Lower limb amputations due to diabetes on the rise

Research by charity Diabetes UK has found that 26,378 people had lower limb amputations linked to diabetes between 2014 and 2017, a 19.4 per cent rise from 2010 to 2013. This means some 170 people undergo some form of amputation each week.

Analysis of government figures found a 4.1 per cent increase in major amputations between 2010-2013 and 2014-17, to 7,305 over the three years, or 47 a week. There was a 26.5 per cent increase in minor amputations – to 19,073, or 122 a week – over the same period, the charity found.

Dan Howarth, head of care at Diabetes UK, said: ‘Many diabetes amputations are avoidable, but the quality of foot care for people living with diabetes varies significantly across England. Transformation funding since 2017 is working and will help to reduce these variations, but much work still needs to be done.’

The charity is urging NHS England to maintain its £44m diabetes transformation fund beyond 2019. The fund aims to improve patients’ access to specialist foot care teams to help avoid amputations.

Louise Tisdale, a clinical specialist physiotherapist in amputee rehabilitation at Royal Wolverhampton Hospitals NHS Trust, is vice-chair of the British Association of Chartered Physiotherapists in Amputee Rehabilitation (BACPAR).

She told Frontline:  ‘Physiotherapists working in amputee rehabilitation are seeing more patients who have had amputations due to the complications of diabetes – either type 1 or type 2. With appropriate management of diabetes and its complications by physiotherapists and a multi-disciplinary team, we would hope amputations can be avoided.

‘For those who have had an amputation our aim would be to avoid a second amputation – which is not uncommon – by better management of their diabetes and supporting a patient and carers in the care of the remaining foot. BACPAR has guidelines to support this.’

Jonathan Valabhji, NHS England’s national clinical director for diabetes and obesity, said: ‘The chance of someone with diabetes having a major amputation is actually going down, with far lower amputation rates than in countries such as Germany. But, as the absolute number of people with diabetes goes up, the number of people at risk of amputations goes up too.’