Diabetic foot costs counted
Experts say diabetic foot disease could be Australia's least known major health problem.
Diabetic foot disease (DFD) is estimated to cost the health care system $1.6 billion a year, has mortality rates worse than many cancers, and by 2012 estimates, claims an amputated limb every 2 hours.
DFD commonly develops from trauma in the presence of peripheral neuropathy or peripheral arterial disease and is complicated by infection.
Neuropathy is arguably the critical factor in DFD as it results in patients losing the ability to feel pain, resulting in critically delayed presentation and treatment.
It is Australia’s leading cause of amputation, and we have the second highest diabetes-related amputation rate among OECD countries.
Dr Peter Lazzarini, co-chair of Diabetic Foot Australia, say this is “partially attributed to the lack of coordinated interdisciplinary DFD services in Australia”.
“We estimate that less than 10 per cent of the 540 interdisciplinary DFD services needed to manage the 50,000 Australians with DFD are available,” Dr Lazzarini and colleagues wrote in a new article for the Medical Journal of Australia.
“This was in stark contrast to the European nations that had the lowest diabetes-related amputation rates in the OECD, such as the United Kingdom, Belgium and the Netherlands. The low rates in these nations have been attributed to coordinated nationwide systems that recognise and reimburse accredited interdisciplinary DFD services.
“Additionally, these nations’ systems regularly monitor and report DFD outcomes for national clinical benchmarking and research network purposes. Germany, for example, has nearly 300 accredited DFD services monitoring outcomes and contributing to research in their system, whereas Australia is yet to even enact a system.”
Diabetic Foot Australia has recently launched the Australian diabetes-related foot disease strategy 2018–2022 (PDF), which they say is the first step towards ending avoidable amputations within a generation.
The strategy outlines key recommendations which “should put Australia firmly on an evidence-based pathway”.