Twice As Likely To Lose a Limb—How Poverty Affects Diabetes

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Exposing the large gap in the current healthcare system, with a particular focus on disadvantaged populations, a new study from the David Geffen School of Medicine at UC Los Angeles reveals that lower-income individuals suffering with diabetes have a significantly larger chance of amputation than those living in wealthier areas.

Publishing their results in the journal Health Affairs, lead researcher Carl D. Stevens and his colleagues highlight a significant number of income-related issues for those with diabetes, and present staggering evidence concluding that individuals living in the poorest areas of California were on average twice as likely to have diabetes-related amputations of their lower appendages than those living in wealthier regions. Although previous studies have discussed income and access to healthcare as they pertain to amputations of limbs caused by side-effects of poorly managed diabetes, Stevens and his colleagues are the first to analyze how overall poverty or wealth directly correlate to the amputations of legs and feet.

"I think our findings show that the medical safety net has big holes in it and people are often falling through those holes; losing their limbs to diabetes when those complications could have been prevented with better care" Stevens says.

A disease caused by the imbalance of glucose (sugar) and insulin (the enzyme necessary for sugar digestion) in the blood stream, diabetes can either be genetically derived or arise later in life because of a malfunction in the body's normal processes for creating energy. Typically arising from excessive intake of sugars, causing the body to stop the production of insulin, previous research has established that income has a direct effect on the development and treatment of the disease due to the fact that the impoverished are less likely to be able to maintain healthy well-rounded diets that are particularly low in sugars and fats.

Known to be a primary cause for the loss of limbs, diabetes is associated with amputations because if its symptoms with poor blood circulation in the extremities. Exacerbated with poor dietary habits and poor regulation of ever-changing blood glucose levels, poverty has proven to contribute to the overall deteriorating health of those afflicted with diabetes.

Particularly abundant in African American and Latino communities, in part because of greater genetic predispositions to the disease, diabetes is of particular concern to disadvantaged populations, but has proven that their low incomes may ultimately lead them to lose a leg or two.

"Patients who live in low-income neighborhoods have less awareness of the disease and [its] consequences" Stevens says. "While expanding health insurance is not the whole solution, it's definitely part of the solution."

Local organizations such as the REACH coalition say that these amputation rates can be reduced, but suggest that it will take a collaborative effort from disadvantaged communities as a whole to help better improve care and education on the disease. In providing culturally-appropriate healthcare and instilling a sense of assurance in physicians, these programs can help identify issues with blood-glucose levels early-on and mitigate any issues that arise because of an unclear understanding of diabetes and its lifetime worth of struggles.