Treating foot ulcers early could help further complications

People with diabetes-related foot ulcers could avoid the condition worsening by getting early treatment, according to a new report.

The recently published National Diabetes Foot Care Audit (NDFA) looked at the treatment and outcomes for more than 5,000 people with diabetes that had diabetic foot ulcers in England and Wales between July 2014 and April 2015.

The audit results found that around half (2,302) of all people included in the study were ulcer-free within 12 weeks of their first expert assessment by a specialist foot care service.

Having foot problems checked out early could prevent further complications

The majority of people with diabetes-related foot ulcers were referred to specialist services (3,699) by a GP or other health service, while the remainder (1,516) self–presented to the service without a referral.

It is estimated that diabetic foot ulcers cost the NHA around £650 million a year, which is the equivalent to £1 in every £150 spent, with around 10% of people with diabetes having a diabetic foot ulcer at some point in their lives. 

The audit also reported that when two weeks or more had passed from the initial presentation of a foot ulcer to their GP and follow-up expert assessment, a patient was significantly less likely to be ulcer-free 12 weeks on.

Of the 2,029 patients seen within two weeks or less, 50% (1,010) were ulcer-free 12 weeks on from assessment.

The audit was carried out by the Health and Social Care Information Centre

Dr William Jeffcoate, Clinical Lead for the audit, said: “This first report from the National Diabetes Foot Care Audit highlights the importance of early expert assessment of all people presenting with a new foot ulcer in diabetes.

“The results show that when the time to expert assessment exceeds two weeks, the condition of the ulcer is on average more severe.

“Whilst future audits will no doubt provide further insight, this report will make a valuable contribution towards improving services, and is an important first step in measuring the quality of care provided for diabetic foot disease in England and Wales.”

The audit report also assessed the local structures for the care of diabetic foot disease provided by clinical commissioning groups (CCGs) and local health boards (LHBs) during October and November 2015. Based on the results of a survey around 60% (82) of providers responded to all the questions asked in the survey and of these, 45% (37) did not have all three basic NICE recommended systems for preventing and managing diabetic foot care disease.

Sarah Bone, DRWF Chief Executive, said: “Awareness of how complications associated with diabetes can be prevented is key. Better prevention programmes and ongoing education and support of self-management is vitally important to reduce risk and improve outcomes.

“Understanding the importance of looking after your feet is just one aspect of DRWF’s ongoing Diabetes Wellness Network programme, which aims to improve knowledge and support a pro-active approach to self-care.”

The NDFA is part of the National Diabetes Audit, which is managed by the Health and Social Care Information Centre (HSCIC) in partnership with Diabetes UK and is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit Programme.

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