Amputations continue to be a major complication of diabetes, despite the fact most are preventable. About one half of all amputations are currently performed among the diabetic population.
Researchers studied changes in the tiny blood vessels in the retinas of about 900 diabetic patients who had been diagnosed with the disease before age 30. All were followed for 20 years to assess how these microvascular changes might relate to subsequent need for an amputation.
The risk was significantly higher for those who had also demonstrated microvascular changes in the retina. The finding held true even after researchers adjusted the results to take other factors that could have impacted the need for amputations -- such as age, sex, blood sugar control, blood pressure, and history of feet ulcers -- into account.
Researchers believe changes in the retina may provide a good way to predict which diabetic patients are most at risk for amputation. "The results of this study suggest a link between microvascular changes in the retinal vessels and risk of undergoing [an amputation] in people with younger-onset diabetes. These results provide evidence that microvascular processes, as reflected in the retina, may contribute to the risk of [amputation]."