Introduction. Over the last few years, lower limb amputations have represented a prevalent worldwide burden in the evolution of diabetic patients, but at what extent this burden affects the Roma population compared to Caucasians in Romania still needs further comprehension.
Aim. The purpose of this study was to assess the prevalence of lower extremities amputations in a Roma population, compared to a Caucasian population, in the presence of diabetes mellitus (DM), as well as to identify the risk factors associated.
Materials and methods. We included 536 patients, of whom 257 Roma subjects and 279 Romanian Caucasians, with the following socio-demographic status: the Roma group included 123 women (48.1%) and 134 men (51.9%), aged between 18 and 86 years, while the Caucasian group registered 107 women (47.9%) and 172 men (61.6%), aged between 18 and 89 years.
Results. Analyzing the whole group, the prevalence of amputations was 5% (n=27). A greater proportion of amputations was found in Romanian Caucasians (n=21, 7.5%), where there were 17 men (9.9%) and 4 women (3.7%) affected, compared to the Roma population (n=6, 2.3%), where all amputations occurred in men. Noticeably, this complication is more predominantly afflicting men.
Conclusions. Non-traumatic lower extremity amputation remains a challenge today in the care of diabetic patients. In our study, higher rates of amputations were observed in Romanian Caucasians, in comparison with the Roma population. Apart from this, this condition was accompanied by many cardiovascular risk factors.
13. Akduman ORL. The early treatment for diabetic retinopathy study. Clinical trials in ophthalmology: a summary and practice guide. 1998. doi: 1998:15-35.
14. Lewis B. Classification of lipoproteins and lipoprotein disorders. J. Clin. Pathol. 1973; S1-5:26–31. doi: 10.1136/jcp.s1-5.1.26.
15. Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis epidemiology, pathophysiology, and management. J. Am. Med. Assoc. 2002; 287(19):2570–2581. doi: 10.1001/jama.287.19.2570.
16. Marso SP, Hiatt WR. Peripheral arterial disease in patients with diabetes. J. Am. Coll. Cardiol. 2006; 47(5):921–929. doi: 10.1016/j.jacc.2005.09.065.
17. American Diabetes Association. Peripheral arterial disease in people with diabetes. Diabetes Care. 2003; 26(12):3333-3341.
18. Moulik PK, Mtonga R, Gill GV. Amputation and mortality in new-onset diabetic foot ulcers stratified by etiology. Diabetes Care. 2003; 26(2):491–494. doi: 10.2337/diacare.26.2.491.
19. Bondor CI, Veresiu IA, Florea B, Vinik EJ, Vinik AI, Gavan NA. Epidemiology of Diabetic Foot Ulcers and Amputations in Romania: Results of a Cross-Sectional Quality of Life Questionnaire Based Survey. J. Diabetes Res. 2016. doi: 10.1155/2016/5439521.
20. Moxey PW et al. Lower extremity amputations - a review of global variability in incidence. Diabet Med. 2011; 28(10):1144–1153. doi: 10.1111/j.1464-5491.2011.03279.x.
21. Peek ME. Gender differences in diabetes-related lower extremity amputations. Clinical Orthopaedics and Related Research. 2011. 1951–1955. doi: 10.1007/s11999-010-1735-4.
22. Wanda BCT, Gonsalves C, Gessey ME, Mainous AG 3rd. A Study of Lower Extremity Amputation Rates in Older Diabetic South Carolinians - PubMed. J S C Med Assoc. 2007. doi: 103(1):4-7.
23. Weiss E, Japie C, Balahura AM, Bartos D, Badila E. Cardiovascular risk factors in a Roma sample population from Romania. Romanian Journal of Internal Medicine. 2018; 65(3). doi:10.2478/rjim-2018-0010.
24. Enache G, Rusu E, Ilinca A, Rusu F, Costache A, Radulian G. Prevalence of obesity and newly diagnosed diabetes in the roma population from a county in the south part of romania (Călăraşi county) -preliminary results. Rom. J. Diabetes Nutr. Metab. Dis. 2016. 23.
25. Enache G, Rusu E, Ilinca A, Rusu F, Costache A, Jinga M, Panus C, Radulian G. Prevalence of Overweight and Obesity in a Roma Population from Southern Romania-Calarasi County. Acta Endo. 2018. doi: 10.4183/aeb.2018.122.
26. Fowkes FGR et al. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: A systematic review and analysis. Lancet. 2013; 382(9901):1329–1340. doi: 10.1016/S0140-6736(13)61249-0.
27. Masseria C, Mladovsky P, Hernández-Quevedo C. The socio-economic determinants of the health status of Roma in comparison with non-Roma in Bulgaria, Hungary and Romania. Eur J Public Health. 2010 Oct; 20(5):549-54. doi: 10.1093/eurpub/ckq102. Epub 2010 Jul 22. PMID: 20650945.