Diabetic Foot

Amputations have a debilitating effect on patients’ quality of life, mobility, living conditions and society as a whole. Patients who undergo amputations have increased mortality risks, with a recent narrative by DUK stating the relative likelihood of death following amputation or foot ulcers within 5 years is greater than colon, prostate and breast cancer. Diabetes increases the risk of developing peripheral arterial disease which may result in lower extremity amputation. Amputations have been debated as an indicator of the quality of diabetic foot services provided and are a proposed indicator of outcomes for diabetes services for Wales using Results based accountability.

Amputation also has huge financial implications to the patients and society with the former likely to incur increased financial support in rehabilitation and housing modifications. In England it is estimated that the inpatient costs for amputation is between £43,546,901 and £48,896,735 with post amputation care costs of £75,807,423.

Management of the Diabetic foot has been described as the ‘PITS’, Prevention, Identification, Treatment and Systems. Central to implementing and achieving this requires an integrated foot service across primary, community and secondary care with Podiatry being recognised as core to achieving this service model of care.

Enclosed are relevant national documents that have been used to influence the service delivery in Wales.

Education tool for diabetic foot screening and assessment.

Below are a number of patient leaflets endorsed by WEDS that may be useful to give to patients.

Documents from 2016

Putting feet first pathway

Operational delvery pathway