Increase in Diabetes-Related Lower Limb Amputations

Peter Russell

December 17, 2018

An average of 169 diabetes-associated lower limb amputations were carried out each week in England over a 3-year period, an analysis has shown.

There were 26,378 lower limb amputations related to diabetes from 2014 to 2017, an increase of 19.4% from 2010 to 2013, according to Diabetes UK.

The charity called on NHS England to continue to support the diabetes 'transformation fund' - an additional £44 million for 2017-19 - so that improvements in care and treatment would continue beyond 2019.

Ulcers and Infections

The latest analysis showed a 26.5% increase in minor lower limb amputations, defined as below the ankle, and a 4.1% increase in major lower limb amputations, defined as below the knee.

Unhealed ulcers and foot infections were identified as the leading cause of diabetes related amputations, with diabetic foot ulcers the underlying cause of more than 80% of amputations.

Someone living with diabetes is 20 times more likely to experience an amputation than someone without the condition, according to Diabetes UK. 

Preventative Care 'Could Cut Healthcare Costs'

The charity highlighted the extra costs to the NHS associated with foot ulcers and amputations, with at least £1 in every £140 of NHS spending going towards foot care for people with diabetes.

It called on NHS England to commit to extending the transformation fund, whose aims include "reducing the number of amputations by improving access to multi-disciplinary foot care teams".

Dan Howarth, head of care at Diabetes UK, said: "The shocking number of lower limb amputations related to diabetes grows year on year. An amputation, regardless of whether it’s defined as minor or major, is devastating and life-changing. A minor amputation can still involve losing a whole foot.

"To reduce the number of amputations related to diabetes, we are calling on NHS England to maintain the diabetes transformation fund beyond 2019. 

"Many diabetes amputations are avoidable, but the quality of foot care for people living with diabetes varies significantly across England. Transformation funding since 2017 is working and will help to reduce these variations, but much work still needs to be done."

The charity said it was vital that people with diabetes knew how to look after their feet, check them regularly, and seek medical attention if they noticed any problems.

Commenting on the analysis, Prof Jonathan Valabhji, NHS England's national clinical director for diabetes and obesity, said: "The chance of someone with diabetes having a major amputation is actually going down, with far lower amputation rates than in countries such as Germany. But as the absolute number of people with diabetes goes up, the number of people at risk of amputations goes up too."


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