrong, D. G. (2006) · The Journal of Foot & Ankle Surgery · doi:10.1053/j.jfas.2006.09.015 · Cited by 43 · see citing works

Flagged first, then by citations

Sorted by citations

Chronic wounds
Falanga, V., Isseroff, R. R., Soulika, A. M., Romanelli, M., Margolis, D. J., Kapp, S., Granick, M. S., & Harding, K. G. (2022) · Nature Reviews Disease Primers · doi:10.1038/s41572-022-00377-3 · Cited by 1,102 · see citing works
The current burden of diabetic foot disease
EDMONDS, M. E., Manu, C. A., & Vas, P. R. J. (2021) · Journal of Clinical Orthopaedics and Trauma · doi:10.1016/j.jcot.2021.01.017 · Cited by 517 · see citing works
Current challenges and opportunities in the prevention and management of diabetic foot ulcers.
Jeffcoate, W. J., Vileikyte, L., Boyko, E. J., Armstrong, D. G., & Boulton, A. J. M. (2018) · Diabetes Care · doi:10.2337/dc17-1836 · Cited by 475 · see citing works
Self-citation
A review of current trends with type 2 diabetes epidemiology, aetiology, pathogenesis, treatments and future perspectives
Reed, J., Bain, S., & Kanamarlapudi, V. (2021) · Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy · doi:10.2147/dmso.s319895 · Cited by 441 · see citing works
Mortality After Nontraumatic Major Amputation Among Patients With Diabetes and Peripheral Vascular Disease: A Systematic Review
Thorud, J. C., Plemmons, B. S., Buckley, C. J., Shibuya, N., & Jupiter, D. C. (2016) · The Journal of Foot & Ankle Surgery · doi:10.1053/j.jfas.2016.01.012 · Cited by 333 · see citing works
Prognosis of the infected diabetic foot ulcer: a 12‐month prospective observational study
Ndosi, M. E., Wright-Hughes, A. M., Brown, S. T., Backhouse, M. R., Lipsky, B. A., Bhogal, M., Reynolds, C., Vowden, P., Jude, E. B., Nixon, J., et al. (2017) · Diabetic Medicine · doi:10.1111/dme.13537 · Cited by 296 · see citing works
Incidence of lower extremity amputations in the diabetic compared with the non-diabetic population: A systematic review
Narres, M., Kvitkina, T., Claessen, H., Droste, S., Schuster, B., Morbach, S., Rümenapf, G., Acker, K. L. V., & Icks, A. (2017) · PLoS ONE · doi:10.1371/journal.pone.0182081 · Cited by 260 · see citing works
Lower extremity amputation rates in people with diabetes as an indicator of health systems performance. A critical appraisal of the data collection 2000–2011 by the Organization for Economic Cooperation and Development (OECD)
Carinci, F., Benedetti, M. M., Klazinga, N., & Uccioli, L. (2016) · Acta Diabetologica · doi:10.1007/s00592-016-0879-4 · Cited by 241 · see citing works
Diabetes, Lower-Extremity Amputation, and Death
Hoffstad, O., Mitra, N., Walsh, J., & Margolis, D. J. (2015) · Diabetes Care · doi:10.2337/dc15-0536 · Cited by 240 · see citing works
Cost of diabetic foot disease to the National Health Service in England
Kerr, M., Rayman, G. A., & Jeffcoate, W. J. (2014) · Diabetic Medicine · doi:10.1111/dme.12545 · Cited by 220 · see citing works
Self-citation
New Developments in Smart Bandage Technologies for Wound Diagnostics
McLister, A., McHugh, J., Cundell, J. H., & Davis, J. (2016) · Advanced Materials · doi:10.1002/adma.201504829 · Cited by 203 · see citing works
Diabetes in the UK: 2019
Whicher, C. A., O’Neill, S., & Holt, R. I. G. (2020) · Diabetic Medicine · doi:10.1111/dme.14225 · Cited by 200 · see citing works
A systematic review and individual patient data meta-analysis of prognostic factors for foot ulceration in people with diabetes: the international research collaboration for the prediction of diabetic foot ulcerations (PODUS)
Crawford, F., Cezard, G. I., Chappell, F. M., Murray, G. D., Price, J. F., Sheikh, A., Simpson, C. R., Stansby, G. P., & Young, M. J. (2015) · Health Technology Assessment · doi:10.3310/hta19570 · Cited by 188 · see citing works
Preventing and treating foot complications associated with diabetes mellitus
Bowling, F. L., Rashid, S. T., & Boulton, A. J. M. (2015) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2015.130 · Cited by 187 · see citing works
Negative pressure wound therapy for treating foot wounds in people with diabetes mellitus.
Liu, Z., Dumville, J. C., Hinchliffe, R. J., Cullum, N., Game, F., Stubbs, N., Sweeting, M., & Peinemann, F. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010318.pub3 · Cited by 173 · see citing works
Negative pressure wound therapy for treating foot wounds in people with diabetes mellitus
Dumville, J. C., Hinchliffe, R. J., Cullum, N. A., Game, F. L., Stubbs, N. C., Sweeting, M. J., & Peinemann, F. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010318.pub2 · Cited by 167 · see citing works
Evidence-based Management of PAD & the Diabetic Foot
Brownrigg, J. R. W., Apelqvist, J., Bakker, K., Schaper, N. C., & Hinchliffe, R. J. (2013) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2013.02.014 · Cited by 162 · see citing works
A Real-Time Gait Event Detection for Lower Limb Prosthesis Control and Evaluation
Maqbool, H. F., Husman, M. A., Awad, M. I., Abouhossein, A., Iqbal, N., & Dehghani-Sanij, A. A. (2016) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2016.2636367 · Cited by 141 · see citing works
Incidence and risk factors for developing infection in patients presenting with uninfected diabetic foot ulcers
Jia, L., Parker, C. N., Parker, T. J., Kinnear, E. M., Derhy, P. H., Alvarado, A. M., Huygens, F., & Lazzarini, P. A. (2017) · PLoS ONE · doi:10.1371/journal.pone.0177916 · Cited by 140 · see citing works
Causes, prevention, and management of diabetes-related foot ulcers
Jeffcoate, W. J., Boyko, E. J., Game, F. L., Cowled, P., Senneville, E., & Fitridge, R. (2024) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(24)00110-4 · Cited by 134 · see citing works
Self-citation
Quercetin Attenuates Diabetic Peripheral Neuropathy by Correcting Mitochondrial Abnormality via Activation of AMPK/PGC-1α Pathway in vivo and in vitro
Zhang, Q., Song, W., Zhao, B., Xie, J. X., Sun, Q. Y., Shi, X., Yan, B., Tian, G., & Liang, X. (2021) · Frontiers in Neuroscience · doi:10.3389/fnins.2021.636172 · Cited by 117 · see citing works
The Diabetic Foot Attack: “’Tis Too Late to Retreat!”
Vas, P. R. J., EDMONDS, M. E., Kavarthapu, V., Rashid, H., Ahluwalia, R. S., Pankhurst, C., & Παπάνας, Ν. (2018) · The International Journal of Lower Extremity Wounds · doi:10.1177/1534734618755582 · Cited by 115 · see citing works
Risk of lower limb amputation in a national prevalent cohort of patients with diabetes
Gurney, J., Stanley, J., York, S., Rosenbaum, D., & Sarfati, D. (2017) · Diabetologia · doi:10.1007/s00125-017-4488-8 · Cited by 113 · see citing works
Lower limb amputation in England: prevalence, regional variation and relationship with revascularisation, deprivation and risk factors. A retrospective review of hospital data
Ahmad, N., Thomas, G. N., Gill, P. S., Chan, C., & Torella, F. (2014) · Journal of the Royal Society of Medicine · doi:10.1177/0141076814557301 · Cited by 113 · see citing works
Diabetes‐related major lower limb amputation incidence is strongly related to diabetic foot service provision and improves with enhancement of services: peer review of the South‐West of England
Paisey, R., Abbott, A., Levenson, R., Harrington, A., Browne, D., Moore, J., Bamford, M., & Roe, M. (2017) · Diabetic Medicine · doi:10.1111/dme.13512 · Cited by 108 · see citing works
Foot Ulcer and Risk of Lower Limb Amputation or Death in People With Diabetes: A National Population-Based Retrospective Cohort Study
Chamberlain, R. C., Fleetwood, K. J., Wild, S. H., Colhoun, H. M., Lindsay, R. S., Petrie, J. R., McCrimmon, R. J., Gibb, F. W., Philip, S., Sattar, N. A., et al. (2021) · Diabetes Care · doi:10.2337/dc21-1596 · Cited by 106 · see citing works
The prevalence of major lower limb amputation in the diabetic and non-diabetic population of England 2003–2013
Ahmad, N., Thomas, G. N., Gill, P. S., & Torella, F. (2016) · Diabetes and Vascular Disease Research · doi:10.1177/1479164116651390 · Cited by 103 · see citing works
Amputation-free survival in 17,353 people at high risk for foot ulceration in diabetes: a national observational study
Vadiveloo, T., Jeffcoate, W. J., Donnan, P. T., Colhoun, H. M., McGurnaghan, S. J., Wild, S. H., McCrimmon, R. J., & Leese, G. (2018) · Diabetologia · doi:10.1007/s00125-018-4723-y · Cited by 92 · see citing works
Self-citation
Corneal Confocal Microscopy to Assess Diabetic Neuropathy: An Eye on the Foot
Tavakoli, M., Petropoulos, I. N., & Malik, R. A. (2013) · Journal of Diabetes Science and Technology · doi:10.1177/193229681300700509 · Cited by 91 · see citing works
Infrared Thermography and Vascular Disorders in Diabetic Feet
Ilo, A., Romsi, P., & Mäkelä, J. (2019) · Journal of Diabetes Science and Technology · doi:10.1177/1932296819871270 · Cited by 90 · see citing works
Epidemiology of Foot Ulceration and Amputation
Margolis, D. J., & Jeffcoate, W. J. (2013) · Medical Clinics of North America · doi:10.1016/j.mcna.2013.03.008 · Cited by 89 · see citing works
Self-citation
Diagnosis and assessment of peripheral arterial disease in the diabetic foot
Brownrigg, J. R. W., Schaper, N. C., & Hinchliffe, R. J. (2015) · Diabetic Medicine · doi:10.1111/dme.12749 · Cited by 88 · see citing works
Survival and factors predicting mortality after major and minor lower-extremity amputations among patients with diabetes: a population-based study using health information systems
Cascini, S., Agabiti, N., Davoli, M., Uccioli, L., Meloni, M., Giurato, L., Marino, C., & Bargagli, A. M. (2020) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2020-001355 · Cited by 86 · see citing works
Burden of diabetic foot disorders, guidelines for management and disparities in implementation in Europe: a systematic literature review
Acker, K. L. V., Léger, P., Hartemann, A., Chawla, A., & Siddiqui, M. K. (2014) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.2523 · Cited by 86 · see citing works
Global trends in the incidence of hospital admissions for diabetes-related foot disease and amputations: a review of national rates in the 21st century
Lazzarini, P. A., Cramb, S. M., Golledge, J., Morton, J. I., Magliano, D. J., & van Netten, J. J. (2022) · Diabetologia · doi:10.1007/s00125-022-05845-9 · Cited by 81 · see citing works
Intracellular Staphylococcus aureus triggers pyroptosis and contributes to inhibition of healing due to perforin-2 suppression
Pastar, I., Sawaya, A. P., Marjanović, J., Burgess, J. L., Strbo, N., Rivas, K. E., Wikramanayake, T. C., Head, C. R., Stone, R. C., Jozic, I., et al. (2021) · Journal of Clinical Investigation · doi:10.1172/jci133727 · Cited by 76 · see citing works
Reducing lower leg amputations in diabetes: a challenge for patients, healthcare providers and the healthcare system
Schaper, N. C., Apelqvist, J., & Bakker, K. (2012) · Diabetologia · doi:10.1007/s00125-012-2588-z · Cited by 73 · see citing works
Diabetic foot disease in the United Kingdom: about time to put feet first
McInnes, A. D. (2012) · Journal of Foot and Ankle Research · doi:10.1186/1757-1146-5-26 · Cited by 67 · see citing works
Amputations and socioeconomic position among persons with diabetes mellitus, a population-based register study
Venermo, M. A., Manderbacka, K., Ikonen, T. S., Keskimäki, I., Winell, K., & Sund, R. (2013) · BMJ Open · doi:10.1136/bmjopen-2012-002395 · Cited by 63 · see citing works
Negative pressure wound therapy for treating foot wounds in people with diabetes mellitus
Dumville, J. C., Hinchliffe, R. J., Cullum, N. A., Game, F. L., Stubbs, N. C., & Sweeting, M. J. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010318 · Cited by 63 · see citing works
The impact of gender, level of amputation and diabetes on prosthetic fit rates following major lower extremity amputation
Davie-Smith, F., Paul, L., Nicholls, N., Stuart, W. P., & Kennon, B. (2016) · Prosthetics and Orthotics International · doi:10.1177/0309364616628341 · Cited by 62 · see citing works
Effect of Exercise on Risk Factors of Diabetic Foot Ulcers
Liao, F., An, R., Pu, F., Burns, S., Shen, S., & Jan, Y. (2018) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0000000000001002 · Cited by 62 · see citing works
Gender differences in the impact of poverty on health: disparities in risk of diabetes‐related amputation
Amin, L., Shah, B. R., Bierman, A. S., Lipscombe, L. L., Wu, C. F., Feig, D. S., & Booth, G. L. (2014) · Diabetic Medicine · doi:10.1111/dme.12507 · Cited by 58 · see citing works
Codelivery of Sustainable Antimicrobial Agents and Platelet-Derived Growth Factor via Biodegradable Nanofibers for Repair of Diabetic Infectious Wounds
Lee, C., Liu, K., Cheng, C.-W., Chan, E., Hung, K., Hsieh, M., Chang, S., Fu, X., Juang, J., Hsieh, C., et al. (2020) · ACS Infectious Diseases · doi:10.1021/acsinfecdis.0c00321 · Cited by 57 · see citing works
Diabetic foot ulcer incidence and survival with improved diabetic foot services: an 18‐year study
Paisey, R., Abbott, A., Paisey, C., & Walker, D. (2019) · Diabetic Medicine · doi:10.1111/dme.14045 · Cited by 55 · see citing works
Geographic Variation of the Incidence Rate of Lower Limb Amputation in Australia from 2007-12
Dillon, M. P., Fortington, L. V., Akram, M., Erbas, B., & Köhler, F. (2017) · PLoS ONE · doi:10.1371/journal.pone.0170705 · Cited by 54 · see citing works
Geospatial mapping and data linkage uncovers variability in outcomes of foot disease according to multiple deprivation: a population cohort study of people with diabetes.
Hurst, J. E., Barn, R., Gibson, L., Innes, H., Bus, S. A., Kennon, B., Wylie, D., & Woodburn, J. (2020) · Diabetologia · doi:10.1007/s00125-019-05056-9 · Cited by 53 · see citing works
Diabetes-related amputations create considerable public health burden in the UK
Graz, H., D’Souza, V., Alderson, D., & Graz, M. (2017) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2017.10.030 · Cited by 53 · see citing works
The German and Belgian accreditation models for diabetic foot services
Morbach, S., Kersken, J., Lobmann, R., Nobels, F. R. E., Doggen, K., & Acker, K. L. V. (2015) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.2752 · Cited by 53 · see citing works
Reduced incidence of lower‐extremity amputations in a Danish diabetes population from 2000 to 2011
Jørgensen, M. E., Almdal, T., & Færch, K. (2013) · Diabetic Medicine · doi:10.1111/dme.12320 · Cited by 52 · see citing works
Barriers to foot care in patients with diabetes as identified by healthcare professionals
Pankhurst, C., & EDMONDS, M. E. (2018) · Diabetic Medicine · doi:10.1111/dme.13653 · Cited by 52 · see citing works
Negative-pressure wound therapy for management of chronic neuropathic noninfected diabetic foot ulcerations – short-term efficacy and long-term outcomes
Borys, S., Hohendorff, J., Koblik, T., Witek, P., Ludwig‐Słomczyńska, A. H., Frankfurter, C., Kiec-Wilk, B., & Malecki, M. (2018) · Endocrine · doi:10.1007/s12020-018-1707-0 · Cited by 52 · see citing works
Ethnicity and risk of lower limb amputation in people with Type 2 diabetes: a prospective cohort study
Robinson, T. E., Kenealy, T. W., Garrett, M., Bramley, D. M., Drury, P. L., & Elley, C. R. (2015) · Diabetic Medicine · doi:10.1111/dme.12807 · Cited by 49 · see citing works
Epidemiology of Diabetic Foot Ulcers and Amputations in Romania: Results of a Cross-Sectional Quality of Life Questionnaire Based Survey
Bondor, C. I., Vereșiu, I. A., Florea, B., Vinik, E. J., Vinik, A. I., & Gavan, N. A. (2016) · Journal of Diabetes Research · doi:10.1155/2016/5439521 · Cited by 49 · see citing works
Impact of health‐care accessibility and social deprivation on diabetes related foot disease
Leese, G., Feng, Z.-Q., Leese, R., Dibben, C., & Emslie-Smith, A. (2013) · Diabetic Medicine · doi:10.1111/dme.12108 · Cited by 50 · see citing works
A longitudinal examination of leisure time physical activity following amputation in England
Wadey, R., & Day, M. C. (2017) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2017.11.005 · Cited by 48 · see citing works
Which Test for Diagnosing Early Human Diabetic Neuropathy?
Malik, R. A. (2014) · Diabetes · doi:10.2337/db14-0492 · Cited by 47 · see citing works
Lower limb amputation in Northern Netherlands
Fortington, L. V., Rommers, G. M., Klaas Postema, A., van Netten, J. J., Geertzen, J. H. B., & Dijkstra, P. U. (2013) · Prosthetics and Orthotics International · doi:10.1177/0309364612469385 · Cited by 46 · see citing works
Rehabilitation of People with Lower-Limb Amputations
Fiedler, G., Akins, J. S., Cooper, R., Munoz, S., & Cooper, R. A. (2014) · Current Physical Medicine and Rehabilitation Reports · doi:10.1007/s40141-014-0068-8 · Cited by 40 · see citing works
Medical strategies to reduce amputation in patients with Type 2 diabetes
Malik, R. A., Tesfaye, S. H., & Ziegler, D. (2013) · Diabetic Medicine · doi:10.1111/dme.12169 · Cited by 40 · see citing works
Risk assessments and structured care interventions for prevention of foot ulceration in diabetes: development and validation of a prognostic model
Crawford, F., Chappell, F. M., Lewsey, J., Riley, R. D., Hawkins, N., Nicolson, D., Heggie, R., Smith, M. C., Horne, M., Amanna, A. E., et al. (2020) · Health Technology Assessment · doi:10.3310/hta24620 · Cited by 39 · see citing works
Why are there no good treatments for diabetic neuropathy?
Malik, R. A. (2014) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(14)70067-1 · Cited by 39 · see citing works
Decrease in Major Amputations in Germany
Santosa, F., Moysidis, T., Kanya, S., Babadagi‐Hardt, Z., Luther, B., & Kröger, K. (2013) · International Wound Journal · doi:10.1111/iwj.12096 · Cited by 38 · see citing works
Decreasing rates of major lower-extremity amputation in people with diabetes but not in those without: a nationwide study in Belgium
Claessen, H., Avalosse, H., Guillaume, J., Narres, M., Kvitkina, T., Arend, W., Morbach, S., Lauwers, P., Nobels, F. R. E., Boly, J., et al. (2018) · Diabetologia · doi:10.1007/s00125-018-4655-6 · Cited by 38 · see citing works
Health service organisation impact on lower extremity amputations in people with type 2 diabetes with foot ulcers: systematic review and meta-analysis
Meza-Torres, B., Carinci, F., Heiß, C., Joy, M., & de Lusignan, S. (2021) · Acta Diabetologica · doi:10.1007/s00592-020-01662-x · Cited by 38 · see citing works
Pilot study to assess measures to be used in the prospective audit of the management of foot ulcers in people with diabetes
Holman, N., Young, B., Stephens, H., Jeffcoate, W. J., & the members of the National Foot Care Audit Steering Group (2014) · Diabetic Medicine · doi:10.1111/dme.12564 · Cited by 36 · see citing works
Self-citation
Substantial reduction in the number of amputations among patients with diabetes: a cohort study over 16 years
Rasmussen, B. S., Yderstræde, K. B., Carstensen, B., Skov, O., & Beck‐Nielsen, H. (2015) · Diabetologia · doi:10.1007/s00125-015-3781-7 · Cited by 36 · see citing works
Impact of diabetes on costs before and after major lower extremity amputations in Germany
Hoffmann, F., Claessen, H., Morbach, S., Waldeyer, R., Glaeske, G., & Icks, A. (2013) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2013.05.001 · Cited by 35 · see citing works
Social Deprivation and Incident Diabetes-Related Foot Disease in Patients With Type 2 Diabetes: A Population-Based Cohort Study
Riley, J., Antza, C., Kempegowda, P., Subramanian, A., Chandan, J. S., Gokhale, K. M., Thomas, G. N., Sainsbury, C. A. R., Tahrani, A. A., & Nirantharakumar, K. (2021) · Diabetes Care · doi:10.2337/dc20-1027 · Cited by 33 · see citing works
Diabetes at the front door. A guideline for dealing with glucose related emergencies at the time of acute hospital admission from the Joint British Diabetes Society (JBDS) for Inpatient Care Group*
Dhatariya, K., James, J., Kong, M., Berrington, R., & the Joint British Diabetes Society (JBDS) for Inpatient Care Group and guidelines writing group (2020) · Diabetic Medicine · doi:10.1111/dme.14304 · Cited by 31 · see citing works
The Role of Lower Extremity Amputation in Chronic Limb-Threatening Ischemia
Kim, T. I., Mena, C. I., & Sumpio, B. E. (2020) · International Journal of Angiology · doi:10.1055/s-0040-1710075 · Cited by 31 · see citing works
Missed Opportunities for Timely Recognition of Chronic Limb Threatening Ischaemia in Patients Undergoing a Major Amputation: A Population Based Cohort Study Using the UK's Clinical Practice Research Datalink
Nickinson, A., Coles, B., Zaccardi, F., Gray, L. J., Payne, T. J., Bown, M. J., Davies, R., Khunti, K. K., & Sayers, R. D. (2020) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2020.05.010 · Cited by 31 · see citing works
Prevalence and Regional Distribution of Lower Limb Amputations from 2006 to 2012 in Germany: A Population based Study
Heyer, K., Debus, E. S., Mayerhoff, L., & Augustin, M. (2015) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2015.07.033 · Cited by 31 · see citing works
Using data to tackle the burden of amputation in diabetes
Jeffcoate, W. J., Barron, E., Lomas, J., Valabhji, J., & Young, B. (2017) · The Lancet · doi:10.1016/s0140-6736(17)32401-7 · Cited by 29 · see citing works
Self-citation
Secular trends in rates of hospitalisation for lower extremity amputation and 1 year mortality in people with diabetes in Hong Kong, 2001–2016: a retrospective cohort study
Wu, H., Yang, A., Lau, E. S. H., Ronald, C. W., Kong, A. P. S., Chow, E., So, W., Chan, J. C. N., & Luk, A. O. Y. (2020) · Diabetologia · doi:10.1007/s00125-020-05278-2 · Cited by 28 · see citing works
Electrochemical approaches to the development of smart bandages: A mini-review
McLister, A., Phair, J., Cundell, J. H., & Davis, J. (2014) · Electrochemistry Communications · doi:10.1016/j.elecom.2014.01.003 · Cited by 27 · see citing works
Incidence of hospitalization and mortality in patients with diabetic foot regardless of amputation: a population study
Monge, L., Gnavi, R., Carnà, P., Broglio, F., Boffano, G. M., & Giorda, C. B. (2019) · Acta Diabetologica · doi:10.1007/s00592-019-01412-8 · Cited by 27 · see citing works
Australian diabetes-related foot disease strategy 2018- 2022: The first step towards ending avoidable amputations within a generation
van Netten, J. J., Lazzarini, P. A., Fitridge, R., Kinnear, E. M., Malone, M., Perrin, B., Prentice, J., Sethi, S., & WRAIGHT, P. R. (2021) · QUT ePrints (Queensland University of Technology) · doi:10.26181/6108c41dd4703 · Cited by 27 · see citing works
Epidemiology of Diabetes Foot Amputation and its Risk Factors in the Middle East Region: A Systematic Review and Meta-Analysis
Bandarian, F., Qorbani, M., Nasli-Esfahani, E., Sanjari, M., Rambod, C., & Larijani, B. A. (2022) · The International Journal of Lower Extremity Wounds · doi:10.1177/15347346221109057 · Cited by 26 · see citing works
Peripheral Arterial Disease and Bypass Surgery in the Diabetic Lower Limb
Albayati, M. A., & Shearman, C. P. (2013) · Medical Clinics of North America · doi:10.1016/j.mcna.2013.03.009 · Cited by 26 · see citing works
Epidemiology of diabetic foot disease and diabetes-related lower-extremity amputation in Australia: a systematic review protocol
van Netten, J. J., Baba, M., & Lazzarini, P. A. (2017) · Systematic Reviews · doi:10.1186/s13643-017-0488-5 · Cited by 26 · see citing works
Peripheral Arterial Disease, Foot Ulcers, Lower Extremity Amputations, and Diabetes
Boyko, E. J., Monteiro‐Soares, M., & Wheeler, S. (2018) · Europe PMC (PubMed Central) · Cited by 26 · see citing works
Social Deprivation, Healthcare Access and Diabetic Foot Ulcer: A Narrative Review
Bonnet, J., & Sultan, A. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11185431 · Cited by 25 · see citing works
Time trends and geographical variation in major lower limb amputation related to peripheral arterial disease in England
Maheswaran, R., Tong, T., Michaels, J. A., Brindley, P., Walters, S. J., & Nawaz, S. (2023) · BJS Open · doi:10.1093/bjsopen/zrad140 · Cited by 25 · see citing works
Understanding variations in reported epidemiology of major lower extremity amputation in the UK: a systematic review
Meffen, A., Houghton, J. S. M., Nickinson, A., Pepper, C., Sayers, R. D., & Gray, L. J. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-053599 · Cited by 25 · see citing works
A Metabolic Insight Into the Neuroprotective Effect of Jin-Mai-Tong (JMT) Decoction on Diabetic Rats With Peripheral Neuropathy Using Untargeted Metabolomics Strategy
Zhang, Q., Song, W., Liang, X., Xie, J. X., Shi, Y., Shi, X., Qiu, B., & Chen, X. (2020) · Frontiers in Pharmacology · doi:10.3389/fphar.2020.00221 · Cited by 24 · see citing works
Trends in diabetes-related lower extremities amputations in Romania—A five year nationwide evaluation
Vereșiu, I. A., Iancu, S., & Bondor, C. I. (2015) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2015.05.020 · Cited by 24 · see citing works
Assessing data on the incidence of lower limb amputation in diabetes
Jeffcoate, W. J., Game, F. L., Morbach, S., Narres, M., Acker, K. L. V., & Icks, A. (2021) · Diabetologia · doi:10.1007/s00125-021-05440-4 · Cited by 23 · see citing works
Self-citation
Chronic Kidney Disease and the Foot in Diabetes - Is Inflammation the Missing Link?
Game, F. L., Selby, N. M., & McIntyre, C. W. (2013) · Nephron Clinical Practice · doi:10.1159/000351813 · Cited by 22 · see citing works
Ankle-brachial index and diabetic neuropathy: study of 225 patients
Chevtchouk, L., da Silva, M. H. S., & Nascimento, O. J. M. (2017) · Arquivos de Neuro-Psiquiatria · doi:10.1590/0004-282x20170084 · Cited by 21 · see citing works
Age- and sex-specific incidence of non-traumatic lower limb amputation in patients with type 2 diabetes mellitus in a U.S. claims database
Gandhi, S. K., Waschbusch, M., Michael, M., Zhang, M., Li, X., Juhaeri, J., & Wu, C. (2020) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2020.108452 · Cited by 21 · see citing works
Regional variation in the risk of lower‐limb amputation among patients with diabetes in New Zealand
Gurney, J., Stanley, J., York, S., & Sarfati, D. (2019) · ANZ Journal of Surgery · doi:10.1111/ans.15079 · Cited by 20 · see citing works
Association among Current Smoking, Alcohol Consumption, Regular Exercise, and Lower Extremity Amputation in Patients with Diabetic Foot: Nationwide Population-Based Study
Lee, Y. J., Han, K., & Kim, J. H. (2022) · Endocrinology and Metabolism · doi:10.3803/enm.2022.1519 · Cited by 20 · see citing works
Real-time gait event detection for transfemoral amputees during ramp ascending and descending
Maqbool, H. F., Husman, M. A., Awad, M. I., Abouhossein, A., & Dehghani-Sanij, A. A. (2015) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc.2015.7319464 · Cited by 20 · see citing works
Protocol for a systematic review and individual patient data meta-analysis of prognostic factors of foot ulceration in people with diabetes: the international research collaboration for the prediction of diabetic foot ulcerations (PODUS)
Crawford, F., Anandan, C., Chappell, F. M., Murray, G. D., Price, J. F., Sheikh, A., Simpson, C. R., Maxwell, M., Stansby, G. P., Young, M. J., et al. (2013) · BMC Medical Research Methodology · doi:10.1186/1471-2288-13-22 · Cited by 19 · see citing works
Self-citation
Application of Multiscale Entropy in Assessing Plantar Skin Blood Flow Dynamics in Diabetics with Peripheral Neuropathy
Liao, F., Cheing, G. L. Y., Ren, W., Jain, S., & Jan, Y. (2018) · Entropy · doi:10.3390/e20020127 · Cited by 18 · see citing works
Epidemiology of major lower extremity amputations in individuals with diabetes in Austria, 2014–2017: A retrospective analysis of health insurance database
Aziz, F., Reichardt, B., Sourij, C., Dimai, H.-P., Reichart, D., Köhler, G., Brodmann, M., & Sourij, H. (2020) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2020.108477 · Cited by 18 · see citing works
Effects of Hydrogel With Enriched Sodium Alginate in Wounds of Diabetic Patients
Barbosa, M. A. G., Paggiaro, A. O., de Carvalho, V. F., Isaac, C., & Gemperli, R. (2018) · Plastic and Aesthetic Nursing · doi:10.1097/psn.0000000000000228 · Cited by 17 · see citing works
Amputationen der unteren Extremität in Deutschland – Regionale Analyse mit Krankenhausabrechnungsdaten von 2011 bis 2015
Spoden, M. (2019) · Das Gesundheitswesen · doi:10.1055/a-0837-0821 · Cited by 17 · see citing works
Geographic and Ethnic Inequalities in Diabetes-Related Amputations
Bellia, A., Meloni, M., Andreadi, A., Uccioli, L., & Lauro, D. (2022) · Frontiers in Clinical Diabetes and Healthcare · doi:10.3389/fcdhc.2022.855168 · Cited by 16 · see citing works

The variation in incidence of amputation throughout England
Jeffcoate, W. J., Young, B., & Holman, N. (2012) · Practical Diabetes · doi:10.1002/pdi.1691 · Cited by 4 · see citing works
Self-citation
Regional variation in lower limb amputation incidence
Shaw, J. E. (2012) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2012.78 · Cited by 13 · see citing works
Changes in the Incidence of Lower Extremity Amputations in Individuals With and Without Diabetes in England Between 2004 and 2008
Vamos, E. P., Bottle, A., EDMONDS, M. E., Valabhji, J., Majeed, A., & Millett, C. J. (2010) · Diabetes Care · doi:10.2337/dc10-0989 · Cited by 156 · see citing works
Quantifying the incidence of lower limb amputation in people with and without diabetes in Wales between 2008–2018
Hayes, J., Rafferty, J., Cheung, W., Akbari, A., Thomas, R., Bain, S. C., Topliss, C., & Stephens, J. W. (2023) · Diabetes Epidemiology and Management · doi:10.1016/j.deman.2023.100144 · Cited by 1 · see citing works
Epidemiological study of lower limb amputation in England between 2003 and 2008
Moxey, P. W., Hofman, D., Hinchliffe, R. J., Jones, K., THOMPSON, M. M., & Holt, P. (2010) · British journal of surgery · doi:10.1002/bjs.7092 · Cited by 196 · see citing works

Authors: Holman, N., Young, R. J., & Jeffcoate, W. J.
Affiliations: Salford Royal NHS Foundation Trust (GB)
Nottingham University Hospitals NHS Trust (GB)
Corresponding author: Jeffcoate, W. J.
ORCID: Holman, N.
Jeffcoate, W. J.
Venue: Diabetologia
Publisher: Springer Science and Business Media LLC
Published: 2012-03-08
Volume: 55
Issue: 7
Pages: 1919-1925
ISSN: 0012-186X (ISSN-L)
1432-0428
DOI: 10.1007/s00125-012-2468-6
OpenAlex: W2115626618
Cited by: 226
References: 18
Citations by year: 2026: 5 · 2025: 6 · 2024: 11 · 2023: 13 · 2022: 12 · 2021: 15 · 2020: 27 · 2019: 20 · 2018: 17 · 2017: 16 · 2016: 19 · 2015: 15 · 2014: 19 · 2013: 20 · 2012: 11
FWCI: 16.67
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
Locations: Diabetologia (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: lower limb amputation, amputation incidence, diabetes mellitus, regional variation, primary care trusts, social deprivation, smoking, health care delivery
MeSH terms: Adolescent, Adult, Aged, Amputation, Surgical, Analysis of Variance, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, England, Ethnicity, Female, Health Services Accessibility, Humans, Male, Middle Aged, Risk Factors, Incidence, Prevalence, Diabetic Foot, Lower Extremity, Healthcare Disparities, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Variation in the recorded incidence of amputation of the lower limb in England

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Self-check

Cites

Cited by

Related

Record

About these checks