PURPOSE: To examine provincial/territorial and rural-urban differences in rates of diabetes-related foot complications and amputation across Canada. METHODS: Canadian adults, excluding Québec residents, hospitalized for a first diabetes-related foot complication (DFC), major (above-ankle) amputation, and major or minor (toe or partial-foot) amputation were identified from the Canadian Institute for Health Information's Discharge Abstract Database (April 1, 2017 to March 31, 2022). Age- and sex-adjusted mean annual event rates (per 100,000 residents) were calculated and compared across provinces/territories and rural/urban residence. RESULTS: The mean annual rate of major amputation was of 8.7 per 100,000 residents, ranging from 6.6 to 15.3 per 100,000 across provinces/territories. The highest rates of major amputation were in Manitoba, Newfoundland and Labrador, and Nova Scotia. The lowest rates of major amputation were in the Territories, British Columbia, and Prince Edward Island. Rates of major or minor amputation, and DFC ranged across provinces/territories from 10.3 to 29.6 per 100,000 and 16.9 to 36.4 per 100,000 respectively. The rate of all events was approximately two times higher among residents of rural compared with urban regions. However, provinces and territories with the highest proportion of rural residents did not consistently exhibit the highest amputation rates. CONCLUSIONS: Diabetes-related foot complications and amputation rates vary widely across provinces/territories and are higher among people living in rural areas. Further research is required to better understand risk factor management and amputation prevention efforts in provinces/territories with a high proportion of rural residents, but comparatively low amputation rates.
Kim et al. (Fri,) studied this question.