For a health issue that has cost the Australian health care system $1.6 billion every year and has a mortality rate worse than many cancers, diabetic foot disease is one of the country’s least known major health problems.
The condition typically develops from trauma caused by peripheral neuropathy or peripheral arterial disease, which is complicated by infection. Neuropathy is a nerve condition that can lead to pain, numbness and tingling and is one of the major factors in diabetic foot disease.
Patients typically lose their ability to feel pain, causing them to delay urgent treatment. Up to 80 per cent of diabetes-related amputations can be avoided with practice treatment and ongoing management. Those with diabetic foot disease are at greater risk of infection, with minor injuries caused by small cuts, bruises or a blisters having the potential to develop into a diabetic foot ulcer. Left untreated, this is often what leads to amputation.
Research published in the Medical Journal of Australia found diabetic foot disease is the leading cause of amputation in the country, and that Australia has the second highest diabetes-related amputation rate among Organisation for Economic Co-operation and Development (OECD) countries. Researchers said diabetic foot condition claims an amputated limb every two hours, with researchers pointing the finger at the lack of coordinated interdisciplinary diabetic foot disease services.
“We estimate less than 10 per cent of the 540 interdisciplinary DFD services needed to manage the 50,000 Australians with DFD are available, Co-chair of Diabetic Foot Australia Peter Lazzarini said in a statement.
Australia also seems to be falling behind European nations such as the United Kingdom, the Netherlands and Belgium, which had the lowest diabetes-related amputations in the OECD. Researchers believe this is due to coordinated nationwide systems that recognise and reimburse accredited interdisciplinary diabetic foot disease services.
“Additionally, these nations’ systems regularly monitor and report DFD outcomes for national clinical benchmarking and research network purposes,” Lazzarini said. “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.”
As such, Diabetic Foot Australia has now launched a strategy that outlines nine key recommendations to help combat the issue. These include increasing access to care, subsidising evidence-based treatment, implementing national models of interdisciplinary care and reporting national outcomes.
Still, researchers are concerned that Australia has failed to act on the issue in the past. Researchers believe this is because the national burden of diabetic foot disease wasn’t severe enough to prioritise, or that previous recommendations lacked actionable detail or evidence.
“Unlike previous statements, the strategy outlines many potential areas for action and measures to monitor progress towards achieving each recommendation that can be undertaken by health professionals, researchers and governments; all supported by extensive local and international evidence-based rationale,” Lazzarini said.
At present, diabetic foot disease accounts for 33 per cent of all diabetes-related clinical costs, but receives less than 0.2 per cent of diabetes-related research funding. Researchers are calling for Australian health professionals, researchers and governments to act.
“Investments in this plan should ensure not only a significant financial return on investment to the health budget but, more importantly, save the limbs and lives of Australians,” Lazzarini concluded.