Diabetes & Foot Ulceration

Diabetes mellitus 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 affected.  In the UK 6% of the population are currently diagnosed with diabetes. To put that into context, that 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 diabetes in the UK.

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The increasing prevalence of diabetes has resulted in a dramatic increase in related complications.  Arterial disease is the principal cause of complications with a 4 times 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 diabetes.

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The single commonest cause for hospitalisation in patients with diabetes is foot ulceration for which PAD is an independent risk factor, being present in 50% of cases.  The lifetime risk of diabetes-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 vital for all patients with diabetes and foot ulceration to be appropriately assessed and treated for PAD in order to reduce the risk of subsequent amputation.

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At Circulation Clinic we have recognised experts in the assessment and treatment of diabetes foot ulceration.  Our aim is to reduce the length of time an ulcer is present, reduce the likelihood of an ulcer recurring and most importantly, avoid the need for amputation.