BBC News, for March 28,2006, reports on a Wolverhampton (UK) study that found not enough was being done for diabetics at high risk of amputation. People are losing limbs, they report, when good intervention might have saved the limb. People with diabetes are at 15 times greater risk of lower limb amputation than the general public, according to the study.
Amputation brings irrevocable consequences, and diminished quality of life. British data (from Diabetes UK) show up to 70 percent of people die within five years of an amputation. You don’t want to go there—unless you have to.
What puts a diabetic at high risk? A history of foot ulcers, nerve damage (neuropathy), circulatory damage and foot deformities (like charcot foot) can set up need for an amputation.
The study showed more than 90 percent of diabetic amputees had been considered as high risk, in the period leading up to their procedure.
But, the study found, more than a quarter of those considered “at high risk for amputation” are not being offered any specialist care. Two out of five are not being educated on how to prevent or treat infections that could lead to the need for amputation. Over one third of the patients surveyed, all of them considered at high risk for amputation from complications of diabetes, had no kind of diabetes review, no assessment of how well they were self-managing their diabetes, that might have helped ensure they did not develop dangerous complications.
Douglas Smallwood, chief executive at Diabetes UK, stated: “It is shocking some people with diabetes are getting substandard foot care, or none at all, if they are at high risk of amputation.
“We know the rate of amputation may be reduced 40 percent or more, through effective foot care. All people with diabetes should receive at least a yearly foot check. Those who have problems need to be provided with a foot care plan that incorporates specialist care and education on what to look out for, and how to avoid infections.”
So what should you do? For a start, when you go to see the doctor, take your shoes off, and ask him or her to take a look at your feet. Do it often. And when you think there is trouble, seek medical help immediately! Let’s keep our feet, folks!