Diabetes-related amputations on the increase

Over 500 lower-limb amputations in 2016
  • Deborah Condon

The number of people requiring diabetes-related amputations is on the increase, the latest figures have shown.

According to the data, 511 people with diabetes had to undergo a lower limb amputation last year. In 2015, this figure was 451, while in 2014, it was 443.

Among the 26 counties in the Republic, 13 recorded an increase in their lower limb amputation figures last year. The biggest increase was seen in Wexford, which saw 13 amputations in 2015, but 29 last year - a jump of 16.

Donegal saw an increase of 10, from seven in 2015 to 17 in 2016.

The biggest reduction was seen in Kildare, which had eight fewer diabetes-related limb amputations last year (26 in 2015 down to 18 in 2016).

The highest number of limb amputations overall takes place in Dublin each year and it recorded a fall in its numbers, from 128 in 2015 to 122 in 2016.

Lower limb amputation is a potential complication of long-term poorly controlled diabetes, however, it is preventable.

Long-term high blood glucose levels can lead to the protective sensations in the toes or feet - the ‘pain alarm system' - slowly disappearing. This makes the feet more susceptible to injury and infection.

Meanwhile, the latest figures show that altogether, 2,820 people were hospitalised last year as a result of diabetes-related foot care complications - up from 2,400 in 2015.

Worryingly, over 1,000 of these patients were under the age of 65 and of working age.

The figures were provided by the HSE to Dublin North West TD, Roisin Shortall, and published by the national charity, Diabetes Ireland.

The charity highlighted the fact that due to continued under-resourcing of podiatry services in Ireland, specialised early screening is inadequate. This means there is a lack of early intervention for patients who require it.

"The HSE provided no extra podiatry posts in 2017, yet we are seeing year on year increases in the number of people requiring in-hospital treatment for diabetes-related foot complications and lower limb loss at huge cost to the Exchequer," commented Dr Ronan Canavan, a consultant endocrinologist at St Vincent's Hospital in Dublin.

He urged all people with diabetes to take care of their feet by examining them daily. They should be on the lookout for small cuts, changes in skin colour or temperature, red areas and swelling.

"People also have to check they have continuing sensation in their feet and be alert to signs such as prickly pain, numbness and peculiar sensations such as a feeling of walking on cotton or of wearing tight socks.

"This is important as without a pain alarm system, injuries and poor fitting shoes may go unnoticed. Where people do find problems with their feet they should immediately seek medical advice," Dr Canavan insisted.

Diabetes Ireland pointed out that the cost of treating 2,820 people with diabetes-related foot complications in hospitals last year was at least €84 million and between them, these patients spent over 32,000 days in hospital.

Foot ulceration is one of the most common foot-related complications. This refers to a patch of broken down skin, which exposes the layers underneath. Last year, 2,309 people were hospitalised for foot ulcers (without amputation), a jump of 361 from 2015's figure of 1,948.

People who need to be admitted to hospital for foot ulcers spend an average of 12-14 days in hospital.

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