JAMA Netw Open: A Population Analysis of Diabetes-Related Nursing Practices, Foot Complications, and Amputations During the COVID-19 Pandemic

Background: Delays in diabetic foot screening and timely treatment of acute foot complications may have contributed to the increase in amputations during the COVID-19 pandemic

DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study included all adult residents of Ontario, Canada with diabetes, and compared January 1, 2020 to February 23, 2021 with January 1, 2019 to Ratio of selected outcomes during February 23, 2020

Main outcomes and measures: Comprehensive assessment of diabetes care including foot examination, glycated hemoglobin (HbA1c) measurement, diabetic foot ulcer, osteomyelitis, emergency department visits or hospitalizations for gangrene, lower extremity patency or endovascular revascularization, minor (toe or partial) Foot) amputation, major (above the ankle) amputation

Results: On March 11, 2020, the study included 1488 605 adults with diabetes (median [IQR] age, 65 [55-74] years; 776 665 [52.

Table 1 Demographic characteristics and complications of amputees by period

Figure 1 Amputation rate among adults with diabetes

Table 2 Prognosis and nursing measures of adults with diabetes by time period

Figure 2 Prognosis and care measures ratios in the 2020-2021 period relative to the 2019-2020 control period

Conclusions: In this population-based cohort study, COVID-19 pandemic-related interruptions in care were not associated with excessive leg amputations among diabetic patients

de Mestral C, Gomez D, Wilton AS, et al.