Diabetic amputations surge among Black and Latino Americans (2024)

Diabetic amputations surge among Black and Latino Americans (1)

Amputations are on the rise in some marginalized communities in the States

(Image credit: Illustration by Julia Wytrazek / Shutterstock)

Diabetic amputations surge among Black and Latino Americans (2)

By Theara Coleman, The Week US

published

The number of people with diabetes in America has been on the upswing in recent years, and so has the number of amputations related to complications from the illness. As with many other health care disparities in the United States, the Black and Latin American communities are getting hit the hardest by the crisis, having their limbs amputated at a higher rate than their white counterparts.

'The most stark disparity in Black versus white health in America'

The number of diabetic Americans suffering from complications that result in amputation has been on the rise in general in the United States. About 154,000 Americans with diabetes undergo amputation each year, per the American Diabetes Association's Amputation Prevention Alliance. As much as 80% of non-traumatic lower limb amputations are due to diabetes complications. And many of the amputations were preventable.

"It is a perfect storm of poor health and lack of medical guidance," Dr. Dean Schillinger, founder of the UCSF Center for Vulnerable Populations, said to The Guardian. A person who has developed a foot ulcer "often doesn't realize they need to not put weight on this foot so it can heal," she said. They're often working to support their families and can't just 'put their feet up for four to six weeks.'"

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Diabetic amputations surge among Black and Latino Americans (3)

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Statistics show that specific communities are more likely to be caught in that perfect storm. Studies show that less affluent Americans with diabetes are more than four times more likely to have a limb amputated than wealthier Americans with diabetes. Black and Latin American diabetics are four times as likely to need amputations than white Americans, according to a September study. Black people are also three times as likely to develop peripheral artery disease (PAD), the "diabetes-related condition that impedes blood flow to the limbs," The Guardian said. Amputations are known as a "mega-disparity" in health care, Schillinger said to the outlet. "It is perhaps the most stark disparity in Black versus white health in America."

Texas has one of the highest rates of diabetes-related amputations, and the majority Mexican American city of San Antonio has been hit hard by the crisis. It has been driven by a "lethal combination of genetics, poor access to health care, diets high in processed foods and sedentary lifestyles," said The New York Times. The problem is especially stark for men, who are about three times more likely to lose a foot to diabetes than women, "possibly because of cultural stigmas that prevent many Latino men from looking closely after their health."

"For Hispanics in South Texas, diabetes is the big boogeyman you're always watching out for, especially if you can't afford preventive care," Joaquin Castro, a congressman who represents San Antonio, said to the Times.

Lagging in preventative care

The rise of type 2 diabetes is a "deadly epidemic" that is "largely reversible with a low-carbohydrate diet," Neil Barsky said in The Guardian. The lack of public urgency around the public health crisis is, in some ways, "the result of the nation's most powerful diabetes advocacy group, the American Diabetes Association (ADA)," which "works hand in glove with its big food, pharmaceutical, and medical technology donors" who benefit from the $400 billion Americans spend annually on diabetes-related care. The struggles diabetic people with limb amputations face are "interwoven with our other challenges of poverty, race and inadequate healthcare," he said. "Amputees in the U.S. are close to invisible."

The difficulty in accessing preventative care is part of the problem's root. By the time patients get to an emergency room, "it is sometimes too late," Dr. David G Armstrong, a professor of surgery at the Keck School of Medicine at the University of Southern California, said to The Guardian. "But if we can see them sooner in the clinic, the vast majority of these cases are preventable."

Dr. Richard Browne, a senior medical executive at Johnson & Johnson, told ABC News that another factor is that many Black patients are not getting the correct information about their diabetes from doctors early on. "Very often, their symptoms are ignored," Browne said. Medical professionals can be affected by "unconscious bias," which leads them to jump to amputation based on assumptions the patient might not return for care. Browne said that with the proper treatment, patients could avoid amputations altogether.

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Diabetic amputations surge among Black and Latino Americans (4)

Theara Coleman, The Week US

Theara Coleman has worked as a staff writer at The Week since September 2022. She frequently writes about technology, education, literature and general news. She was previously a contributing writer and assistant editor at Honeysuckle Magazine, where she covered racial politics and cannabis industry news.

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Diabetic amputations surge among Black and Latino Americans (2024)

FAQs

Diabetic amputations surge among Black and Latino Americans? ›

Black and Latin American diabetics are four times as likely to need amputations than white Americans, according to a September study. Black people are also three times as likely to develop peripheral artery disease (PAD), the "diabetes-related condition that impedes blood flow to the limbs," The Guardian said.

What is the rate of amputations among diabetics? ›

Every 3 minutes and 30 seconds in the United States, a limb is amputated due to diabetes. Amputations are on the rise in the United States—154,000 people with diabetes undergo amputation each year. And as high as 80% of non-traumatic lower limb amputations happen due to diabetes complications.

Why do some diabetes undergo amputations? ›

People living with diabetes have an increased risk of needing lower limb amputation. Wounds or ulcers that do not heal are the most common reason for amputation. Factors such as high blood sugar levels and smoking can increase the risk of foot-related complications, which can lead to a need for amputation.

Is every 30 seconds a leg is amputated due to diabetes? ›

Diabetic foot or leg amputation is a primary complication of diabetes. Across the globe, it's estimated that a limb is amputated every 30 seconds, and 85% of these amputations are due to a diabetic foot ulcer.

What is the mortality rate for diabetic BKA patients? ›

In a review study based on data from 31 publications, mortality rates of 53% to 100% at five years, 40-82% after below-knee amputation, and 40-90% after above-knee amputation were reported,6 which shows a high overall mortality rate, higher than that obtained in our study (46.4%).

What are three things you should never do with a diabetic and their feet? ›

Don'ts
  • 1 ) Don't use heating pads. Heating pads, electric blankets, hot water bottles, or even extremely hot baths can all be relaxing and soothing, but for someone with diabetes, they can be dangerous. ...
  • 2 ) Don't remove corns on your own. ...
  • 3 ) Get your feet wet in snow or rain.
Feb 21, 2018

What do diabetic legs look like? ›

The medical name for shin spots is diabetic dermopathy. You may also hear people refer to this condition as spotted leg syndrome. When this condition begins, you usually see round or oval spots, which often develop on the shins. The spots may be brown or reddish brown in color.

What is the life expectancy of a person with an amputated leg? ›

Life expectancy after amputation

A 65% four-year mortality rate for those undergoing major Lower Extremity Amputations (LEAs); removing large sections of a limb, typically performed above or below the knee.

What age do diabetics get amputated? ›

Table 1
DiabeticNondiabetic
Initial unilateral amputationInitial unilateral amputation
Women62 (47)79 (50)
Age (years)77 ± 983 ± 8
Men71 (53)78 (50)
8 more rows

Why does diabetic foot happen? ›

They can happen over time when high blood sugar damages the nerves and blood vessels in the feet. The nerve damage, called diabetic neuropathy, can cause numbness, tingling, pain, or a loss of feeling in your feet. If you can't feel pain, you may not know when you have a cut, blister, or ulcer (open sore) on your foot.

What percent of amputations are traumatic? ›

There are nearly 2 million people living with limb loss in the United States (1). Among those living with limb loss, the main causes are vascular disease (54%) – including diabetes and peripheral arterial disease – trauma (45%) and cancer (less than 2%) (1).

What are the statistics for multiple amputations? ›

While exact numbers are not known, it is estimated that approximately 7.3 % of individuals with trauma-associated amputation have multiple limb loss [3]. During U.S. military operations in Afghanistan and Iraq, rates of multiple limb loss ranged from 20 to 60 % [4].

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