Diabetes – Foot Care and Amputations

Posted By Moosa Duke - 6th March 2013

Thousands of diabetes patients end up having a foot amputation because of slow treatment warns Diabetes UK, a leading UK charity for people with diabetes.

Diabetes is one of the leading causes of amputation of the lower limbs throughout the world.  It affects approximately 3.7 million people in the UK. It is estimated that this will rise to 4 million by 2025. There are also thought to be a further 1 million people with undiagnosed diabetes. Patients are suffering because many areas do not have services in place to quickly deal with foot ulcers and infections.

Diabetes was discussed in Parliament in January 2013 and Ministers highlighted that it remains one of the largest challenges to our health care system today.  The work of NHS Diabetes was instrumental in monitoring variations in care.

People with diabetes may suffer all sorts of complications including reducing blood flow to vessels in the feet and nerve damage which reduces sensation. If a foot ulcer occurs, which is an open sore where there is poor blood supply, the ulcer is more likely to become infected. Unfortunately the infection further reduces blood supply which leads to gangrene. If this happens it may be necessary to amputate the affected limb to prevent the spread of infection and further damage.

50% of all amputations occur in people who have diabetes.

Last year an NHS report stated that the annual cost of diabetes-related amputations was £120m.Diabetes UK report that there are already 6,000 diabetes-related amputations a year and this is projected rise to 7,000 by 2015.  It believes that up to 80% of foot amputations could be avoided if better care was in place.  It recommends that all hospitals should have a multi-disciplinary footcare team as recommended in national guidelines.Figures suggest that 40% of hospitals currently do not have such teams in place.Every hospital also needs to be able to guarantee that people with urgent foot problems can be assessed by the right professionals within 24 hours. This is because ulcers can deteriorate extremely quickly and a matter of hours can make the difference between keeping a foot and losing it.

Barbara Young, Chief executive of Diabetes UK, said: “It is unacceptable that every single week people with diabetes who have treatable foot problems are having feet or toes amputated because they are not being treated quickly enough…If every hospital had a multi-disciplinary foot care team and ensured access to that team within 24 hours, then that would make a huge difference to the amputation rates.”

Recommendations that could dramatically reduce diabetes-related amputation rates were set out in a report, which Diabetes UK has produced with the Society for Chiropodists and Podiatrists and NHS Diabetes.Matthew Fitzpatrick, spokesman for the College of Podiatry, said they strongly welcomed the recommendations saying:

“The most important aspect is that patients appreciate how to check themselves and are seeking appropriate advice when they need it…If they’re worried then their local podiatrist should be the first port of call.”

The charity Diabetes UK is marking the new data on amputation rates with a national campaign – Putting Feet First – urging patients, the NHS and Ministers to take foot care seriously.

See the following link for the 15 essential checks and services a diabetic should receive: http://www.diabetes.org.uk/upload/About%20us/15%20measures%20checklist.pdf