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Early assessment means quicker recoverery of diabetic ulcers

31 March 2016

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Patients with diabetic ulcers who are assessed quickly are more likely to be ulcer free three months later, a report has found.

The research from the new National Diabetes Foot Care Audit looked at more than 5,000 patients presenting with a diabetic foot ulcer in England and Wales between July 2014 and April 2015.

The initial findings showed that patients who were seen later were significantly less likely to be ulcer-free 12 weeks later.

A total of 10% of patients with diabetes have a foot ulcer at some time which costs the NHS £650 million, or the equivalent of £1 in every £150 spent.

Most of the cases the researchers followed were referred to specialist services by their GP or other health services, with just 1,516 self-referrals.

Researchers found that half of the patients seen within two weeks or less were ulcer-free 12 weeks after their first assessment.

However just 43% of patients who were first seen between two weeks and two months were ulcer free 12 weeks later.

The ulcer-free rate had dropped to 34% for patients who were not seen until more than two months after developing the ulcer.

Dr William Jeffcoate, clinical lead for the audit, said:“This first report from the National Diabetes Foot Care Audit highlights the importance of early expert assessment of all people presenting with a new foot ulcer in diabetes.

“The results show that when the time to expert assessment exceeds two weeks, the condition of the ulcer is on average more severe.

“Whilst future audits will no doubt provide further insight, this report will make a valuable contribution towards improving services, and is an important first step in measuring the quality of care provided for diabetic foot disease in England and Wales.”

Diabetes UK chief executive Chris Askew said: “People with diabetes must be provided with information on how to look after their feet, and those who are at increased risk of foot ulcers must be given information about the care and treatment they need and how to access it quickly. Left untreated or poorly managed, diabetic foot ulcers can cause much suffering for individuals, and ultimately pose the threat of an amputation that could have been avoided.”

The audit also found that 45% of CCGs and local health boards which responded to its survey did not have all three basic The National Institute for Health and Care Excellence recommended systems for preventing and managing diabetic foot care disease.