Abstract:
OBJECTIVE:To evaluate temporal trends in rates of initial lower extremity amputation (ILEA) among patients with diabetes in the Veterans Health Administration (VHA). RESEARCH DESIGN AND METHODS:Retrospective administrative data analysis of VHA clinic users with diabetes in fiscal years (FY) 2000 to 2004 (1 October 1999-30 September 2004). We calculated annual age- and sex-standardized rates of initial major, minor, and total amputations for the overall population and for various racial/ethnic groups (African Americans, Hispanics, and whites). Trends in ILEA risk were evaluated with and without adjustment for demographic characteristics and other potential risk factors, including presence of microvascular and macrovascular diseases, and antiglycemic treatment. RESULTS:Study populations of VHA patients with diabetes and without prior amputations ranged from 405,580 in FY 2000 to 739,377 in FY 2004. Age- and sex-standardized ILEA rates decreased by 34% (7.08/1,000 patients in FY 2000 to 4.65/1,000 patients in FY 2005) during the 5-year period. Minor and major amputation rates decreased by 33% (4.59 to 3.06/1,000) and 36% (2.49 to 1.59/1,000), respectively. Of major amputations, below-knee rates decreased from 1.08 to 0.87/1,000 (-19%), and above-knee decreased from 1.41 to 0.72/1,000 (-49%). Similar trends were seen for all racial groups. ILEA risk decreased by 28% (odds ratio 0.72 [95% CI 0.68-0.75]) when FY 2004 was compared with FY 2000 in the model, adjusting for demographic characteristics. This risk decrease was 22% in the model adjusting for all independent variables (odds ratio 0.78 [95% CI 0.74-0.82]). CONCLUSIONS:Downward 5-year trends in ILEA rates were observed for all amputation levels and among all racial groups, even after adjustment for risk differences over time.
journal_name
Diabetes Carejournal_title
Diabetes careauthors
Tseng CL,Rajan M,Miller DR,Lafrance JP,Pogach Ldoi
10.2337/dc10-1775subject
Has Abstractpub_date
2011-05-01 00:00:00pages
1157-63issue
5eissn
0149-5992issn
1935-5548pii
dc10-1775journal_volume
34pub_type
杂志文章相关文献
DIABETES CARE文献大全abstract:OBJECTIVE:The aim of this study was to compare the University of Texas (UT) and Site, Ischemia, Neuropathy, Bacterial Infection, and Depth (SINBAD) foot ulcer scores in predicting ulcer outcome within a routine diabetes foot clinic. RESEARCH DESIGN AND METHODS:From 2006 to 2018, data were collected from all patients a...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc20-1817
更新日期:2021-02-01 00:00:00
abstract::Since little is known regarding the appropriate time for preprandial insulin administration, we compared the effects of 30-min subcutaneous insulin infusions started 60 min, 30 min, and immediately before meal ingestion on postprandial plasma glucose and insulin profiles in eight subjects with insulin-dependent diabet...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.6.4.374
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to examine patient-reported outcomes in a controlled trial of a multifaceted provider-level intervention to improve quality of care for rural patients with type 2 diabetes. RESEARCH DESIGN AND METHODS:We conducted a before/after intervention study with concurrent controls in two rur...
journal_title:Diabetes care
pub_type: 临床试验,杂志文章,多中心研究
doi:10.2337/diacare.27.6.1306
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of flexible intensive insulin therapy (FIIT) and an automated bolus calculator (ABC) in a Danish type 1 diabetes population treated with multiple daily injections. Furthermore, to test the feasibility of teaching FIIT in a 3-h structured course. RESEARCH DESIGN AND METHODS:The Bolus...
journal_title:Diabetes care
pub_type: 杂志文章,随机对照试验
doi:10.2337/dc11-2044
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that microalbuminuria may show an independent statistical association with diabetic neuropathy. RESEARCH DESIGN AND METHODS:An observational study of a prospectively identified cohort was conducted at the University Medical Center. The cohort consisted of 78 consecutive diabetic patien...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.15.4.528
更新日期:1992-04-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to compare clinical and biomechanical characteristics of balance in diabetic polyneuropathic elderly patients and normal age-matched subjects. RESEARCH DESIGN AND METHODS:Fifteen elderly with distal neuropathy (DNP) and 15 healthy age-matched subjects were evaluated with the b...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.23.8.1187
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:This study investigated whether intimacy and autonomy in mother-daughter interactions and relational aspects of the self are associated with metabolic control in adolescent girls with type 1 diabetes. RESEARCH DESIGN AND METHODS:This cross-sectional study included 88 girls with diabetes (mean age 14.9 +/- 2....
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.27.3.709
更新日期:2004-03-01 00:00:00
abstract::Limited weight loss following jejunoileal bypass in 24 diabetic persons who were still distinctly overweight five to ten months after a mean weight decrease of 78 lbs. was accompanied by a return of normal fasting glucose and insulin levels, normal insulin responses, and a decrease in glucose intolerance. The glucose ...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.1.3.158
更新日期:1978-05-01 00:00:00
abstract:OBJECTIVE:Our objective was to compare the performance of oral glucose tolerance tests (OGTTs) and multivariate models incorporating commonly available clinical variables in their ability to predict future cardiovascular disease (CVD). RESEARCH DESIGN AND METHODS:We randomly selected 2,662 Mexican-Americans and 1,595 ...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.25.10.1851
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:To know the nutritional pattern of people with diabetes in Spain and that pattern's relationship with targets of metabolic control. RESEARCH DESIGN AND METHODS:The Diabetes Nutrition and Complications Trial (DNCT) is a prospective multicenter study designed to determine the nutritional behavior of diabetic p...
journal_title:Diabetes care
pub_type: 杂志文章,多中心研究
doi:10.2337/diacare.20.7.1078
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVE:Improved appetite control, possibly mediated by exaggerated gut peptide responses to eating, may contribute to weight loss after Roux-en-Y gastric bypass (RYGB). This study compared brain responses to food ingestion between post-RYGB (RYGB), normal weight (NW), and obese (Ob) unoperated subjects and explored ...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc15-2721
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:Adverse microbial exposures might contribute to diabetogenesis. We hypothesized that clinical periodontal disease (a manifestation of microbial exposures in dysbiotic biofilms) would be related to insulin resistance among diabetes-free participants. The roles of inflammatory mediation and effect modification ...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc12-0072
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:Despite being a safe, effective therapy for lowering cardiovascular risk, only 20% of diabetic patients were using aspirin in the early 1990s. This study examines current physician practices and the use of aspirin therapy by individuals with diabetes. RESEARCH DESIGN AND METHODS:A random sample of diabetic p...
journal_title:Diabetes care
pub_type: 杂志文章,多中心研究
doi:10.2337/diacare.25.6.965
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:To compare pharmacokinetics (PK) and pharmacodynamics (PD) of insulin glargine in type 2 diabetes mellitus (T2DM) after evening versus morning administration. RESEARCH DESIGN AND METHODS:Ten T2DM insulin-treated persons were studied during 24-h euglycemic glucose clamp, after glargine injection (0.4 units/kg...
journal_title:Diabetes care
pub_type: 杂志文章,随机对照试验
doi:10.2337/dc14-0649
更新日期:2015-03-01 00:00:00
abstract::Skin wrinkling, which may be dependent on peripheral autonomic innervation, was assessed in 100 normal and 42 diabetic subjects using a temperature-controlled water bath with immersion of the hands for 30 min. Markedly decreased skin wrinkling was observed in diabetic subjects and in manual workers, but did not correl...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.7.3.224
更新日期:1984-05-01 00:00:00
abstract:OBJECTIVE:To estimate the within-person variability (SDi) for the overnight urinary albumin excretion rate (AER) in diabetic patients with persistent microalbuminuria. RESEARCH DESIGN AND METHODS:Thirteen normotensive diabetic patients in stable medical control, with normal renal function and without any associated ca...
journal_title:Diabetes care
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.2337/diacare.17.5.425
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVE:To validate fasting indices of insulin sensitivity and secretion in a diverse pediatric population against gold standard estimates from euglycemic and hyperglycemic clamps. RESEARCH DESIGN AND METHODS:A total of 31 children (mean BMI 25.1 +/- 4.9 kg/m(2), mean age 8.7 +/- 1.4 years, 15 girls and 16 boys, 12 ...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.25.11.2081
更新日期:2002-11-01 00:00:00
abstract::Urinary C-peptide (UCP) is a noninvasive measure of integrated insulin production, and the usefulness of 24-h collections has been previously reported. Only small numbers of subjects have been studied using shorter urine collections. To see how well 4-h urine collections for C-peptide (UCP) correlate with serum immuno...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.6.5.488
更新日期:1983-09-01 00:00:00
abstract:OBJECTIVE:Direct medical cost of diabetes in the U.S. has been estimated to be 2.3 times higher relative to individuals without diabetes. This study examines trends in health care expenditures by expenditure category in U.S. adults with diabetes between 2002 and 2011. RESEARCH DESIGN AND METHODS:We analyzed 10 years o...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc15-0369
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:To create a simple prediction rule that could perform as well as the 2-h postchallenge plasma glucose (PCPG) test to predict those at risk for diabetes. We created a prediction rule in one sample and prospectively validated it for incident diabetes in a separate cohort. RESEARCH DESIGN AND METHODS:A cross-se...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.28.2.404
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:To compare peak pressures on the sole of the foot in non-insulin-dependent diabetic patients with isolated, unilateral amputations of the great toe and first metatarsal with the patients' contralateral, intact foot. RESEARCH DESIGN AND METHODS:Eleven patients with a unilateral great toe and partial first met...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/diacare.18.11.1460
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVE:To assess the costs and project the potential lifetime cost-effectiveness of the ongoing Autoimmunity Screening for Kids (ASK) program, a large-scale, presymptomatic type 1 diabetes screening program for children and adolescents in the metropolitan Denver region. RESEARCH DESIGN AND METHODS:We report the res...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc19-2003
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:To understand why low-fat high-carbohydrate (CHO) diets lead to higher fasting and postprandial concentrations of triglyceride (TG)-rich lipoproteins in patients with non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS:Patients with NIDDM were placed randomly on diets containing eith...
journal_title:Diabetes care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2337/diacare.18.1.10
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVE:To estimate the health-related quality of life (HRQOL) and treatment satisfaction for patients with type 2 diabetes in the Netherlands and to examine which patient characteristics are associated with quality of life and treatment satisfaction. RESEARCH DESIGN AND METHODS:For a sample of 1,348 type 2 diabetes...
journal_title:Diabetes care
pub_type: 杂志文章,多中心研究
doi:10.2337/diacare.25.3.458
更新日期:2002-03-01 00:00:00
abstract:OBJECTIVE:Diabetic patients have a high prevalence of coronary artery disease (CAD), but timely diagnosis of CAD remains challenging. We assessed the ability of coronary computed tomography angiography (CCTA) to detect CAD in diabetic patients and to predict subsequent cardiac events. RESEARCH DESIGN AND METHODS:We an...
journal_title:Diabetes care
pub_type: 临床试验,杂志文章
doi:10.2337/dc09-2104
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:Emerging evidence suggests that peripheral neuropathy begins in the early stages of diabetes pathogenesis. Our objective was to describe the prevalence of peripheral neuropathy and nerve dysfunction according to glucose tolerance and metabolic syndrome status and examine how these conditions are associated wi...
journal_title:Diabetes care
pub_type: 杂志文章,多中心研究
doi:10.2337/dc14-2585
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the temporal patterns of cardiometabolic multimorbidity (CM) and depression in White Caucasians (WCs) and African Americans (AAs) with early-onset type 2 diabetes and their impact on long-term atherosclerotic cardiovascular disease (ASCVD). RESEARCH DESIGN AND METHODS:From U.S. electronic medical...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc20-2045
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of the diabetic retinopathy (DR) screening with digital camera by endocrinologists with that by specialist and resident ophthalmologists in terms of sensitivity, specificity, and level of "loss of chance." RESEARCH DESIGN AND METHODS:In a cross-sectional study, 500 adult diabetic pati...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc10-1373
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:To investigate whether self-rated health profiles compiled using the EuroQol group's visual analog scale (EQ VAS) are independent predictors of vascular events and major complications in people with type 2 diabetes after controlling for standard clinical risk factors. RESEARCH DESIGN AND METHODS:The study is...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc07-1391
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVE:While there is growing evidence on the effectiveness of structured care for diabetic patients in trial settings, standard population level evaluations may misestimate intervention benefits due to patient selection. In order to account for potential biases in measuring intervention benefits, we tested the impa...
journal_title:Diabetes care
pub_type: 杂志文章
doi:10.2337/dc13-2141
更新日期:2014-07-01 00:00:00