Researchers studying Medicare claims ranging from 2007–2011 reported that black Type 2 diabetics are far more likely to lose a limb due to complications from the disease.
A report from the Dartmouth Atlas Project indicated that blacks were three times more likely than non-blacks to lose their leg from complications arising from Type 2 diabetes.
Leg amputation is generally a treatment of last result, where other preventative and corrective measures have been unable to cure or ease a patient’s circulation issues.
The report focused on those patients suffering from both Type 2 diabetes and peripheral arterial disease. The latter narrows and blocks blood vessels from the heart to the legs, which can result in a lack of blood flow that later requires amputation.
Circulation issues, if left unchecked and untended, often become fixable only through surgery.
The discrepancy is at least partially attributed to a corresponding reduced likelihood of blacks receiving preventative care, including blood tests and regular foot exams.
One of the most common tests for preventing and detecting likely diabetes-related complications is the blood lipids test. An examination of 2010 records indicated that 75 percent of black Type 2 diabetics were administered this test versus 82 percent of non-black patients.
While the difference in amputation rates is already fairly striking, Dr. Philip Goodney, lead author of the report, said that “there are certain parts of the country where the disparity is larger.”
The report indicates that the Southeast saw a higher incidence of amputations than did other parts of the nation. Mississippi, in particular, was singled out as having a very high difference in amputation rates by race. Hospitals in Meridian and Tupelo saw 14.2 and 16.1 amputations per 1000 black patients, but just 3.8 and 4.8 amputations per 1000 non-black patients.
Overall, in the United States, preventative care, better monitoring practices and advancements in medicine have seen the rate of amputations drop.
While we must look for opportunities to expand education and preventive care for all patients at risk for amputation, it seems clear to us that we can make the greatest gains by focusing on African-American patients in the highest risk regions, typically in the poor rural regions of the Southern United States, where the highest amputation rates remain.
A copy of the complete report can be downloaded free from the Dartmouth Atlas website.