Peripheral Artery Disease as a Prognostic Factor for Amputation in Type 2 Diabetes Mellitus: An Evidence-Based Case Report
DOI:
https://doi.org/10.29303/jk.v15i2.9505Keywords:
diabetes mellitus, peripheral arterial disease, amputation, prognosisAbstract
Type 2 diabetes mellitus (T2DM) is associated with macrovascular and microvascular complications, including peripheral artery disease (PAD) and diabetic foot ulcer (DFU). PAD leads to reduced perfusion, delayed wound healing, and gangrene, thereby increasing the risk of lower-extremity amputation (LEA). Determining whether a history of PAD predicts amputation risk in adults with T2DM is important for prognosis and clinical decision-making. A structured search was performed in PubMed, Cochrane, and ProQuest using predefined keywords. Eligible studies included systematic reviews, meta-analyses, and cohort or survival studies involving adults with T2DM and PAD, with amputation as the outcome. Articles published within the last 10 years were reviewed. Two cohort studies and one systematic review met inclusion criteria. Each selected study underwent critical appraisal for validity, clinical relevance, and applicability. All included studies demonstrated that PAD markedly increases amputation risk in patients with diabetes. A large retrospective cohort of 50,276 individuals found that PAD alone increased amputation risk 12.3-fold, and when combined with diabetes, the risk rose to 51.8-fold. Data from the Western Denmark Heart Registry showed that diabetic patients had a 5.51-fold higher hazard of LEA compared with non-diabetic individuals. A prospective primary care cohort identified PAD-related DFU and diabetic retinopathy as independent predictors of amputation (HR 3.39, 95% CI 1.37–8.39). Evidence consistently indicates that a history of PAD significantly elevates LEA risk in adults with T2DM. These findings support the need for careful risk assessment, preventive interventions, and multidisciplinary management to reduce amputation risk in this population.
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Copyright (c) 2026 Ita Marlita Sari
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