Diabetes & Foot Ulceration
Diabetes mellitus (DM) is a global pandemic; in 2015, there was an estimated 415 million adults living with diabetes, approximately 5% of the world population. By 2040 this figure is projected to grow by >50% such that 642 million adults, 7.5% of the world population, will be afflicted. The prevalence of DM in the United Kingdom is currently 6% i.e. 6% of the population are affected. To put that into perspective the prevalence of DM is nearly 4 times higher than all cancers combined and is still rising: it is estimated that by 2025 there will be 5-6 million people living with DM in the UK.
The increasing prevalence of DM has resulted in a dramatic increase in diabetes-related complications. Arterial disease is the principal causes of complications with a 4x increase in the lifetime risk of developing coronary (heart), cerebrovascular (brain) and peripheral artery disease (PAD), with disease severity and rates of progression greater than in individuals without DM.
The single commonest cause for hospitalisation in patients with DM is foot ulceration for which PAD is an independent risk factor being present in 50% of cases. The lifetime risk of DM related foot ulceration may be as high as 25% and its occurrence increases the risk of subsequent major lower limb amputation: 5% of individuals undergo an amputation within 1 year of developing a foot ulcer. The lack of adequate blood supply contributes to the need for amputation in up to 90% of patients. It is thus vitally important for all patients with DM and Foot Ulceration to be appropriately assessed and treated for PAD in order to reduce the risk of subsequent amputation.
At the Circulation Clinic we have recognized experts in the assessment and treatment of DM foot ulceration. Our aim is reduce the length of time an ulcer is present, reduce the likelihood of an ulcer recurring and most importantly avoid the need for amputation.