Diabetes-related amputations create considerable public health burden in the UK

Heather Graz, Vijay K. D'Souza (Lead / Corresponding author), David E.C. Alderson, Michael Graz

Research output: Contribution to journalReview articlepeer-review

27 Citations (Scopus)


Aims: The main aim of this study was to assess the cost of diabetic amputation (both direct and indirect) to the National Health Service from the point of amputation onwards.

Methods: This systematic review involved searches of published literature between January 2007 and March 2017 mainly using the bibliographic databases, the Cochrane Library, EMBASE via Ovid® MEDLINE via Ovid® as well as grey literature, both in print and in electronic formats published through non-commercial publications, which reported the cost of amputation due to diabetic foot ulcers.

Results: The studies included in this review varied considerably in estimating the cost including cost elements and how those costs were categorised. The cost estimates for inpatient care associated with amputation involving admissions or procedures on amputation stumps in people with diabetes was £43.8 million. The annual expenditure for post-amputation care involving prosthetic care, physiotherapy, transport and wheelchair use was £20.8 million.

Conclusions: There is a considerable public health and economic burden caused by diabetes-related amputations in England. More focussed research is needed with improved methods of estimating costs that would account for direct and indirect costs associated with diabetic amputation.

Original languageEnglish
Pages (from-to)158-165
Number of pages8
JournalDiabetes Research and Clinical Practice
Early online date11 Nov 2017
Publication statusPublished - Jan 2018


  • Diabetes mellitus
  • Major amputation
  • Minor amputation
  • National Health Service
  • Post-amputation

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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