Hospitalizations for acute diabetic complications in Italy, 2001–2010.

*<p>Age at first discharge in the study period.</p

Temporal trend in hospitalization rates/1,000 diabetic people for acute diabetic complications, by North, Center and South of Italy, 2001–2010.

<p>Vertical bars indicate 95% CIs.</p

Hospital admission rates for acute diabetic complications in Italy, 2001–2010.

*<p>Standardized by age and gender on 2001 Italian population.</p>**<p>Relative percentage variation from 2001 to 2010.</p

Hospital admission rates per 1,000 diabetic people for acute diabetic complications, by age groups, 2001–10, Italy.

*<p>Relative percentage variation from 2001 to 2010.</p

Rate of amputees (top) and hospitalization for amputation (bottom) in persons with and without diabetes, Italy 2010.

§<p>All discharges for amputation (i.e. major, minor and not specified level).</p>∧<p>Rates are expressed per 100,000 000 persons with and without diabetes respectively.</p>*<p>Age at first amputation.</p

Lower Extremity Amputations in Persons with and without Diabetes in Italy: 2001–2010

<div><p>Objective</p><p>To analyze hospitalization for lower extremity amputations (LEAs) and amputee rates in persons with and without diabetes in Italy.</p><p>Research Design and Methods</p><p>All patients with LEAs in the period 2001–2010 were identified analyzing the National Hospital Discharge Record database. For each year, amputee and hospitalization rates for LEAs were calculated either for persons with diabetes or without. Time trend for major and minor amputations were analysed.</p><p>Results</p><p>From 2001 to 2010 a mean annual number of 11,639 individuals underwent a lower extremity amputation: 58.6% had diabetes accounting for 60.7% of total hospitalizations. In 2010, the crude amputee rate for LEAs was 20.4 per 100,000 inhabitants: 247.2 for 100.000 persons with diabetes, and 8.6 for those without diabetes. Having diabetes was associated to an increased risk of amputation (Poisson estimated RR 10.9, 95%CI 9.4–12.8). Over the whole period, a progressive reduction of amputee rates was observed for major amputations either among persons with diabetes (−30.7%) or without diabetes (−12.5%), while the rates of minor amputations increased progressively (+22.4%) among people without diabetes and were nearly stable in people with diabetes (−4.6%). A greater number of minor amputations were performed among persons with than without diabetes: in 2010, the minor-to-major ratio among persons with diabetes (2.5) was more than twice than in those without diabetes (1.0).</p><p>Conclusions</p><p>The nationwide analyses confirm a progressive reduction of hospitalization and amputee rates for major LEAs, suggesting an earlier and more diffuse approach aimed at limb salvage.</p></div

Relative risk of lower extremity amputation in people with diabetes, compared with those without diabetes, adjusted for age, sex and calendar year: results of the Poisson models.

*<p>Relative risk per one year increment;</p>§<p>reference group 0–34 years.</p

Amputee rate in people with diabetes (rates per 100,000 persons with diabetes) and without diabetes (rates per 100,000 persons without diabetes).

<p>Age and sex standardized rates (in brackets) are calculated on the basis of 2001 Italian resident population.</p><p>Note. Total amputations: minor, major and not specified level.</p

Hospitalization rate for amputation in people with diabetes (rates per 100,000 persons with diabetes) and without diabetes (rates per 100,000 persons without diabetes).

<p>Note. Total amputations: minor, major and not specified level.</p><p>Age and sex standardized rates (in brackets) are calculated on the basis of 2001 Italian resident population.</p