The diabetic foot : how to save a limb : part I

Abstract

The high prevalence of diabetes mellitus in our country is well recognized and it is estimated that there are around 40,000 diabetics in Malta. This is steadily increasing as it is in the rest of the world, as a result of longer life expectancy, sedentary lifestyles, and dietary choices. Diabetic foot problems are the most serious and costly complications of diabetes. The World Health Organisation estimates that in the high income countries treatment of diabetic foot complications accounts for 15-25% of all healthcare resources for diabetes. Over one million major lower limb amputations are performed each year in diabetics amounting to a leg being lost to diabetes every 30 seconds. In Malta 120 major amputations are performed per year and this figure has remained relatively static for at least the last 6 years. The sad thing is that a lot of these complications can be prevented using low cost and low technology solutions. The International Working Group on the diabetic foot (IWGDF) states that by implementing a care strategy that combines prevention, the multidisciplinary treatment of foot ulcers, appropriate organization, and close monitoring and education of people with diabetes and healthcare professionals.It is possible to reduce major amputations by a staggering 85%