Background/purpose: Diabetes Mellitus is accompanied with long term complications including diabetic foot ulcers and lower extremity amputation. This study aims to identify the main risk factors contributing to lower extremity amputation among Palestinian diabetic patients.
Methods: A matched case-control study was conducted, where 47 diabetic patients with amputation and 94 controls were selected from the Ministry of Health hospitals and primary care clinics. Both groups were matched for age and gender. Data was collected using face to face questionnaire and reviewing the patient's data basis.
Results: The study included 141 diabetic patients, who agreed to participate and filled the questionnaire. Among the participants, 53% were male, 72% were illiterate, and 59% were unemployed. No significant difference between the two groups for socio-demographic characteristics was observed. Logistic Regression Model identified lack of practicing foot care, heavy smoking, having diabetes complications, low density lipoprotein level > 100 mg/dl and HbA1c level to be significantly associated with lower extremity amputation (P-value <0.001, 0.001, 0.011, 0.035, 0.027; respectively).
Conclusions: Foot care practice, heavy smoking, diabetes complications, low density lipoprotein levels are modifiable variables. We recommend increasing awareness about regular follow up for HbA1c and low density lipoprotein levels. Also, counseling on a healthy lifestyle including smoking has a great positive impact on a patient's health and subsequently preventing amputation.