Putting Feet First Aims to Reduce Diabetic Foot Amputations

UK charity aims to lower rising numbers of diabetic foot amputations. A new initiative called ‘Putting Feet First’ aims to slash the numbers of amputations carried out on diabetics by a half over the next five years.

Sam Wright, 56, from Conlig, Northern Ireland is one of a growing number of diabetics in the United Kingdom who have lost limbs to amputation.

Diagnosed with type 2 diabetes more than 10 years ago, Wright admits that he didn’t immediately take care of his condition until December 2008, when he began to experience problems with his left foot.

“In March 2009, my life changed forever,” he tells BBC News. “This is when my left leg was amputated, just below the knee, at the Royal Victoria Hospital, Belfast.

“All this could possibly have been avoided if I had seen a podiatrist on a regular basis,” he laments. “Instead I left it until hard skin developed on my left heel. This skin then cracked and eventually ulcerated.

“I went to the local doctors on Monday morning — by Monday afternoon I was admitted to hospital and I was operated on that evening to try and save my foot, he recalls. “This was unsuccessful and the following Wednesday my leg was amputated.”

Alarmed over the increase in the numbers of diabetes-related foot amputation across the UK, the national charity Diabetes UK has launched a campaign to raise awareness of foot care and other ways to ameliorate ailments related to diabetes.

In the UK, around 5,000 diabetes-related amputations are carried out each year — but experts argue that a whopping 80 percent of these could have been avoidable if better healthcare had been provided to patients and if they had been taught to manage their condition.

An Amputation significantly lowers a person’s quality of life and increases the risk of dying within the next few years. Noting this, Barbara Young, chief executive of Diabetes UK, has called for more action.

The new initiative launched — called ‘Putting Feet First’ — aims to slash the numbers of amputations carried out on diabetics by a half over the next five years.

Rising number of diabetics
Insulin is a hormone in the human body that regulates blood sugar, and diabetes occurs when the pancreas doesn’t produce enough insulin or when the body can’t effectively use the insulin it produces. Hyperglycemia — or raised blood sugar — is a common effect of uncontrolled diabetes that, over time, damages many of the body’s systems — especially the nerves and blood vessels.

Worldwide, 346 million people have diabetes, with 80 percent of diabetes deaths occurring in low- and middle-income countries, the World Health Organization says, projecting that these deaths will double between 2005 and 2030.

High blood sugar levels cause damage to the nerves — diabetic neuropathy — and this affects up to half of people with diabetes. Tingling, pain, numbness, or weakness in the feet and hands are common signs. Diabetic foot problems arise from reduced circulation to, and damaged nerve endings in, the feet.

The new campaign aims to teach diabetics how to look after their feet. “A single preventable amputation is one too many so the fact that hundreds of people in Northern Ireland have endured unnecessary foot amputations is nothing short of shameful,” says Iain Foster from Diabetes UK in Northern Ireland.

“Many people with diabetes aren’t even aware that amputation is a potential complication, he points out. “We also need to make sure that people with diabetes understand what health care they should be getting.”

“Foot ulcers can deteriorate in a matter of hours,” Foster warns, “so failing to refer someone quickly enough can literally be the difference between losing a foot and keeping it.”

To increase awareness of the signs of early foot problems, as well as the need for a quick and timely referral to specialist staff, the UK charity will work with doctors’ practices and hospitals.

As Baroness Young points out, annual foot checks “are important for identifying problems at an early stage, but many thousands of people aren’t getting them. And when they are being done, they are sometimes insufficiently thorough.”

To lower the rates of amputations that could have been prevented in the first place, Diabetes UK advises all diabetes patients to:
• Manage their levels of blood sugar, cholesterol and blood pressure properly
• Check their feet on a regular basis
• Be aware of the level of healthcare they should expect