Diabetics Can Act to Avoid the Risk of an Amputation

Amputation due to diabetes is surprisingly common, especially in those patients who don’t take care of their blood sugar levels. However, even when the blood sugar is under control, there can be conditions in diabetics that lead to the need for non-traumatic amputation. It’s most important that diabetics take great care of any lesions on their toes, feet, or legs, to ensure that an infection can’t get established. But a new report in the Lancet shows that there’s another factor that should be watched – the blood lipids.

Australian physicians conducted a study to assess the effectiveness of a drug, fenofibrate (Tricor®), on the occurrence of amputation in almost 10,000 type 2 diabetic patients over a 5-years’ duration. Half the participants took 200 mg daily of fenofibrate, and half took a matching placebo.

There were 115 lower limb amputations during the study. Previous cardiovascular disease, small blood vessel disease, skin ulcers, smoking, and longer duration of diabetes were all more frequent in patients who had amputations than those who didn’t. However, the risk for amputation was 36% lower for all patients given fenofibrate, compared with placebo. The risk of minor amputations (below the ankle) was 47% lower with fenofibrate than with placebo.

The researchers, together with a review of the study in the journal, are impressed by the difference produced by fenofibrate. They theorize that, in fact, it has little to do with fenofibrate’s principal action – lowering triglyceride levels – but rather a direct effect of the drug on skin or wound healing that’s often necessary to avoid infection.

Whatever. The bottom line from this finding is that: 1. Diabetics must continue to be aware of, and take care of, any lesions of their lower limb, feet, and toes; 2. Ask their doctor if it would be worthwhile taking fenofibrate – it may also have benefits in preventing diabetic retinopathy.