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resources : fact sheets : sdpi–improving diabetes health outcomes : reducing lower extremity amputations

Fact Sheets

Special Diabetes Program for Indians: Improving Diabetes Health Outcomes print version print version
(PDF - 285 KB)
Reducing Lower Extremity Amputations updated June 2008

With support from the Special Diabetes Program for Indians, facilities in the Indian health system are implementing foot care interventions that, when introduced system-wide, have the potential to cut the risk for lower extremity (below the knee) amputations significantly.
  • A clinical study in one region of the Indian Health Service (IHS), the Bemidji Area IHS, showed that the use of foot care guidelines decreased amputation rates by 50%.
  • The same study showed that additional vascular surgery outreach services and the use of specialty shoes further reduced the amputation rate by half, resulting in an overall reduction in amputations of 75%.
  • The Bemidji Area IHS and Alaska Area IHS have served as leaders in developing and distributing diabetes foot care practice guidelines for the Indian health system.
Man having leg checked.
Why is this important?
  • More than half of all lower extremity amputations in the United States occur in people with diabetes.
  • People with diabetes are at risk for foot injuries due to numbness caused by diabetes–related nerve damage and low blood flow to the legs and feet. The most serious injury is a foot ulcer, which is at very high risk of becoming infected. Foot ulcers that do not heal are a frequent cause of amputation in people with diabetes.
  • Approximately 75% of lower extremity amputations due to diabetes can be prevented through the use of appropriate diabetes care practices, minor surgery, and low-tech strategies, such as foot and nail care, shoe inserts, and specialty shoes.

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