Amputations was the topic of a study that reported in the magazine General Hospital Psychiatry issue on the American veterans who are diabetics. This group was found to have an increased chance of major amputations when they score low on a mental health functioning test. That is why mental assessment should be a part of the overall management of diabetes.
This news item suggests the need to evaluate patients for mental health issues as this seems to be a risk factor. This way, some suitable intervention can be undertaken to reduce the risk for amputation. So did the senior authors of the VA Health Care System in New Jersey report.
Dr. Tseng and his team studied almost 115000 diabetics at Veteran Health Administration Clinic during the period of 1998-2000. These patients completed a mental health functioning test. They then evaluated the results of the test. Hopefully my readers on diabetes leg pain will take note of this.
Here's what they found. They found that 450 patients underwent amputations of the ankle which are considered major while 431 had toes to ankle amputations which are considered minor. They then compared this with the findings on the measurement of the mental health functioning.
The ones who scored lower showed a greater risk for amputation. This was the finding after taking into account the other factors like obesity, less health care, poor diabetes control and smoking. The major amputation rate was .5% among those who scored below average, .3% for those who obtained above average and .2% for those who have the highest score in the test.
It goes to show that increase in mental health functioning score of five points was linked to a reduced risk of major amputation by 5%. And when adjustment was made, mental health functioning stopped being a major risk for amputations that are minor.
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The link between mental health functioning was mentioned before but this is the first time that it has been formally studied. Mental health issues may get in the way with the care of people with diabetes including complications with the foot care. Being aware of this could lead to better care for diabetics and fewer amputations.