The psychosocial impact associated with diabetes-related amputation

Aims Research has suggested that the additional impact of a diabetes‐related amputation is associated with poorer physical functioning, poorer psychosocial outcome and greater body image disturbance. However, no study to date has compared patients with diabetes with and without amputation and adequately controlled for additional medical morbidity often found among individuals with an amputation. The aim of this study was to statistically control for any group differences on medical and demographic variables to examine the isolated psychosocial impact of diabetes‐related amputation. Methods Individuals with diabetes with an amputation (n = 50) were compared to a control sample (individuals with diabetes without an amputation; n = 240). All participants completed a demographic and medical questionnaire, as well as measures of psychological distress, quality of life and body image. Results The results indicated that, in univariate analyses, depression, physical quality of life and body image disturbance were all poorer in the amputee group. These differences remained for body image disturbance (P = 0.005), but were no longer significant for depression or physical quality of life in multivariate analyses controlling for important demographic and medical variables. Conclusions The present study found that the impact of diabetes‐related amputation was significant for body image disturbance. However, it appears that other psychosocial outcomes are better accounted for by medical co‐morbidities common in this group rather than the amputation itself. This research certainly highlights that clinicians must assess for and address all potential medical contributors to psychosocial outcomes, rather than assuming that people will experience poorer outcomes following amputation. What's new? The manuscript is the first to empirically examine the isolated impact of a diabetes‐related amputation by controlling for important medical factors. The manuscript is the methodologically strongest study in this area to date. The results reveal that body image disturbance appears to be influenced by the amputation itself, while other psychosocial outcomes previously attributed to amputation may be better accounted for by the overall poorer physical health.