Trends of lower-limb complications in patients with type 2 diabetes mellitus during the COVID-19 pandemic
Authors' conclusion
The disproportionately sharper increase in LEA rates compared with DFU prevalence post-pandemic suggests that delayed care during the pandemic may have contributed to a higher burden of preventable amputations.
Study context
- Population
- Adults with T2D, TriNetX, 2016–2023; mean age 66 ± 14.0 years, 47.3 % female
- Participants
- 5,292,512 adults
- Exposure
- Pre-pandemic vs pandemic vs post-pandemic periods
- Outcome
- DFU prevalence and LEA incidence (annual percent change)
Methodological detailsTriNetX, Joinpoint regression
- TriNetX
- Joinpoint regression
Main finding
As reported in the abstract
- DFU prevalence annual percent changes (APC), pre-pandemic
- 9.08% (increased; 95% CI 6.24, 12.65)
- DFU prevalence APC, pandemic
- −0.15% (stable; 95% CI −1.94, 1.69)
- DFU prevalence APC, post-pandemic
- 6.89% (rose significantly; 95% CI 3.50, 9.75)
- Lower extremity amputation (LEA) incidence APC, pre-pandemic
- 9.18% (increased; 95% CI 7.15, 12.58)
- LEA incidence APC, pandemic
- −3.75% (stable; 95% CI −6.45, 0.63)
- LEA incidence APC, post-pandemic
- 11.46% (increased significantly; 95% CI 8.09, 19.63)
Observational data: associations, not effects.
Original publication
Trends of lower-limb complications in patients with type 2 diabetes mellitus during the COVID-19 pandemic. Diabetes Res Clin Pract. Published 19 June 2025. doi:10.
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