Australian first study finds massive diabetic foot disease costs
New research shows preventable hospitalisation from diabetic foot
disease is costing Australia hundreds of millions of dollars each year.
Senior Research Fellow at the Queensland University of Technology
and co-chair of Diabetic Foot Australia, Peter Lazzarini, said the
importance of early prevention of diabetic foot disease was never
more important than in this year?s National Diabetes Week (10-16
July).
Mr Lazzarini led the Australian-first study published in BMJ Open
finding one in every 22 patients in our hospitals have active diabetic
foot disease.
Our study, which investigated a representative sample of
hospitalised patients in five hospitals across metropolitan and
regional Queensland, found 4.6% of all patients had active diabetic
foot disease and nearly half of those were in hospital because of
their diabetic foot disease.
This equates to 27,600 hospitalisations each year caused by diabetic
foot disease in Australia, which puts diabetic foot disease easily in
the top 20 causes of hospitalisation in Australia.
He said this amounted to an annual direct cost to Australia for
hospitalisation alone of $350 million.
This figure is much higher than we previously thought and is still
very much a conservative estimate, because this cost only relates to
patients admitted because of their diabetic foot disease in public
hospitals, he said.
Mr Lazzarini said diabetic foot disease didn?t stop with hospitalisation
and that it also causes 4,400 amputations and nearly 1,700 deaths in
Australia each year.
If diabetic foot disease is left untreated it can quite easily result in
hospitalisation, amputation and even death, he said.
Unfortunately, we also found that people hospitalised because
of diabetic foot disease had rarely received the recommended multidisciplinary
foot care needed to properly treat their disease
in the year prior to their hospitalisation. This seems to confirm our
thoughts that people with diabetic foot disease that do not see a
multi-disciplinary foot disease team are more likely to end up in
hospital.
However, Mr Lazzarini offers a message of hope: early prevention.
We know from our previous research in Australia that when
people with diabetic foot disease receive this recommended
multi-disciplinary foot care we can prevent around half of the
hospitalisations, amputations and costs that would have occurred
without this care. Diabetic foot disease is a readily preventable
disease if diagnosed and treated early.
Mr Lazzarini, and a national expert team from Diabetic Foot Australia,
are advocating for a national multi-disciplinary approach this National
Diabetes Week to help end avoidable hospitalisation and amputation
from diabetic foot disease.
Our study, and similar research from Europe and the US, firstly
recommends everyone with diabetes presenting to a hospital needs
to have their feet screened for diabetic foot disease. This would help
identify nearly everyone who presents to an Australian hospital that
needs treatment for this disease but doesn?t necessarily know it.
Secondly, everyone who is found to have diabetic foot disease needs
to be seen by a multi-disciplinary foot disease team both in and out
of hospital. In the UK they are up in arms that 20% of their hospitals
do not have these teams. We estimate only 20% of our hospitals in
Australia actually have these teams and this needs to significantly
improve.
Thirdly, people with diabetes need to see their GP or podiatrist
at least every year for a foot screen. Unfortunately, people with
diabetes can lose feeling in their feet and left unchecked diabetic
foot disease can develop in the form of sores, infections and poor
circulation.
We know that about 50 per cent of the over one million Australians
with diabetes have a foot screen each year. This means we don?t
know if diabetic foot disease has affected the other 50 per cent and
sometimes it?s too late when we do. If we can pick up diabetic foot
disease early and refer people to these multi-disciplinary foot teams
we can prevent thousands of hospitalisations, amputations and even
deaths.
We know these simple preventative measures can save our
hospital system millions and millions of dollars each year, but most
importantly, change the lives of thousands of Australians with
diabetes by empowering them to keep both their feet firmly on the
ground and out of hospital.
Diabetic Glenn Wilson from Albany Creek QLD knows only too well
the value of early intervention.
Wilson has lost all toes on his left foot and one on his right from
diabetic foot disease.
There are so many things that people take for granted that I can no
longer do. I?ll never again be able to walk along the beach and feel
the sand between my toes. I can?t ride a pushbike. I can?t even ride an
exercise bike because I have no feeling in my left foot.
However, Wilson sees himself as both a part of the problem and the
solution.
You need to be on your toes to keep your toes.
My diabetes wasn?t well managed. I remember my feet being so cold
and had no idea it was a sign of foot disease. All this information
wasn?t available when I first had diabetes.
Now, I am empowered. I have regular check-ups with my GP and
a multi-disciplinary diabetic foot team. I self-check for any injuries
or abnormalities and infection daily. And I am proactive in seeking
treatment as soon as I notice a problem.
When I saw an infection on my foot a while ago and couldn?t get an
appointment with my GP, I came to the QUT Podiatry Clinic and was
able to have a script prepared so I could get the antibiotics I needed.
This early intervention prevented an infection which could have led to
an amputation.
Knowledge is power. If you or someone you know is having a similar
problem, I hope my story can give you the knowledge you need to
seek help now.
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