Diabetes-Related Amputations Higher for Nonwhites

A "disproportionate" number of African Americans, Hispanics and American Indians have amputations each year because of complications from diabetes or peripheral vascular disease, studies have found. Knight Ridder/Baltimore Sun reports that while these groups have higher rates of diabetes, researchers attribute the higher amputation rate to a lack of preventive and regular health care and the "fact that care was received at hospitals ... with less technological expertise." However, many health officials say the discrepancy is caused by more "insidious factors." Research conducted in Boston concluded that the "difference in severity of disease between African-American and white patients is not likely to explain fully" the differences in amputation rates. What may be "at play," researchers hypothesize, is a "sense among physicians" that nonwhites would have difficultly in complying with the "rigorous care" required to prevent amputation, such as multiple daily medications, wound-dressing changes and "immaculate hygiene." Therefore, it is easer to "lop off" a limb, even though it is "unlikely that patients preferred amputation" to medical therapies. Reed Tuckson, a physician and former vice president for professional affairs for the American Medical Association, said, "Decisions are being made to lop off an extremity because of concerns for compliance," and "there are a lot of people who really are not getting the help they need to properly manage chronic conditions," adding, "there seems to be no one assigned in the medical care system to attend to that agenda" (Knight Ridder/Baltimore Sun, 3/27).