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NHS Medical Directorate Diabetic foot disease Preventing loss of life and limb Dr Rowan Hillson MBE National Clinical Director for Diabetes
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Diabetic foot diseasePreventing loss of life and limb
Dr Rowan Hillson MBE
National Clinical Director
for Diabetes
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Diabetes in England (diagnosed)
2.2 million people with diabetes (1.3 million in 2003)
(Retinal screening programme, 2009)
4.8% adults (QOF 2008)
2.5 million UK
Everyone with diabetes deserves
the highest standards of
personalised diabetes care,
no matter where, when or
by whom they are cared for.
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Why do people with diabetes get foot trouble?
• Neuropathy - nerve damage 20 – 40% of people with diabetes
• Peripheral vascular disease - circulation damage 20 – 40%
• Ligament and joint problems – deformity
• High glucose – infection
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Foot ulcers in diabetes
Following pressure or injury
Ball of foot in neuropathy. Pressure sores if immobile or in bed
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Gangrene
Poor circulation
After injury
With infection
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Multiple foot problems. Infection. Recurrence
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Amputation
100+ major amputations
a week (Diabetes UK)
Half those who have a
major amputation die
in the next 5 years (Robbins 2008)
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Prevention
Most diabetic foot problems could have
been prevented
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tePreventionTeach people with diabetes to look after their feetHealthcare professionals must check feet
Process
NDA (1.4 m people)
2003 - 04 2007 - 08
HbA1c 68 91
Cholesterol 65 90
Smoking history noted 63 86
Foot exam 29 77
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Prompt, proper treatment
