Diabetes wellness visits reduce risk of amputation, study finds

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A new study by University of Virginia School of Medicine researchers found that patients with diabetes who take part in an annual wellness visit covered by Medicare are 36% less likely than those who don’t.

The researchers analysed data from 2006 to 2015 on Medicare patients in the “Diabetes Belt,” 644 counties located in the Appalachian region of the U.S. with higher diabetes rates. The state of Mississippi is included in the Diabetes Belt. It also includes portions of Alabama, Arkansas and Florida. Patients in the Diabetes belt had 27% higher chances of needing a lower extremity amputation than those who live in nearby counties.

Researchers found that patients who had their annual wellness visit free of charge were 36% less likely to have an amputation than those who didn’t, regardless of where they lived.

“Our results confirmed our hypothesis about an association between Annual Wellness Visits and a lower risk of major lower-extremity Amputations, highlighting how important it is to connect patients to preventive care services,” said Jennifer Lobo Ph.D., a researcher at UVA’s Department of Public Health Sciences.

Preventive diabetes care is important

People with diabetes are more at risk of developing serious health problems such as blindness and kidney failure. Preventive care is the best way for diabetes complications to be avoided or delayed.

The Diabetes Belt had a lower rate of foot complications due to diabetes than the surrounding counties. This may indicate that there are delayed diagnoses that could lead to amputations.

Researchers believe that patients with diabetes who attended their Annual Wellness Visits may have had foot problems diagnosed earlier, which could help prevent amputations. Researchers suggest that patients who use their Annual Wellness Visits are more likely to be involved in their care, which could reduce the chance of more serious complications. The researchers suggest that policymakers prioritize incentives for Medicare patients to use their annual wellness visits to reduce the incidence of diabetes-related amputations.

Researchers also found significantly higher rates in diabetes-related amputations among nonHispanic Black patients, both inside and outside of the Diabetes Belt. The researchers recommend additional resources or policy changes—such as increased diabetes education or the use of patient navigators that help guide patients through the healthcare system—to address systemic barriers that are preventing non-Hispanic Black patients with diabetes from accessing the preventive care they need to prevent amputations.

Lobo stated that Annual Wellness Visits are free for Medicare beneficiaries. However, additional incentives or resources are needed to overcome systemic barriers to patient access. “Patient education about the importance of Annual Wellness Visits and preventive medicine could also help improve their utilization, hopefully reducing the rate major amputations.”

The American Diabetes Association’s Scientific Sessions, New Orleans, June 5, was where the researchers presented their findings.

Do you live in a “hot spot” for diabetes complications and other health issues?

More information:
Conference: professional.diabetes.org/scientific-sessions

Provided by
University of Virginia

Study shows that diabetes wellness visits reduce the chance of an amputation.
Retrieved 20 June 2022
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