Background and Aim
Diabetes related foot disease is the leading cause of hospitalisation for people with diabetes1.Determining risk factors and implementing preventative strategies is essential in reducing foot disease and its complications2. Here we examine the prevalence of foot disease, its complications, and management in patients with diabetes in specialist Diabetes Centres across Australia.
Cross-sectional data from the ANDA-AQCA 2013 collection was examined. Patient demographics, glycaemic control, self-reported peripheral neuropathy, foot ulceration, amputation and podiatry attendance were assessed. Statistical analysis was undertaken using Stata 12.
3843 people with diabetes were studied. The mean duration of diabetes was 14.2±11.0 years. The majority of patients had type 2 diabetes (T2DM) 71.7% followed by type 1 diabetes (T1DM) 20.8% and other diabetes (7.5%).
Of those with T2DM, 25.4% reported peripheral neuropathy, 11.3% peripheral vascular disease, 7.4% past foot ulceration, 3.4% current foot ulceration and 1.0% lower limb amputation in the previous year. 54% of those with peripheral neuropathy reported a diabetes duration of ≥16yrs.
Of those with T1DM, 18.6% reported peripheral neuropathy, 6.2% peripheral vascular disease, 5.0% past foot ulceration, 2.1% current foot ulceration and 1% lower limb amputation in the previous year. 80% of those with peripheral neuropathy reported a diabetes duration of ≥ 16 years.
25.4% of all patients studied reported multiple foot complications; peripheral vascular disease and peripheral neuropathy and a current ulcer.
Of those with a current ulcer, 81% had seen a podiatrist in the previous year (77.8% with T2DM 17.3% with T1DM). Of those without a current ulcer, 39.5% had seen a podiatrist in the previous year (80.1% with T2DM, 17.3% with T1DM).
There is a high prevalence of diabetes related foot disease in Australians with diabetes being managed in Diabetes Centres. Increased preventive use of podiatry services may reduce numbers of patients experiencing ulceration or requiring amputation.