A new study found poor diabetes patients are 10 times more likely to lose their legs, feet or toes than wealthier patients.
Dr. Carl Stevens, lead author of the study and a clinical professor of medicine at the David Geffen School of Medicine at UCLA, worked with his colleagues in analyzing the data from a survey estimating the frequency of diabetes in different areas in the United States. The analysts also looked at the average household income and hospital discharge data of diabetes-related amputations.
"I've stood at the bedsides of diabetic patients and listened to the surgical residents say, 'We have to cut your foot off to save your life,'" said Dr. Stevens. "These patients are often the family breadwinners and parents of young children - people with many productive years ahead of them."
The research team created a visual presentation mapping diabetic amputation rates in different zip codes. It showed a concentration in areas that were home to citizens with lower incomes, some of whom fell below the poverty line. In Southern California, amputation rates were 10 times higher in poor areas such as Compton.
The data revealed California surgeons amputated roughly 8,000 legs, feet, and toes of patients. More than 14 percent of the patients had at least two amputations. Most of the patients were black, non-English speakers, male, and seniors.
The researchers believe early diagnosis and treatment could have prevented complications leading to amputation. Doctors have appealed to the government to improve the healthcare system by developing new strategies that will benefit diabetic people residing in low-income neighborhoods.
"When you have diabetes, where you live directly relates to whether you'll lose a limb to the disease," said Dr. Stevens. "Millions of Californians have undergone preventable amputations due to poorly managed diabetes. We hope our findings spur policymakers nationwide to improve access to treatment by expanding Medicaid and other programs targeting low-income residents as we did in California in 2014."
Further details of the study were published in the August issue of Health Affairs.
