There were 27,465 lower limb amputations related to Type 1 and Type 2 diabetes in England from 2015 to 2018, an increase of 18.3 percent from 2011 to 2014. There were hundreds more major amputations below the knee during the same period, analysis by Diabetes UK has revealed. People with Type 1 and Type 2 diabetes have a higher risk of developing foot issues because raised blood sugar can cause circulation problems. Unhealed ulcers and foot infections are the leading cause of diabetes-related amputations.
Foot ulcers and amputations are hugely costly for the NHS, with at least £1 in every £140 of NHS spending going towards foot care for people with diabetes.
But one in six hospitals does not have multi-disciplinary specialist foot care teams, Diabetes UK warns.
Dan Howarth, the charity’s head of care, said: “Ensuring that multidisciplinary specialist foot care teams are in every single hospital across the country will not only significantly improve outcomes for people with diabetes, it will also cut long-term costs to the NHS.
“The differences in the standard of treatment between areas is unacceptable.
“An amputation, regardless of whether it’s defined as minor or major, is devastating.
“A ‘minor’ amputation can still involve losing a whole foot.”
A sixth of the NHS hospitals budget is spent treating those with diabetes, which affects an estimated four million people in Britain, costing taxpayers £14billion a year. In 2018 hospitals spent £5.5billion caring for people with the condition, with some £3billion needed to treat diabetes complications such as kidney failure and sight loss.
Type 1 diabetes sufferer James O’Neil, 50, was told by doctors he had to lose a toe.
James, from Northampton, has suffered since the age of 12, but was active and used insulin. But he said: “Unfortunately this wasn’t going to last. At work one day a stone got in my shoe, but due to the lack of sensation in my feet I didn’t feel it rubbing against my toe.
“This resulted in a huge blister that turned into a foot ulcer.” He was told to give up work to heal his foot, but he loved his job and said he needed the cash.
James was due to turn 40 when he was told the toe had to be amputated.
Then after surgery he was diagnosed with the muscle-wasting disease Charcot-Marie-Tooth.
He said: “I had to give up my job and I was told that if the problems with my feet persist, I might have to have both legs amputated.”
No matter where you live, you should be able to access the care and treatments you need.
However, for diabetics this is not always a reality.
According to Diabetes UK, the number of diabetes-related lower limb amputations is rising and yet one in six hospitals still does not have multi-disciplinary specialist foot care teams (MDFT).
Diabetes foot care costs the NHS £1 in every £140 spent.
There is evidence that good access to MDFT is reducing amputations, cutting costs and bed-days.
NHS England needs to deliver on its Long Term Plan so that all hospitals provide access to the specialists.
In the meantime, diabetics should look out for reduced feeling in the feet or legs, changes in the skin colour and shape of feet or a cut/blister that they can’t feel. Speed is vital. A blister can turn into an amputation in less than a week if left untreated.
This is a devastating and life-changing event. Better quality care can help stop it.
Rachel Berrington is a senior diabetes nurse at University Hospitals of Leicester NHS Trust
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