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Diabetic foot disease Preventing loss of life and limb. Dr Rowan Hillson MBE National Clinical Director for Diabetes. Diabetes in England (diagnosed). 2.2 million people with diabetes (1.3 million in 2003) (Retinal screening programme, 2009) 4.8% adults (QOF 2008) 2.5 million UK - PowerPoint PPT Presentation
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Diabetic foot diseasePreventing loss of life and limb
Dr Rowan Hillson MBENational Clinical Directorfor Diabetes
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Diabetes in England (diagnosed)
2.2 million people with diabetes (1.3 million in 2003)(Retinal screening programme, 2009)
4.8% adults (QOF 2008)
2.5 million UK
Everyone with diabetes deservesthe highest standards of personalised diabetes care, no matter where, when or by whom they are cared for.
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Why do people with diabetes get foot trouble?
• Neuropathy - nerve damage 20 – 40% of people with diabetes• Peripheral vascular disease - circulation damage 20 – 40%• Ligament and joint problems – deformity• High glucose – infection
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Foot ulcers in diabetes
Following pressure or injuryBall of foot in neuropathy. Pressure sores if immobile or in bed
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Gangrene
Poor circulationAfter injuryWith infection
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Multiple foot problems. Infection. Recurrence
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Amputation
100+ major amputations a week (Diabetes UK)
Half those who have a major amputation die in the next 5 years (Robbins 2008)
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Prevention
Most diabetic foot problems could have
been prevented
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ePreventionTeach people with diabetes to look after their feetHealthcare professionals must check feet
ProcessNDA (1.4 m people)
2003 - 04 2007 - 08
HbA1c 68 91
Cholesterol 65 90
Smoking history noted 63 86
Foot exam 29 77
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Prompt, proper treatment