It’s Time To Ensure Everyone Has the Right to Avoid Diabetic Amputations

Access and delivery of health care in the United States has never been an equal proposition. Proper care has always depended on one’s zip code, race, ethnicity, gender, and other factors out of one’s control. In many ways, those deficiencies have been highlighted by the ongoing COVID-19 crisis. 

Much has been written about how racial and ethnic minority populations are at increased risk of contracting the virus and many have been hospitalized and died at increased rates because of it. There are multiple factors at play here, but a big one is that these populations are already more likely to have a preexisting condition that makes them more susceptible to becoming seriously ill after contracting COVID-19. 

Among the most prominent of these pre-existing conditions is diabetes, which affects more than 34 million Americans and disproportionately affects minorities and people of certain geographic regions and income levels. When you consider that almost 40 percent of U.S. COVID-19 fatalities have been people with diabetes, it’s easy to see the toll the virus has taken on some of our most vulnerable. As National Diabetes Month comes to a close, it’s well past time we address these inequities and establish better ways to get quality care to everyone who needs it. 

As National Diabetes Month comes to a close, it’s well past time we address these inequities and establish better ways to get quality care to everyone who needs it. 

This summer, the American Diabetes Association launched their Health Equity Now campaign in an effort to illuminate problems that disproportionately affect minority communities, like unaffordable insulin, food deserts, and lack of access to new technologies. 

They also highlighted the right to avoid diabetic amputations, which is one aspect of diabetes care in which inequities are particularly stark. This summer, ProPublica published an article featuring Podimetrics advisory board member Dr. Foluso Farkorede highlighting his work in solving this problem, showing that Black people with diabetes, particularly those in the rural South, lose limbs to diabetes at triple the rate of others. These numbers are especially alarming when considering that many of these amputations can be prevented if the problem is detected early, which is entirely possible with today’s technology. 

The problem is that underserved populations are rarely given access to this preventive and specialty care, meaning they lose limbs at an unnecessarily high rate. 

The longer-term effects of this are striking. The loss of mobility and independence for a patient post-amputation is dramatically reduced. Further, the five-year mortality rate for someone who has a diabetic amputation is as high as 70 percent. 

That’s not to mention the immense drain these inequities put on the health care system as a whole. A 2018 study estimated the total cost of treating diabetes in 2015 was $1.3 trillion, with as much as one-third of this expense linked to lower extremity issues. That’s particularly troubling since much of it could have been saved with better access to preventive care. 

This represents just one example in diabetes care in which part of the population is worse off because of care inequities. Lack of internet access reduces the ability for patients in rural areas to take advantage of the surge in telemedicine brought on by COVID-19. An insufficient amount of doctors and specialists to care for people in these communities limits their options. And many solutions that do exist price people out. 

As we move beyond American Diabetes Month, we should not only raise awareness of the disease itself, but also how it disproportionately afflicts some people more than others. Identifying these discrepancies is critical in ultimately solving them, and as we move into 2021 we should prioritize eliminating disparities in diabetes care. It will help millions of people lead better, longer lives, save billions of dollars, and it’s just the right thing to do.