New analysis by Diabetes UK has revealed that the number of diabetes-related amputations in England has now reached an all-time high of 20 a day.The figures, calculated using new Public Health England data (1), show that the annual number of diabetes-related amputations in England is now 7,370 a year, compared to the previous figure of 7,042. Yet, with good diabetes healthcare and support, experts estimate that four out of five amputations could be prevented as 80 per cent begin as foot ulcers, which are largely avoidable and far more treatable if found early.The figures show that despite welcome action in some areas of the country on preventing diabetes -related amputations, the overall rate has stayed the same. And because of the sharp increase in the number of people with diabetes in the past 20 years, the number of diabetes-related amputations is continuing to rise. Diabetic foot disease remains the most common cause of hospital admission associated with the condition.While there is some good news that the major amputation rate (classed as amputations above the ankle) has decreased slightly since Diabetes UK launched the Putting Feet First campaign in 2012 (2), the charity is alarmed that the variation rates between the best and the worst performing areas continue to widen. Those areas more successful in tackling diabetes-related amputation continue to lower their rates, whereas the rate for the worst performing has not dropped in the last year.Diabetes UK is calling on the Government and the NHS to do more to tackle the devastating and life-changing problem of diabetes-related amputation by improving diabetes footcare. The charity wants to see targeted action to improve the worst performing areas where rates are worsening or failing to improve.It is vital that everyone with diabetes has access to trained healthcare professionals, footcare protection teams and multidisciplinary footcare teams to make sure problems are identified and treated early and urgently. It is particularly important that if anyone with diabetes has a foot infection or new ulcer they get urgent attention from a team of specialists as evidence shows the longer the delay before seeing a specialist team, the more likely it is that foot ulcers will be severe and slow to heal, leading to a greater risk of amputation.Chris Askew, Chief Executive of Diabetes UK, said: “The fact that the total number of amputations is continuing to rise is a huge concern. We know the devastating impact they have on people’s lives as well as the huge cost to the NHS, yet we are not seeing action happening quickly enough across all areas of the country to address this.“We have seen some areas making real efforts to improve the poor state of diabetes footcare, but these figures are a stark reminder that there is still so much more to be done, especially with regard to significant variation from GP practices and between different health areas. It’s a travesty that good quality foot care is a postcode lottery. People need to be getting the right care in the right place at the right time now.”Chris Brown, 64, from Bristol, has lost both legs below the knee due to his diabetes, the first in May 2009 and the second in December 2015. He now says even the most basic tasks can leave him struggling.“As I have no feeling at all in my lower legs it can be tough to even work out when I’m upright and properly balanced. I fall regularly and things that I used to do without thinking will take forever to accomplish.“I used to be a voracious reader but now I struggle to concentrate in the way I used to. I moved to a bungalow after my second amputation and while it does make my life significantly easier in many ways it also means I am seven miles away from town and it has made it harder for me to see friends and family. I don’t want anyone to underestimate how life-changing amputations are and how it will impact on your life in ways you can’t even imagine.”
