Diabetes Care in the UK

Two media stories have caught my attention his week concerning diabetes care in the UK.

Earlier this week it was reported on the BBC website that Diabetes UK had stated 80% of foot amputations could be prevented if better care was in place. By 2015 the number of diabetes related amputations is expected to rise to 7,000 per year.

Both type 1 and type 2 diabetes, if poorly controlled, can cause complications such as reducing the blood flow to the vessels in the feet, and nerve damage which affects sensation.

The Society for Chiropodists and Podiatrists and NHS Diabetes recommend that all hospitals have a multi-disciplinary foot care team as stated in the national guidelines. Figures suggest 40% of hospitals do not have such teams in place.

The second story was on the radio reporting that of the NHS bill for diabetes care, which is around £9bn, 80% is from hospital care treating complications that could have been prevented. The argument is for more action at the primary and earlier hospital intervention.

This appears born out by the report of Diabetes UK.

Barbara Young, Chief Executive of Diabetes UK, said it was unacceptable that every week people with diabetes, who have treatable foot problems are having feet or toes amputated because they are not being treated quickly enough. She added that some prevention work was so poor people were not even asked to take their shoes off when attending their annual foot check.

“ fact, putting these kinds of systems in place can actually save money because of the amputations that they prevent are so expensive.” (BBC news website 23/2/13)

The cost of the failure to prevent these amputations is also reflected in the increased care bill for those who have suffered an amputation and need additional aids and assistance. The cost of this failure is therefore probably much higher. As budgets get tightened there is some question as to whether the appropriate care will be provided.

If the complication can be avoided, as often as possible, then so will the additional cost.