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Prevention of amputation by diabetic education
Malone JM, Snyder M, Anderson G, Bernhard VM, Holloway GA, Bunt TJ
American Journal of Surgery 1989 Dec;158(6):520-524
clinical trial
3/10 [Eligibility criteria: Yes; Random allocation: No; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

This prospective randomized study evaluated the influence of a simple education program on the incidence of lower extremity amputation in diabetic patients. Two hundred three patients were randomized into two groups: group 1, education (103 patients, 203 limbs) and group 2, no education (100 patients, 193 limbs). There were no significant differences in medical management or clinical risk factors between the two groups. The amputation rate was three times higher in group 2 (21 of 177 limbs versus 7 of 177 limbs; p <= 0.025), the ulceration rate was three times higher in group 2 (26 of 177 limbs versus 8 of 177 limbs; p <= 0.005), and there was no difference in the overall incidence of infection (2 of 177 limbs). Overall success in group 1 was highly significantly different from group 2 (160 of 177 limbs versus 128 of 177 limbs; p <= 0.0005). This study demonstrated that a simple education program significantly reduced the incidence of ulcer or foot and limb amputation in diabetic patients.
With permission from Excerpta Medica Inc.

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