Diabetes Type I, II

The main objective of the research was to determine if height is a factor of lower-

extremity amputations among patients with diabetes mellitus (type 1 and 2). Taller

patients with diabetes mellitus have been shown to be more susceptible than shorter

diabetic patients to peripheral sensory loss. Because peripheral sensory loss with the

development of foot ulcers is the most common indication for lower-extremity

amputation among diabetic patients. In Taiwan diabetics mellitus accounts for a third to

half of all lower extremity amputations, the procedure is less common among Taiwanese

people. Similarly low procedures rates have been observed in other Asian populations.

The reason for the difference in rate between ethnic groups is unknown, but height may

be a factor.

The study design was approved and supported by an ad hocethics committee of the

Department of Health of Taiwan. Because more than 96% of Taiwan residents are

covered by the compulsory National Health Insurance plan better known as NHI. In

Taiwan hospitals are more accessible by people in all parts of the land. Because they

don't have to wait for referrals to see doctors on average a patients with diabetes visits an

outpatient clinic 35.8 times per. Therefore changes in patient are carefully monitored in

Taiwan and more often the here in the U.S. The database of 66 hospitals and clinic

located in every region of Taiwan were used to identify all patient seen in these

institutions between 1995 and 1998 with a diagnosis of diabetes mellitus. Between Mar 1,

1995 and Apr 30, 2002, trained interviewer administered the survey by telephone using a

structured questionnaire they made up to 3 attempts to research subjects before excluding

them from the study. The interviewers handed in the questionnaires every week, and all

returned questionnaires were checked for internal consistency by an assistant and then

checked again by chin-Hsiao Tseng the researcher. The information obtained during the

interview included demographic data; self reported height and weight; ethnic back

ground of both parents; history of lower extremity amputation; initial symptoms or

clinical events that led to the diagnosis of diabetes. Another interview was conducted

other than by the initial interviewer. The correlation coefficients for the 2 interviewer for

the continuous variables were 0.972, 0.904, 0.626 and 0.436 respectively. Percentage

agreement 91.7% and 97.7% respectively. Height was categorized in quartiles. Logistic

regression analysis were used to estimate the odds ratios.

Of the 128,572 randomly selected subjects 93,484 (72.7%) completed the

telephone survey. The age and sex distribution of the respondents was comparable to that

of the original cohort of the 256,036 patients.