World Diabetes Day 2005

Diabetes and Foot Care - Put Feet First Prevent Amputations

World Diabetes Day 2005 focused on diabetes and foot care, completing the series of themes on diabetes complications that began in 2001. The year marked the beginning of a year-long focus for the campaign. Rather than directing all our efforts on November 14, IDF began spreading activities over the year in order to extract maximum benefit from the awareness-raising opportunities that present themselves. A year-long campaign allows IDF to draw greater attention to the theme of World Diabetes Day and ensures that materials reach our membership in a timely fashion.

Diabetes is a serious chronic disease. In 2006 the global prevalence of diabetes was estimated at 246 million. This figure is predicted to reach 380 million by 2025 as a consequence of longer life expectancy, sedentary lifestyle and changing dietary patterns. Although many serious complications, such as kidney failure or blindness, can affect individuals with diabetes, it is the complications of the foot that take the greatest toll. Of all lower extremity amputations, 40-70% are related to diabetes. In most studies the incidence of lower leg amputation is estimated to be 5-25/100,000 inhabitants/year: among people with diabetes the figure is 6-8/1,000.

Lower extremity amputations are usually preceded by a foot ulcer in people with diabetes. The most important factors related to the development of these ulcers are peripheral neuropathy, foot deformities, minor foot trauma and peripheral vascular disease. The spectrum of foot lesions varies in different regions of the world due to differences in socio-economic conditions, standards of foot care and quality of footwear.

The diabetic foot is a significant economic problem, particularly if amputation results in prolonged hospitalization, rehabilitation, and an increased need for home care and social services. Approximately 3-4% of all people with diabetes have a foot problem and use 15-25% of the healthcare resources available for diabetes. The average cost for primary healing in the USA has been estimated to be between US$7,000 and US$10,000. The direct cost of an amputation associated with the diabetic foot is estimated to be between US$30,000 and US$60,000. The estimated cost for three years of subsequent care ranges from US$43,000 to US$63,000 - mainly due to the increased need for home care and social services. The corresponding cost for individuals with primary care has been estimated to be just over US$16,000 to nearly US$27,000. In addition to these costs, there are indirect costs due to loss of productivity to consider. If cost estimates are broadened to include the costs to the individual and loss of quality of life, then the estimated cost of the diabetic foot in the USA is some US$4 billion a year.

Foot complications are one of the most serious and costly complications of diabetes. However, through a care strategy that combines: prevention; the multi-disciplinary treatment of foot ulcers; appropriate organization; close monitoring, and the education of people with diabetes and healthcare professionals, it is possible to reduce amputation rates by between 49% and 85%. It is this objective that should motivate the advocacy work of those fighting to make a difference for those living with diabetes around the world.

The following campaign materials are available for download: