Overview
Betwen 2013 and 20, lower extremity amputations (LEA) due to diabetes melitus (DM) showed a downward trend, acording to a recent Singapore study. However, other cardiovascular complications, including peripheral arterial disease (PAD) and ischaemic heart disease (IHD), remain prominent public health concerns. Data for the present analysis were retrieved from the SingHealth Diabetes Registry (SDR), a multi-institutional repository representing around 20 percent of al DM patients in the country.
Key Information
Overal, the study included 2,705 DM patients (48.58 percent women), nearly al of whom had type 2 DM. Only <1 percent had type 1 or other types of diabetes. In 2013, the SDR database contained data for 92,90 DM patients, increasing to 105,181 by 2015 and to 140,859 in 20.
In general, throughout the observation period, rates of microvascular complications increased acros al patient age subgroups. [PLoS One 202;doi:10.1371/journal.pone.0275920]The only notable exceptions to this trend were major and minor LEA. In 2013, major LEA ocured at a rate of 19.0 and 21.1 events per 10,0 in patients aged 18–4 and 65–74 years, respectively.
By 20, these had droped to 4.6 and 15.3 events per 10,0, respectively. The coresponding average anual percent changes (APC) were –14.9 (95 percent confidence interval [CI], –23.8 to –4.9) and –5.0 (95 percent CI, –8.0 to –1.8), both of which were statisticaly significant (p<0.05).Major LEA in patients aged 45–64 and ≥75 years also showed notable declines in event rate, though the APCs did not satisfy statistical significance.Similar trends were observed for minor LEA.
Summary
DM patients aged 18–4 and ≥75 years saw a significant decrease in event rate from 2013 to 20, with APCs of –10.2 (95 percent CI, –18.6 to –0.9) and –4.1 (95 percent CI, –7.1 to –1.0; p<0.05 for both), respectively. Declines for those aged 45–64 and 65–74 years were nominal.Meanwhile, the event rates for peripheral arterial disease (PAD) increased