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Diabetes and the risk of amputation

Diabetes is one of the most common chronic diseases in the UK. In 2013 almost 2.9 million people were suffering from the disease and there is no sign that the number will be declining. Sanja Strkljevic discusses the link between the diabetes and amputation.

Related Areas of Practice:
Sanja acts for both adults and children in cases involving negligent medical treatment provided by the NHS and in the private sector. Her particular interest lies in the field of obstetrics and gynaecology, amputation and fatal accidents litigation.
Diabetes is the most common cause of non-traumatic limb amputations. The most recent data from Public Health England shows that in one year, diabetes was the cause of around 6000 leg, toe or foot amputations in England. A staggering amount.

People with diabetes are estimated to be up to 30 times more likely to have an amputation compared with the general population.

The risk of foot problems in people with diabetes is increased and it is well known that anyone who has diabetes can be affected by foot problems.

Diabetes can damage the nerves, muscles sweat glands and circulation in the feet, particularly when it is poorly controlled. Thus, it can affect the feet in a number of ways, and this includes loss of sensation and reduced blood flow to the feet which can have serious repercussions.

For example, when skin on the foot is damaged it may not heal easily and it could cause an ulcer to form on the foot.

It is estimated that 10% of people with diabetes will have a foot ulcer at some point in their lives. Similarly, if a person has lost feeling in their feet, then it is possible that they may damage their feet without realising it.

It is understood that many diabetes-related amputations are preceded by foot ulceration caused by a combination of impaired circulation and nerve damage. Indeed, the estimate is that diabetic foot ulcers precede more than 80% of amputations in people with diabetes.

Furthermore, after a first amputation, people with diabetes are twice as likely to have a subsequent amputation as those who do not suffer from the disease.

The importance of good management of diabetes cannot be underestimated.

Neither can the regular multidisciplinary review of diabetic patients. As part of the multidisciplinary approach to everyone who has diabetes should have their feet checked regularly by a podiatrist, a nurse or a doctor.

If a person is at an increased risk of an ulcer, they may be monitored more frequently.

The National Institute for Clinical Excellence (NICE) has a well-established set of guidelines for diabetic foot problems; most recently updated in January 2016.

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