Comparison of post amputation outcome in patients with type 2 diabetes from specialized foot care centres in three developing countries

Objective: To evaluate post amputation outcome and associated complications in type 2 diabetic patients who had undergone major amputations in developing countries. Patients and Methods: A total of 526 (M:F; 369:157) subjects from three centers [India (IND), n=194, Bangladesh (BAN) n=177 and Tanzania (TAN) n=155 who had undergone amputation and subsequently visited the hospital were included in this analysis. Details on foot problems and associated complications were recorded. Results: The prevalence of amputations was similar in all centres. The history of minor amputation and foot deformity was high in BAN. Recurrence of foot ulceration was more in TAN (30%) than in IND (9%) and BAN (11%). Re-amputation rate was similar in all groups (3%). The use of artificial limb was most in BAN (97%). Myocardial infarction was more prevalent in IND (15%). In Tanzania, 31% had died during the follow-up period and it was 16% and 5% in IND and BAN. The causes of death were infection due to septicemia and cardiovascular events which finally led to multisystem organ failure. Conclusion: The outcome following a major diabetic foot amputation was compared in three developing countries. Recurrence of foot infection was common in Tanzania. The most frequent causes of death were infection and cardiovascular events. © 2010 Elsevier Ireland Ltd.