The prevalence of major lower limb amputation in the diabetic and non-diabetic population of England 2003-2013

Aims: To determine the prevalence of amputation and revascularisation among diabetics and non-diabetics between 2003 and 2013. Methods: Retrospective analysis of English hospital data with census estimates for population aged 50-84 years. Results: There were 42,294 major and 52,525 minor amputations and 355,545 revascularisations. Major amputation rates fell by 20% (27.7-22.9), with minor amputations (22.9-35.2) and revascularisations (199.8-245.4) rising. The major amputation rate reduced in diabetics (men, 180.5-111.8; women, 92.8-52.7) faster than non-diabetics (men, 24.6-18.7; women, 11.0-8.9). In total, 48.2% of men and 58.0% of women amputees were not diabetic. Conclusion: Diabetics continue to experience six times the rate of amputation than non-diabetics. However, half of major amputees were not diabetic and experienced slower rates of decrease. Non-diabetics, particularly those with peripheral arterial disease, should have access to appropriate services, particularly foot care.