New campaign to reduce epidemic of diabetes-related amputations

Australia’s diabetes experts gathered in Sydney this weekend to discuss bold new plans to dramatically reduce the number of diabetes-related amputations in Australian hospitals every year.

Diabetes Australia CEO Professor Greg Johnson said there were around 4,400 amputations performed in Australian hospitals every year - and up to 85 per cent of these could be prevented.

“The number of diabetes-related amputations of toes, feet and limbs is a national tragedy and we need to do more as a community to save limbs, to save lives and to save hospital budgets,” Professor Johnson said.

“Diabetes-related amputations cost the Australian health system around $875 million per year. On top of this, there is a huge personal cost to the individual and their family.”

“This is why we are calling on the Australian Government to implement a Diabetes Amputation Prevention Initiative to ensure systematic early detection of foot problems, and early treatment to prevent amputations.”

“We need to ensure people with diabetes understand what they need to do to look after their feet, make sure they can access specialised foot health teams when they need to, and ensure we set targets across the health system to reduce amputations and measure our progress.”

“We can end most diabetes-related amputations within a generation - but we need to act urgently.”

Professor Johnson said Diabetes Australia’s new hard hitting public awareness campaign would raise awareness about this critical issue.

“Most people in the community have no idea that diabetes causes so many amputations. We need to raise awareness within the community and with key political leaders about the scale of the problem, its impact and what we need to do to fix it,” he said.

“The new campaign features the stories of Paul Walker and Ida Ratiner, two people who have lived with type 2 diabetes for many years and have narrowly avoided having limbs amputated thanks to innovative treatment”.

“Every year thousands of Australians are not so lucky and have to undergo traumatic and debilitating amputations. The sad truth is that health outcomes for people undergoing major amputations are poor. Many people will die in the first five years after a major amputation.”

The National Association of Diabetes Centres representative, Professor Stephen Twigg, said the Association plans to roll out an accreditation program to ensure diabetes high risk foot services meet national standards of care for treating diabetes foot ulcers.

“Evidence shows people receive the best outcomes when they have access to a diabetes high risk foot care team in a service that includes an experienced doctor, podiatrist, nurse and, commonly, vascular and orthopaedic specialists, all working together to support the person with diabetes,” Professor Twigg said.

“At present, only some of the 120 diabetes centres and similar sites in Australia, have the interactive team of health professionals required to meet practice standards to manage foot ulcers in people with diabetes."

“We need to increase the number of diabetes high risk foot care services across Australia. Currently it is estimated that there is about one service for every one million Australians. I think we need to lift that to about one service for every one hundred thousand Australians."

“Australia lags behind a number of international health systems including the UK, Belgium and Germany where they have successfully reduced the number of major, or above the ankle, amputations, and have made team-based quality foot ulcer care more accessible across their countries.”

Leading endovascular surgeon A/Professor Ramon Varcoe from the Prince of Wales Hospital, who specialises in revascularisation (getting the blood flow back into limbs) said it was far more cost-effective to save limbs than amputate them.

“It costs the hospital system around $500,000 to amputate a leg and this doesn’t take into account the loss of productivity, carer costs, costs of prosthetic limbs and all the other costs. It also doesn’t include the dramatic impact on the quality of life of individuals,” Dr Varcoe said.

“Every limb we save is going to change the life of an individual, their family and their community and that can't be underestimated."

“Given the costs of amputations the solution isn’t a massive funding increase, it’s about changing the way we do things to help save people’s limbs.”

Ida Ratiner, of Bondi Junction, faced the grim prospect of losing her leg until a chance encounter with a GP led to seeking a second opinion from Dr Varcoe. “Nobody could help me and then I met Dr Varcoe. He gave me my life back.”

Diabetes NSW & ACT CEO Sturt Eastwood said the number of amputations in NSW was forecast to increase over the decade ahead.

“Last there were 1,315 diabetes related amputations in NSW and it’s projected that over the next 10 years, 330,000 people in NSW will require hospitalisation for diabetes related foot infections, ulcers or amputations,” Mr Eastwood said.

“The cost to the NSW community will be almost $3 billion. So we are urging people to help us spread the word about the seriousness of diabetes, and the complications, such as amputations, that are associated with it.”

“Too many people are missing out on vital health checks because they don’t understand what they need to do to look after their feet. This includes learning how to check their feet and making regular appointments with their diabetes healthcare team including their GP, diabetes educator and podiatrist."

The campaign is supported by Abbott Vascular and Ascent Footwear.