科学美国人60秒:Poor Diabetics Suffer More Amputations

Diabetics who live in poor areas in California are far more likely to suffer an amputation than are diabetics in wealthier neighborhoods. So finds an analysis in the journal Health Affairs. [Carl D. Stevens et al, Geographic Clustering Of Diabetic Lower-Extremity Amputations In Low-Income Regions Of California] 

The study reveals that patients in low-income zip codes were up to 10 times more likely to lose a leg or foot than diabetic patients in more affluent zip codes. In poor areas like Compton, as many as 10.7 out of 1,000 diabetic adults ages 45 and older wound up losing a lower limb due to diabetes complications. In wealthier areas, including Malibu and Beverly Hills, no more than 1.5 diabetics per 1,000 lost a limb to the disease.

Fewer healthcare options for poorer patients and their providers may have contributed to the disparity, the researchers write.

The diabetes patients most at risk for amputations were male, older than 65, black and non-English speaking.

When blood sugar and other health metrics are carefully monitored and controlled, diabetes amputations are much more preventable. Otherwise, diabetes can lead to impaired circulation in the feet and nerve damage. Those conditions, in turn, can keep patients from noticing developing infections. 

The researchers advise daily foot washing and checks for cuts to help keep patients on their feet. And improved health care access for communities most in need is a must.

- Dina Fine Maron

(The above text is a transcript of this podcast.)