Hundreds of diabetics lose their lower limbs and toes in Ireland each year. However, a new study suggests that amputations could be reduced in statewide foot care clinics.
With diabetes rates expected to increase in the coming years, there is concern about the number of amputations performed in Irish hospitals as a result of complications from the disease.
Research by Tallaght University Hospital and the Royal College of Surgeons found that Irish public hospitals recorded 3,104 admissions with lower extremity amputations between 2016 and 2019 – 68 percent of surgeries were classified as minor amputations, mostly on toes relate, while 32 percent were major amputations below or above the knee.
The Irish researchers found that three quarters of minor amputations and just over half of major amputations are performed in patients with diabetes.
Patients with diabetes are at greater risk of needing a lower limb amputation – this is a common procedure in patients with non-healing diabetic ulcers. Lower extremity amputations can save patients ‘lives, but have serious implications for survival of patients’ health-related quality of life, the study found.
The clinical prognosis of patients with diabetes undergoing lower extremity amputation has been found to be poor. 9 to 20 percent of patients require another amputation within the year and 28 to 51 percent require another amputation within five years.
The two-year survival rates after major limb amputation were estimated to be 50% and the five-year survival rates to be 29%.
The study, which was just published in the Irish Journal of Medical Science, found that the annual number of procedures varied between 700 in 2016 and 848 in 2018. Authors Anna Mealy, Sean Tierney and Jan Sorensen stated that it was established that diabetes is on the rise in Ireland.
“Approximately 68 percent of all amputations were performed in those diagnosed with diabetes, and 75 percent of the amputations in those diagnosed with diabetes were minor amputations,” the study said.
Analysis of the existing literature found that implementing comprehensive foot care programs could reduce amputation rates from 37.5 percent to 50 percent.
“A modest 20 percent reduction in the number of amputations in patients with diabetes in Ireland could avoid 80 minor amputations and 26 major amputations per year,” the study said.
In 2015, an estimated 209,000 people were living with diabetes in Ireland. This number should increase by 5 to 10 percentage points annually.
According to HSE, current estimates suggest that diabetes and its complications account for 10 and 14 percent of the total health budget. In addition to amputation, complications of diabetes include loss of vision, kidney failure, and cardiovascular disease.
Several studies have recommended dedicated foot teams as a cost-effective means of improving patient care and reducing the need for amputations.
“Despite its advantages and an HSE care model that supports its development, multidisciplinary foot protection clinics have not yet been established in Ireland, although the care model is currently under review,” the latest study said.
They said a primary goal of the National Diabetes Clinical Program is to have a foot protection team at a local hospital made up of general practitioners, podiatrists and specialists in diabetes nurses. The multidisciplinary foot teams for treating active diseases should be at every level. four hospital.
The HSE said in a statement that a new model for diabetic foot care is being finalized.
“We would envision that this will lead to a significant increase in multidisciplinary diabetic foot teams in our hospitals and foot protection teams in the community,” a spokesman said.
Sunday independent
