{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:11:46Z","timestamp":1792627906452,"version":"4.5.0"},"reference-count":36,"publisher":"American Diabetes Association","issue":"5","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2003,5,1]]},"abstract":"<jats:p>OBJECTIVE\u2014To report the incidence of diabetes-related lower-extremity complications in a cohort of patients enrolled in a diabetes disease management program.<\/jats:p>\n                  <jats:p>RESEARCH DESIGN AND METHODS\u2014We evaluated screening results and clinical outcomes for the first 1,666 patients enrolled in a disease management program for a period of 24 months (50.3% men, aged 69.1 \u00b1 11.1 years).<\/jats:p>\n                  <jats:p>RESULTS\u2014The incidence of ulceration, infection, amputation, and lower-extremity bypass was 68.4, 36.5, 5.9, and 7.7 per 1,000 persons with diabetes per year. Amputation incidence was higher in Mexican Americans than in non-Hispanic whites (7.4\/1,000 vs. 4.1\/1,000; P = 0.003, odds ratio [OR] 1.8, 95% CI 1.2\u20132.7). The amputation-to-ulcer ratio was 8.7%. The incidence of Charcot arthropathy was 8.5\/1,000 per year. Charcot was more common in non-Hispanic whites than in Mexican Americans (11.7\/1,000 vs. 6.4\/1,000; P = 0.0001, 1.8, 1.3\u20132.5). The prevalence of peripheral vascular disease was 13.5%, with no significant difference based on ethnicity (P = 0.3). There was not a significant difference in incidence of foot infection (P = 0.9), lower-extremity bypass (P = 0.3), or ulceration (P = 0.1) based on ethnicity. However, there were more failed bypasses in Mexican Americans (33%) than in non-Hispanic whites (7.1%). Mexican Americans were 3.8 times more likely to have a failed bypass (leading to an amputation) or be diagnosed as \u201cnonbypassable\u201d than non-Hispanic whites (75.0 vs. 44.0%; P = 0.01, 3.8, 1.2\u201311.8).<\/jats:p>\n                  <jats:p>CONCLUSIONS\u2014The incidence of amputation is higher in Mexican Americans, despite rates of ulceration, infection, vascular disease, and lower-extremity bypass similar to those of non-Hispanic whites. There may be factors associated with failed or failure to bypass that mandate further investigation.<\/jats:p>","DOI":"10.2337\/diacare.26.5.1435","type":"journal-article","created":{"date-parts":[[2007,3,5]],"date-time":"2007-03-05T17:51:27Z","timestamp":1173117087000},"page":"1435-1438","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":395,"title":["Diabetic Foot Syndrome"],"prefix":"10.2337","volume":"26","author":[{"given":"Lawrence A.","family":"Lavery","sequence":"first","affiliation":[{"name":"Department of Surgery, Diabetex Research Group, Baltimore, Maryland"},{"name":"The Department of Orthopedic Surgery and Rehabilitation, Loyola University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Department of Surgery, Diabetex Research Group, Baltimore, Maryland"},{"name":"Department of Orthopaedics, Southern Arizona Veterans Affairs Medical Center, Tucson, Arizona"},{"name":"Department of Medicine, Manchester Royal Infirmary, Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert P.","family":"Wunderlich","sequence":"additional","affiliation":[{"name":"Department of Surgery, Diabetex Research Group, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Tredwell","sequence":"additional","affiliation":[{"name":"Department of Surgery, Diabetex Research Group, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.M.","family":"Boulton","sequence":"additional","affiliation":[{"name":"Department of Medicine, Manchester Royal Infirmary, Manchester, United Kingdom"},{"name":"Department of Medicine, University of Miami School of Medicine, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","reference":[{"key":"2022031216492833000_R1","doi-asserted-by":"crossref","unstructured":"Lavery LA, Ashry HR, van Houtum W, Pugh JA, Harkless LB, Basu S: Variation in the incidence and proportion of diabetes-related amputations in minorities. 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