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Diabetics run a high risk of amputations
TOO many diabetics in Swindon are undergoing avoidable amputations, a charity has warned after it emerged 111 patients lost a limb over the last three years.
According to figures released by Diabetes UK, 3.6 per 1,000 people with diabetes each year had a lower limb amputation between 2010 and 2013. This was well above the national average of 2.6 per 1,000 per year.
This represented 111 amputations, of which 18 were major – above the ankle – and 93 considered minor or from the ankle down.
Swindon’s Clinical Commissioning Group, the body which buys health in the town, recently introduced a new vascular procedure to restore blood flow to people’s legs and feet and prevent amputation. So far it has helped to avoid three amputations in Swindon.
There have also been improvements in the number of patients undergoing major amputations which dropped from 1.2 per 1,000 adults with diabetes between 2009 to 2012, to 0.6 in 2010 to 2013. This meant that Swindon went from having one of the highest major amputation rates in the South West, to one of the lowest.
Yet they remained much too high, according to diabetes campaigner Stephen MacMahon, of Eldene.
“Nearly all amputations are avoidable if you have the proper care, and the cost of an amputation for social services and the person and the family is massive.
“The vascular procedure is delivered by a vascular team from Gloucester. They can now save a limb by putting a bypass in it to reinstate blood flow and stop amputations.
“But it should have been practiced here all along. It’s looking more hopeful now. But we have a long way to go.”
Diabetes complications include nerve damage and poor blood circulation. These problems make the feet vulnerable to skin sores that can worsen quickly and are difficult to treat. A non-healing ulcer that causes severe damage to tissues and bone may lead to a toe, foot or leg amputation.
Stephen, whose wife Helen was diagnosed with Type 2 diabetes in 2002, added: “It’s about educating patients on how to help themselves, but also medical staff.
“But often GPs just ask patients how their feet are but don’t check them. It just slips through. With neuropathy, patients have a lack of sensation and it affects their feet. They could have infections or wounds in their feet and not feel anything. And that could lead to amputation.”
Evidence shows up to 80 per cent of diabetes-related amputations could be prevented across the country. And Diabetes UK is concerned that some people with diabetes in Swindon are still not getting the footcare they need, putting them at risk of amputations.
Diabetes UK South West regional manager Phaedra Perry said: “While we are pleased to see some progress in Swindon in reducing the number of people undergoing major amputations, we want to see more action to bring the rate down further.
“We’ve seen podiatry numbers increased from a woeful two to 6.8 this year which is a great improvement. However at the moment there is only a monthly clinic for reviewing those considered at high risk of a foot problem, risking delays to treatment. What we now need is more decisive action to drive down amputation rates further.”
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