Health monitoring data from Tiruchy district in Tamil Nadu recorded 1,732 amputations among people with diabetes aged between 40 and 70 during the three years ending August 15, 2026.
The procedures ranged from the removal of a toe or part of the foot to amputation of the leg, according to a report by The New Indian Express.
The figures demonstrate the continuing burden of diabetic foot complications and the importance of connecting screening with wound care, vascular assessment, offloading, limb-salvage surgery and rehabilitation.
They also require careful interpretation. A toe amputation, partial-foot amputation and major lower-limb amputation have very different clinical and rehabilitation consequences. The published data do not provide a breakdown by amputation level, distinguish first amputations from repeat procedures or establish how many individual patients underwent the 1,732 recorded amputations.
Screening through Tamil Nadu’s foot-care programme
The data were compiled through Padham Padhukappom Thittam, Tamil Nadu’s integrated diabetic foot-care programme.
Health workers operating through the primary healthcare network examine people with diabetes for ulcers, loss of protective sensation and other warning signs. Patients requiring further treatment can then be referred for specialist care.
The programme was established to detect diabetic neuropathy and blood-vessel obstruction earlier, prevent ulceration and reduce avoidable limb loss.
Tamil Nadu issued the programme’s government order in October 2024. The state allocated ₹26.62 crore to establish foot-screening services across 2,336 primary health centres, 299 government hospitals and 36 medical college hospitals.
The model covers ulcer prevention, wound management, surgery and rehabilitation. It was developed following a pilot programme in Thanjavur, where more than 1.65 lakh people with diabetes reportedly received foot examinations. Read the Tamil Nadu government announcement.
What the Tiruchy data show
The newspaper reported that 3,74,070 patients—including people with hypertension and diabetes—were listed under the programme in Tiruchy during the three-year period.
Recorded findings and interventions included:
- 1,263 cases of callosity
- 245 minor ulcers
- 432 major ulcers
- 240 people identified as having an at-risk foot or neuropathy
- 137 surgical-offloading procedures
- Four recorded limb-salvage cases
- 44 cases classified as unsalvageable
- 1,732 amputations of different levels
The report also states that 1,062 people were screened for established foot ulcers or skin manifestations. A separate figure says that 2,122 patients with established ulcers or skin manifestations were identified and referred using Ayushman Bharat Health Account identification.
The relationship between these two figures is not explained. Further information is therefore needed before using the data to calculate screening coverage, ulcer prevalence, amputation rates or programme outcomes.
The figures nevertheless indicate that a significant number of people are reaching services with established tissue damage, infection or other advanced complications.
A Health Department official explained that doctors seek to preserve as much of the foot as possible. Where infection or dead tissue is severe, removing the affected area may be necessary to prevent progression and protect the patient’s life.
Screening must lead to timely treatment
Identifying an at-risk foot is only the beginning of an effective prevention pathway.
A person found to have neuropathy, callus, deformity, ulceration or impaired circulation may require several different interventions. These can include diabetes management, patient education, regular foot inspection, callus management, suitable footwear, pressure redistribution, wound offloading, infection control and vascular investigation.
Clear referral thresholds are particularly important. A wound accompanied by spreading infection, gangrene, rest pain, reduced circulation or systemic illness requires urgent medical assessment.
Screening programmes should therefore be evaluated not only by how many feet are examined but also by:
- The proportion of identified patients who complete referral
- Time between screening and specialist assessment
- Ulcer-healing rates
- Recurrence and re-ulceration rates
- Major and minor amputation rates
- Time to provision of footwear, orthoses or prostheses
- Patient mobility and participation after treatment
- Availability of follow-up close to the patient’s home
Without effective referral and treatment capacity, screening may document risk without changing its outcome.
A role for orthotic and pedorthic intervention
Orthotists, prosthetists and professionals working in therapeutic footwear can contribute at several stages of the diabetic foot pathway.
For a person with loss of protective sensation but no active ulcer, intervention may include appropriately selected footwear, accommodative insoles and pressure redistribution. The objective is to reduce repetitive stress at vulnerable areas while accommodating deformity and avoiding harmful seams or points of compression.
Active ulcers may require specialised offloading selected as part of a coordinated wound-care plan. The device must be appropriate for the ulcer location, infection status, circulation, balance and the person’s ability to use it safely.
Following a toe or partial-foot amputation, patients may need footwear modification, a toe filler, a custom foot orthosis or a partial-foot prosthesis. The design should account for altered loading, reduced lever-arm function, balance and the risk of further tissue breakdown.
These interventions require continuing review. A person with neuropathy may not feel excessive pressure or early skin damage, making visual inspection and scheduled follow-up essential.
Rehabilitation after major amputation
When limb salvage is no longer possible, a coordinated transition into rehabilitation should begin as early as medically appropriate.
Care may include residual-limb management, positioning, strengthening, contracture prevention, mobility training, psychological support and assessment for a prosthesis. The opposite limb also requires close protection because it may be exposed to the same neuropathic and vascular risks.
For prosthetic candidates, socket design must consider skin integrity, circulation, sensation, residual-limb shape, strength and expected activity. Diabetes-related amputation frequently involves more complex medical considerations than traumatic limb loss.
Patients who are not immediate prosthetic candidates still require appropriate mobility support, pressure care and a plan for reassessment.
Limited insurance coverage reported
Of the 2,122 patients identified and referred with established ulcers or skin manifestations, only 43 reportedly had recorded insurance coverage. Sixteen were covered under the Chief Minister’s Comprehensive Health Insurance Scheme and 27 through private insurance.
Based on the published figures, this represents approximately 2% of the referred group. However, the report does not explain whether the remaining patients received publicly funded treatment through other routes or whether insurance information was incomplete.
The finding nevertheless raises questions about how wound care, vascular procedures, offloading devices, therapeutic footwear and post-amputation rehabilitation are financed.
Turning data into prevention
Tamil Nadu’s decision to establish a statewide diabetic foot-care pathway is an important public-health intervention. The Tiruchy figures show why the programme is needed, but future reporting should separate minor from major amputations, identify repeat procedures and publish outcomes against a clearly defined diabetic population.
For India’s P&O community, the priority is to ensure that orthotic, pedorthic and prosthetic services are integrated into the pathway—not introduced only after an amputation has occurred.
Effective diabetic foot care should begin with prevention, provide rapid escalation when a wound develops and continue through rehabilitation when limb loss cannot be avoided.
- The New Indian Express: 1,732 Foot Amputations Recorded in Tiruchy
- National Health Mission Tamil Nadu: Padham Padhukappom Thittam
- Tamil Nadu Government Announcement on Diabetic Foot-Care Clinics
- Tamil Nadu National Programme for Prevention and Control of Non-Communicable Diseases