As many as 3,600 diabetes-related amputations that occur in Australia are "entirely preventable" and result from inadequate monitoring of the disease, according to new analysis by medical experts.
A national diabetes conference has been told that around 85 per cent of harrowing amputations could be avoided each year if more was done at a national level to prevent risk factors, monitor those at risk and respond to diabetes nerve and circulation damage that affects the legs and feet.
"Monitoring individuals at increased risk is crucial so early ulcer detection and treatment can occur – translating to reduced amputations," said Associate Professor Paul Wraight who heads the Diabetic Foot Unit at The Royal Melbourne Hospital.
Australia has one of the highest rates of lower limb amputations in the developed world with around 85 diabetes sufferers having a foot or part of their leg removed each week.
"Feet are often the forgotten complication of diabetes. Unlike kidney disease and cardiovascular disease, there aren’t national networks and protocols established to oversee individuals with diabetes related foot complications," A/Prof Wraight said.
Assoc. Prof Wraight believes a hospital and community-based care program focused on diabetic foot health, involving GPs, specialists, nurses and allied health professionals, may hold the key to reducing lower limb amputation among people with diabetes.
The introduction of a multidisciplinary foot care program at The Royal Melbourne Hospital has seen the number of individuals with diabetes having their feet examined rise from 35 to 100 per cent. "Amputation rates dropped immediately following the introduction of the program, with amputation rates down 60% by the end of the first year," said Assoc. Prof Wraight.
"We are working to roll-out this model of care to other hospitals around the country, but increased funding is desperately needed," he said.
"It’s a simple proposition – ignore the feet and diabetes will continue to be the leading cause of lower limb amputation. By focusing on the feet of individuals with diabetes thousands of amputations can be prevented."
Peter Lazzarini, who is a Senior Research Fellow at the Queensland University of Technology, explained that "it wasn’t until the last few years when we began to analyse the data against world standards that we realised there was a real problem with the number of amputations".
Global data indicates that men have lower limbs removed at twice the rate of women. Men are also more likely to develop nerve and circulation problems at a younger age and that these diabetes related conditions can then progress more rapidly to amputation. 2