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Diabetes and Footcare Services: What do You Think? calls for improvements in patient education and the development of a multidisciplinary footcare team (MDT) to care for those with urgent problems.

The new report, based on a survey and meetings with people living with the condition, is written by Diabetes UK and the county’s podiatry team from Gloucestershire Care Services.

Around 125 amputations are carried out in the UK every week on people with diabetes because of complications connected with diabetes. Up to 80 per cent of these are preventable. Diabetes UK’s Putting Feet First campaign was launched in 2012 to improve the quality of footcare and reduce the number of diabetes-related amputations across the country.

Diabetes and Footcare Services: What do You Think? found that more than eight out of ten people with diabetes received an annual foot check, which is an important part of footcare for people with diabetes.

But importantly the report also found that many people are unaware of how to prevent foot problems through a lack of proper education on the subject.

The report has made four recommendations to improve services for patients in the area:

  • The development of a MDT in Gloucestershire
  • Improvement of education and training on managing and screening foot complications for staff working in primary care
  • More involvement of people with diabetes in their own care
  • Establishment of a community based foot protection team

One of the reasons for the high levels of preventable amputations is that diabetic foot problems can deteriorate very quickly and this is why people with diabetes who have foot or leg ulcers should be referred to a MDT within 24 hours. MDT are specialist clinics where different clinicians such as podiatrists, doctors and surgeons work together. There is evidence that MDTs are effective at preventing diabetic amputations and they can also save the NHS money because amputations are so expensive to treat.

Hospitals are recommended to have MDTs for patients with diabetes by the National Institute for Health and Clinical Excellence. According to Diabetes UK, having these teams in place to ensure quick referral can help reduce the amputation rate in people with diabetes, which is more than 20 times higher than in people without the condition.

Diabetes UK South West Regional Manager, Graham Cooper, said: “We know that good footcare for people with diabetes is vitally important to prevent devastating complications such as amputations.  We hope that our recommendations are carefully considered and taken on board by the local health organisations.  In particular, we need to see that people with diabetes have access to a specialist MDT within 24 hours of referral at a hospital. Having these teams in hospitals can help reduce the amputation rate in people with diabetes, which is more than 20 times higher than in people without the condition. Diabetes UK would like local commissioners and providers to work together to implement an MDT. We will continue to campaign to get the best services for the more than 37,000 people affected by diabetes in Gloucestershire.”

Alex Harrington, Clinical Lead Podiatrist with Gloucestershire Care Services and a member of the South West NHS Diabetes Footcare Network, said: “It is fantastic that so many people came along to the consultation events and took the time to fill in the questionnaires which fed into this report.  It is really important that we listen to those who were involved, and provide early intervention and prevention which can help improve the outcomes for people with diabetes. It encourages people to be involved in their own care and equipped for self-management in the years to come. I hope that we can work together as a health community – continuing to work across different organisations to develop and improve services – to take forward the recommendations from the report and improve the health outcomes for people with diabetes in Gloucestershire”.

Gloucestershire Clinical Commissioning Group lead for Diabetes, Dr Jeremy Welch said: “We welcome the report’s publication and look forward to discussing the key themes in detail with local diabetes leads. This, along with the outcome of the footcare review, will be used to inform and shape future developments.”

Notes to editor:

1 Diabetes UK is the leading UK charity that cares for, connects with and campaigns on behalf of all people affected by and at risk of diabetes.  For more information on all aspects of diabetes and access to Diabetes UK activities and services, visit www.diabetes.org.uk
2 In the UK, there are around 3.7 million people who have diabetes.  There are 2.9 million people living with Type 1 and Type 2 diabetes, and around 850,000 more who have Type 2 diabetes but don’t know they have it because they haven’t been diagnosed.  As many as 7 million people are at high risk of developing Type 2 diabetes and if current trends continue, an estimated 5 million people will have diabetes by 2025.
3 Diabetes is a condition where there is too much glucose in the blood because the body cannot use it properly.   If not managed well, both Type 1 and Type 2 diabetes can lead to devastating complications.  Diabetes is the leading cause of blindness in people of working age in the UK and is a major cause of lower limb amputation, kidney failure and stroke.
4 People with Type 1 diabetes cannot produce insulin.  About 10 per cent of people with diabetes have Type 1.   No one knows exactly what causes it, but it’s not to do with being overweight and it isn’t currently preventable.  It usually affects children or young adults, starting suddenly and getting worse quickly.  Type 1 diabetes is treated by daily insulin doses – taken either by injections or via an insulin pump – a healthy diet and regular physical activity.
5 People with Type 2 diabetes don’t produce enough insulin or the insulin they produce doesn’t work properly (known as insulin resistance).  85 to 90 per cent of people with diabetes have Type 2.  They might get Type 2 diabetes because of their family history, age and ethnic background puts them at increased risk.  They are also more likely to get Type 2 diabetes if they are overweight.  It starts gradually, usually later in life, and it can be years before they realise they have it. Type 2 diabetes is treated with a healthy diet and increased physical activity.  In addition, tablets and/or insulin can be required. 

6 For more information on reporting on diabetes, download our journalists’ guide: www.diabetes.org.uk/journalists-guide