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Warning that diabetic lower limb amputations continue to rise

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New data has revealed that the number of major lower limb amputations for patients with diabetes is continuing to rise as the condition becomes more prevalent. 

Public Health England’s National Cardiovascular Intelligence Network has published findings from the Diabetes Foot Care Profiles, which show the number of amputations above the ankle have increased.

“It’s a tragedy that so many people are unnecessarily having to face the life-changing consequences of diabetes”

Jennifer Smith

According to the data, 7,545 major amputations were carried out between 2015 to 2018, in comparison to 6,957 from 2012 to 2015.

PHE has made clear that the rate of amputations among diabetics has not increased significantly, but rather amputations are on the up because more people have diabetes. 

In addition, it was also found that during the three-year period of 2015 to 2018, patients from England had 147,067 hospitals for diabetic foot disease and that the average length of stay was eight days.

It was found that the total number of days spent in hospital for this, accumulated to 1,826,734 days, said PHE.

Meanwhile, the data also showed 85,837 individual patients were admitted for foot disease and a third of these had more than one stay during the three years.

Overall, it was found that the rate of major amputations was greatest among men. More specifically, the data showed that while the risk of diabetes was higher in some ethnic groups, especially South Asian, the rate of major amputations caused by diabetes was greatest in white males.

PHE highlighted that the findings showed there was a significant variation in the risk of amputation across the country.

Dr Jenifer Smith, programme director at PHE for the NHS Diabetes Prevention Programme, said: “It’s a tragedy that so many people are unnecessarily having to face the life-changing consequences of diabetes, such as amputations.

“Survival rates and quality of life for people following such major surgery can often be poor,” she said. “This shouldn’t be happening when the condition is preventable.”

“It’s important that those providing the service need to work closely with their local public health teams who know their community”

Jennifer Smith

As part of a drive to help reach more people at high risk of developing type 2 diabetes, the NHS Long Term Plan included a commitment to double the NHS Diabetes Prevention Programme over the next five years.

PHE explained that the programme, which it delivers jointly with NHS England and Diabetes UK, will support 200,000 people each year to reduce their risk of developing type 2 diabetes that can be prevented by better lifestyle choices.

The health service 10-year plan that was launched in January described the programme as the “largest undertaking of its kind in the world” and stated that “over 100,000 people have already benefited since its introduction in 2016”.

The plan noted that in “many areas demand has outstripped supply” and pledged to increase the programme for the next five years and offer a new digital option to widen patient choice.

Dr Smith said: “The NHS Diabetes Prevention Programme has been hugely successful in providing help and support to those at risk of developing the condition, which is why it’s now being doubled in size.

“It’s important that those providing the service need to work closely with their local public health teams who know their community, to ensure they’re reaching and meeting the needs of those at greatest risk,” she added.

“Type 2 diabetes remains the greatest health challenge in this country and many adults are in danger of developing this deadly but preventable disease,” said Dr Smith.

According to PHE, the prevalence of type 2 diabetes is set to increase from 3.9 million in 2017, to 4.9 million by 2035 – equivalent to around 9.7% of the adult population.

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