Diabetes is sadly one of the most common chronic diseases in the UK affecting nearly three million people with an estimation that this figure will increase to five million by 2025.
In England alone, the number of patients diagnosed with the disease between 2006 and 2013 rose by a worrying 53% with the individuals affected having their life expectancy reduced by up to 15 years.
It is well known by those unfortunate enough to suffer with either type of diabetes that footcare is essential. The disease can have an adverse affect on both the nerves and blood supply in the feet as well as being generally associated with slow wound healing and is the leading cause of non-traumatic limb amputation in the UK.
For many, a small cut or blister is a minor irritation however, for a diabetic the same small cut or blister can develop into a significant ulcer potentially leading to the amputation of toes and legs and in severe cases, even result in death.
The National Institute for Health and Care Excellence (NICE) launched new guidelines to the NHS this month emphasising the importance of medical professionals urgently referring patients with serious foot problems.
The guidelines state that in circumstances where a life threatening limb or foot problem is considered, the patient should be referred immediately to hospital.
NICE has identified that the following conditions in patients are red flags for an urgent referral for treatment:
1. ulceration with fever or any signs of sepsis
2. ulceration with limb ischaemia
3. clinical concern that there is a deep seated soft tissue or bone infection (with or without ulceration).
4. gangrene (with or without ulceration)
In addition to the above, all diabetic patients experiencing other active foot problems should be referred to the local multi-disciplinary foot care team within one day and should be seen for triage purposes within a further working day.
The latest NICE guidelines are by no means completely new however, unfortunately it has been all too common for those caring for diabetic patient’s feet, including GP’s, practice nurses and podiatrists, to fail to follow this critical advice.
A delay in treating a diabetic foot ulcer appropriately can often significantly affect the patient’s chance of recovery and increase the risk that they will have their toes, feet and on occasion, whole leg(s) amputated or in the worst circumstances, lead to their death.
It is important for diabetics to ensure that they take good care of their feet and act on any wounds that appear seeking medical attention and treatment quickly before the injury escalates into something far more serious. The NHS provides some useful advice on how to do this here.
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