Abstract
BACKGROUND - Diabetes mellitus is the most common non-communicable disease affecting millions of people worldwide. It results from the body's inability to process glucose sufficiently, which results in multiple complications, including lower extremity amputations. The prevalence of diabetes mellitus is rapidly rising due to factors such as sedentary lifestyle, urbanisation and non-nutritional diet.
Diabetes mellitus is one of the leading causes of disability and premature mortality worldwide. The management of diabetes mellitus and its complications is physically, emotionally, and financially draining. A strong association exists between diabetic foot complications and poor quality of life.
METHODS – This retrospective cross-sectional design study investigated the incidence of mortality in patients with a diabetic-related lower extremity amputation. at provincial hospitals in Johannesburg, South Africa. The setting for this study was three public hospitals in the Gauteng province, namely Dr George Mukhari Academic Hospital (DGMAH), Helen Joseph Hospital (HJH), and Chris Hani Baragwanath Academic Hospital (CHBAH).
RESULTS - 278 patients’ record files were obtained of diabetic-related lower extremity amputations. There was an average of 117 deaths over five years, resulting in a five-year mortality rate of 42.1%. Males had a higher mortality rate than females. Most patients had a below-knee amputation. Diabetic foot infection was the leading cause of lower extremity amputation observed in this study.
CONCLUSION - The rate of diabetes-related lower extremity amputations is increasingly alarming. This study demonstrated that diabetic-related LEAs are associated with a considerable mortality rate. LEAs may result in severe disability, and they've been shown to have a strong association with poor quality of life. Developed countries have demonstrated a considerable reduction in the number of lower extremity amputations using MDT with the involvement of podiatrists in the management of diabetic patients. However, South African public health services remain inadequate in managing diabetic patients presenting with foot complications.