Endocrine Abstracts

Background and Aim: Recent international studies indicate a secular decrease in the proportion of patients with diabetes who undergo lower limb amputations (LLA). However, our findings suggest that the proportion of diabetics among patients undergoing non-traumatic, non-cancer related lower limb amputations has increased over the past decades despite comprehensive preoperative investigations and other surgical interventions. To further explore the underlying reasons for this, we aimed to explore any gender differences in the preoperative treatment and assessment regarding indication for vascular surgery.

Methodes: Medical records for all patients identified with LLA by the electronic discharge registers at Innlandet Hospital, Elverum, from 2013 through 2019 were retrieved. Traumatic and cancer-related amputations were excluded. All codes for amputations and exarticulations were included, and amputations were verified by manual review by two of the authors. Only the first minor or major amputation in an individual were included in further analyses. Diabetes was defined by the WHO criteria. Descriptive statistics and chi-square tests were performed using the SSPS TM version 26

Results: We identified 190 persons undergoing non-traumatic, non-cancer related amputations of the lower limb. Of the 120 men 70 % had type 1 or 2 diabetes. 50% of the women had diabetes. 66 % of the persons with diabetes and 72 % of the persons without diabetes had a vascular angiography (CT, MRI or conventional) preoperative. The proportion of amputees who underwent an angiography of the lower limbs were higher in men than in women (P=0.048). When stratifying in groups with and without diabetes, this difference was found only in the non-diabetes group (P=0.004). No statistical differences were found regarding other markers or risk factors of vascular disease, such as smoking, use of statins or anti-platelet agents.

Conclusion: The gender difference in favour more investigations with preoperative angiography before LLA in men, was not found in persons with diabetes, indicating equal treatment across the genders in this group.