In one recent year 8,000 legs, feet and toes had to be amputated, doctors say, to save the lives of diabetic Californians.
But if you live in Beverly Hills or Malibu, you were far less likely to be one of these folks, even if you have diabetes. In fact, if you live in East L.A. or Compton, you were 10 times more likely to lose one of your favorite body parts to diabetes than you would have been had you lived in one of those upper-crust zip codes.
That's the recent conclusion of researchers at UCLA. What gives?
Lead author Carl Stevens, a clinical professor of medicine at the David Geffen School of Medicine at UCLA, suggests it might be a matter of deferred health-care and “late intervention,” by which time it's too late to save a leg, foot or toe.
And all that, of course, comes down to having the money to treat diabetes early.
Stevens and colleagues focused their analysis on 45-and-older diabetes patients in California. Their findings were published in the August issue of Health Affairs. According to UCLA, here's how the study went down:
The authors used data from the UCLA Center for Health Policy Research's California Health Interview Survey, which estimated the prevalence of diabetes among low-income populations by ZIP code. They blended these statistics with household-income figures from the U.S. Census Bureau and hospital discharge data from the Office of Statewide Health Planning and Development that tracked diabetes-related amputations by ZIP code.
The doctors found that diabetics who lived in the state's poorest zip codes were 10 times more likely to have amputations than those who lived in the wealthiest enclaves.
Stevens says, “I've stood at the bedsides of diabetic patients and listened to the surgical residents say, 'We have to cut your foot off to save your life.'”
Race also appeared to play a role: Both African Americans and Asian Americans saw diabetic amputations at about double the rate at which they represent diabetes sufferers in California, UCLA said.
In other words, blacks represent less than 6 percent of diabetes patients but 13 percent of diabetic amputees, the study says.
Here's the key problem, UCLA states:
People with poorly managed diabetes often suffer from a compromised immune system. As a result, a blister or other foot injury may rapidly progress to a serious, even life-threatening infection. Early diagnosis, antibiotics and expert wound care can stop the process, but patients lacking access to treatment risk gangrene and blood infections that require immediate amputation.
Study co-author David Schriger, a professor of emergency medicine at the Geffen School of Medicine, blames us—all of us:
The U.S. spends more health care dollars per person than any country in the world. Yet we still can't organize our health care system in a way that gives everyone adequate treatment.
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