Social and Structural Determinants of Lower Extremity Amputations in Diabetes.

Curr Diab Rep

Division of Vascular Surgery, UC Davis Health Heart and Vascular Center, UC Davis Advanced Wound Care Program, Vascular Residency, UC Davis Health, 2335 Stockton Blvd, NAOB 5017, Sacramento, CA, 95811, USA.

Published: July 2025


Category Ranking

98%

Total Visits

921

Avg Visit Duration

2 minutes

Citations

20

Article Abstract

Purpose Of Review: Lower extremity amputations (LEAs) are among the most severe complications of diabetes, with approximately 1.5 million procedures performed globally each year. This review explores the impact of social and structural determinants of health on amputation rates in diabetic patients, highlighting disparities driven by systemic factors.

Recent Findings: Structural determinants such as healthcare policies and economic systems intersect with social factors, including access to care, racial disparities, and socioeconomic status, influencing amputation risk. Black patients with diabetes face up to a fourfold increased risk of major amputation compared to non-Hispanic white patients. Lower socioeconomic status is also strongly linked to higher amputation rates. Geographic and environmental factors, like food deserts and limited access to specialized care, further exacerbate these disparities. Emerging prevention strategies, such as telemedicine and mobile health units, demonstrate promise in improving access to care. Addressing disparities in LEAs requires comprehensive policy changes and targeted interventions. Future directions include leveraging artificial intelligence and precision medicine alongside community-based programs to reduce amputation rates in high-risk diabetic populations.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222403PMC
http://dx.doi.org/10.1007/s11892-025-01598-yDOI Listing

Publication Analysis

Top Keywords

structural determinants
12
amputation rates
12
social structural
8
lower extremity
8
extremity amputations
8
access care
8
socioeconomic status
8
amputation
5
determinants lower
4
amputations diabetes
4

Similar Publications

Background: Idiopathic normal pressure hydrocephalus (iNPH) predominantly manifests with gait disturbances, yet clinical assessments are vulnerable to confirmation bias, particularly post-shunt surgery. Blinded video evaluations are a method to enhance objectivity in gait assessment, but their reliability has never been systematically investigated. The aim was to evaluate the inter-rater reliability of blinded gait assessments in iNPH patients and to investigate how these assessments correlate with the Hellström iNPH scale and patient-reported health status following shunt surgery.

View Article and Find Full Text PDF

Background: The benefits of physical activity for frail older acutely hospitalized adults are becoming increasingly clear. To enhance opportunities for physical activity on geriatric wards, it is essential to understand the older adult's perspective.

Aim: The aim of the study was to explore the experiences and perceptions of physical activity among older adults during hospital stays on a geriatric ward.

View Article and Find Full Text PDF

Background: Centromeres are crucial for precise chromosome segregation and maintaining genome stability during cell division. However, their evolutionary dynamics, particularly in polyploid organisms with complex genomic architectures, remain largely enigmatic. Allopolyploid wheat, with its well-defined hierarchical ploidy series and recent polyploidization history, serves as an excellent model to explore centromere evolution.

View Article and Find Full Text PDF

Experiencing stigmatization during the COVID-19 pandemic: a qualitative study among healthcare workers.

BMC Infect Dis

September 2025

Department Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum-Str. 13, Greifswald, 17489, Germany.

Background: Healthcare workers (HCWs) played a crucial role in dealing with the COVID-19 pandemic. In addition to increased workloads, they were confronted with stigmatization due to their work in the health sector.

Methods: Guided by the Health Stigma and Discrimination Framework (HSDF), this study aimed to explore the experiences of stigmatization of HCWs in Germany using semi-structured interviews (N = 34) and investigate effective coping strategies and existing needs in this context.

View Article and Find Full Text PDF

Background: Although current evidence supports the effectiveness of social norm feedback (SNF) interventions, their sustained integration into primary care remains limited. Drawing on the elements of the antimicrobial SNF intervention strategy identified through the Delphi-based evidence applicability evaluation, this study aims to explore the barriers and facilitators to its implementation in primary care institutions, thereby informing future optimization.

Methods: Based on the five domains of the Consolidated Framework for Implementation Research (CFIR), we developed semi-structured interview and focus group discussion guides.

View Article and Find Full Text PDF