, Volume 55, Issue 12, pp 3397-3398
Date: 02 Oct 2012

Potential inaccuracy in recording the presence of diabetes in people with amputations of the lower limb in hospitals in England. Reply to Ahmed M, Moulik P and Macleod A [letter]

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To the Editor: We thank Ahmed et al for their valuable comment [1] and while we wish to counter one or two of their points, we are in general agreement with the warning highlighted by their letter.

The analysis in our paper [2] referred to the incidence of amputations among people with diabetes while the figures quoted in the letter relate to prevalence. The incidence of major amputation among people with diabetes for April 2007 to March 2010 in Shropshire County PCT and Telford and Wrekin PCT, which were included in the original paper, were 0.82 and 1.18 per 1,000 person-years, respectively. Further examination of the data shows that there were 30 major amputations in 28 patients in Shropshire PCT and 25 major amputations among 21 patients in Telford and Wrekin PCT in this time period. The analysis presented in our paper identified all amputations among patients registered with a GP belonging to a PCT irrespective of where the operation was done. While the majority of the amputations i