Poor people with diabetes up to 10 times likelier to lose a limb than wealthier patients
Most amputations preventable with earlier medical care, UCLA researchers say
August 4, 2014 — It’s no secret that poverty is bad for your health. Now a new UCLA study demonstrates that California diabetics who live in low-income neighborhoods are up to 10 times more likely to lose a toe, foot or leg than patients residing in more affluent areas of the state. Earlier diagnosis and proper treatment could prevent many of these amputations, the researchers say.
The study authors hope their findings, published in the August issue of Health Affairs, will motivate public agencies and medical providers to reach out to patients at risk of late intervention and inspire policymakers to adopt legislation to reduce barriers to care.
“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,'” said lead author Dr. Carl Stevens, a clinical professor of medicine at the David Geffen School of Medicine at UCLA. “These patients are often the family breadwinners and parents of young children — people with many productive years ahead of them.”
The authors used data from the UCLA Center for Health Policy Research’sCalifornia Health Interview Survey, which estimated the prevalence of diabetes among low-income populations by ZIP code. They blended these statistics with household-income figures from the U.S. Census Bureau and hospital discharge data from the Office of Statewide Health Planning and Development that tracked diabetes-related amputations by ZIP code.
The result was a detailed set of maps showing diabetic amputation rates by neighborhood for patients 45 and older — the age range at greatest risk for amputation from disease complications.
In 2009, California doctors surgically removed nearly 8,000 legs, feet and toes from 6,800 people with diabetes. Roughly 1,000 of these patients underwent two or more amputations. On average, 20 diabetic Californians were wheeled into the operating room each day for an amputation.
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