Geographic disparities in diabetes-related amputations--Texas-Mexico border, 2003.

The risk for lower extremity amputation (LEA) is estimated at 15 to 40 times higher among persons with diabetes than among persons without diabetes. In Texas, the prevalence of diabetes is higher near the Mexico border, where persons are more likely to have lower levels of education, lower incomes, no health insurance, and other barriers to obtaining health care. To determine whether diabetes-related LEA rates are higher near the Texas-Mexico border, rates were calculated, in both the general population and among persons with diabetes, for diabetes-related LEAs in border and nonborder counties. Data used for this analysis included 2003 Texas Inpatient Hospital Discharge Data (TIHDD), 2003 Texas population estimates, and data from the 2003 Texas Behavioral Risk Factor Surveillance System (BRFSS). The results of the analysis indicated that the age- and sex-adjusted rate of diabetes-related LEAs in the general population along the border was nearly double the rate of nonborder counties. Among persons with diabetes, the rate along the border also was significantly higher than among those in nonborder counties, but the rate differences were primarily among men aged > or =45 years. Additional measures to prevent diabetes and improve education regarding diabetes care are needed to reduce the excess burden of LEAs among persons with diabetes along the border.