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Call for an end to "national disgrace" of diabetes-related amputations

Diabetes UK has today launched a campaign to bring an end to the "national disgrace" of thousands of preventable amputations in people with diabetes, as new research has once again highlighted the unacceptably poor levels of foot care for people with the condition.

The Putting Feet First campaign, launched at the Diabetes UK Professional Conference 2012 in Glasgow, highlights the fact that people with diabetes are over 20 times more likely to have a lower limb amputation. About 80 per cent of the 6,000 diabetes-related amputations in England every year are preventable.

Reduce amputations by 50 per cent

By demanding an end to the postcode lottery of NHS foot care, we aim to reduce diabetes-related amputations by 50 per cent within five years.

A new study presented at today’s conference suggests that an unacceptably high number of hospitals are failing to comply with National Institute for Health and Clinical Excellence guidance on when to refer patients to specialist foot care. Meanwhile, a separate study at University Hospitals Birmingham NHS Foundation Trust has found that fewer than half of patients admitted with emergency diabetes-related foot problems had the blood supply to their feet assessed, whilst little more than a quarter were assessed for nerve damage.

Huge variation

A further study, published in the journalDiabetologia, found that people with diabetes are 20 times more likely to undergo an amputation. By comparing figures from Primary Care Trusts across England, the researchers also found a huge variation in the rates of amputation. The figures revealed a tenfold difference in amputation rates, from two amputations in every 10,000 people with diabetes, to 22 in every 10,000.

In light of the findings, William Jeffcoate, one of the chief researchers on the report, called for a more integrated approach to foot care. He said, "Foot disease is very complicated and a single professional hasn't necessarily got the skills to manage every aspect of it.

"And that's why I believe that only if you can gather a multi-disciplinary team and make sure that people have rapid access to assessment by such a team, it's only in that way that we think you can provide the best service."

Putting Feet First

We hope that this new research will highlight the importance of healthcare professionals supporting the Putting Feet First campaign by making sure they understand the foot care people with diabetes should be getting, and the potentially devastating consequences of this not happening. We want everyone with diabetes to get a thorough annual foot check, and foot ulcers in people with the condition to be referred to specialist diabetes foot care teams within 24 hours.

And as well as demanding better NHS foot care, we are trying to raise awareness of the issue so that people with diabetes understand how important it is that they look after their feet, and know that they should be checking them regularly.

"National disgrace"

Barbara Young, Chief Executive at Diabetes UK, said, "A single preventable amputation is one too many and so the fact that thousands of people in the UK are enduring unnecessary foot amputations is nothing short of a national disgrace.

"A big part of bringing this to an end is giving people with diabetes information about how to look after their feet, as many of them are not even aware that amputation is a potential complication. But we also need to make sure they understand what healthcare they should be getting.

"The difference between losing a foot and keeping it"

"The sad fact is that there are large parts of the country where diabetes foot care is not good enough, and the two studies presented at our conference today highlight yet more examples of people not getting the care they deserve. Quality of care makes a big difference to amputation rates. Foot ulcers can deteriorate in a matter of hours, so failing to refer someone quickly enough can literally be the difference between losing a foot and keeping it.

"Amputations have a devastating effect on quality of life and so every amputation that results from poor healthcare is a tragedy. Put together, these add up to a scandal that is one of the reasons that life expectancy for someone with diabetes is significantly shorter than for the general population. It is a scandal that needs to be brought to an end."

Barbara has also written for the BBC, explaining why Putting Feet First is so important.Read the piece on the BBC website.

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