Amputations in patients attending a diabetic clinic in Addis Abeba, Ethiopia.

During 18 years, 1976 to 1994, 43(1.9%) of the 2,250 patients registered in the Diabetic Clinic at Yekatit 12 Hospital, Addis Abeba, Ethiopia (six patients) required an amputation at diagnosis or during the course of diabetes mellitus. Male to female ratios was 2:1; eight patients had Type 1 and 35 Type 2 diabetes. Diabetic peripheral neuropathy was the underlying condition in at least 21 of the 43 patients; only five cases of ischaemic gangrene were seen. Mean ge at amputation was 37.4 +/- 8.7 years in Type 1 patients and 58.6 +/- 12.1 in Type 2. Twenty-three of the 43 are now dead, 12 of the deaths having been due to sepsis in patients who refused an amputation in the face of progressing gangrene. Eleven of the 43 still attend regularly up to 11 years after an amputation. Most patients who needed below-knee amputations did not regain independence because of difficulty obtaining prostheses.