Significant variation in incidence of foot amputations

This study finds an 8-fold difference across PCTs, in incidence of foot amputations for people with and without diabetes

A study in Diabetologia looked at the incidence of amputations in adults with and without diabetes, in the 151 Primary Care Trusts (PCTs) in England. They found that the incidence of amputation varied 8-fold across PCTs in people both with diabetes and without. Amputations varied 10-fold in people with diabetes.

 “If the observed variation between PCTs in the incidence of amputation does reflect differences in the local structures of care including the varying involvement and/or organisationof an expert multidisciplinary team in the management of limb-threatening disease, this has major implications for planning foot care services for people with or without diabetes, both in England and in other countries. Every person with lower limb disease should have access to the same clinical expertise, and inclusion of all the necessary skills inevitably means multidisciplinary team work. For people with diabetes the need for multidisciplinary teams to be established throughout the country has been emphasised in the UK via the Putting Feet First report and the updated version of the National Minimum Skills Framework  recently published by Diabetes UK and NHS Diabetes, as well as the 2011 guidelines on the management of established foot disease in hospitals published by the National Institute for Health and Clinical Excellence. This study supports the hope that universal implementation of such structures will lead to a reduction in the current substantial level of geographical variation in the incidence of amputation, with a resultant reduction in the incidence overall.”

See full text of article: Variation in the recorded incidence of amputation of the lower limb in England. N. Holman, R. J. Young, W. J. Jeffcoate. Diabetologia DOI 10.1007/s00125-012-2468-6 (6th March, 2012).

See also: Call for an end to “national disgrace” of diabetes-related amputations. Diabetes UK, 7th March.  

The Putting Feet First campaign, launched at the Diabetes UK Professional Conference 2012 in Glasgow, highlights the fact that people with diabetes are over 20 times more likely to have a lower limb amputation. About 80 per cent of the 6,000 diabetes-related amputations in England every year are preventable.”