Diabetic foot disease is Australia’s least known major health problem,
costing the nation $1.6 billion each year. About $875 million is spent
every 12 months on diabetes-related amputations alone, with each
procedure costing the public health system $23,500, and an additional
$6000 per year, afterwards. Prostheses are also funded by the public
health system, as well as the National Disability Insurance Scheme.
In response to the spiralling costs, Diabetes Australia’s 4400 Reasons
to End Amputations campaign is working to raise awareness, with the
aim of ending most diabetes-related amputations within a generation.
Visit diabetesaustralia.com.au/4400-reasons for more information.COUNTING THE COST
Given that 85 per cent of
diabetes-related amputations,
including ones like Rod’s, and
right through to below-knee
amputations, are preventable,
it’s also heartbreaking.
“I’m a lot healthier now and
so much more vigilant about
my feet than I was back then,”
he says, “but I can’t turn the
clock back.”
Life as an amputee
Rod’s advice is to be prepared
for a long recovery if you have
an amputation. “One of the
things that shocked me after
surgery was that the wound
was left open, rather than being
stitched up,” he says. “It looked
like an axe had been dropped
on my foot and the healing
process was incredibly slow.”
Dr Carsten Ritter, a specialist
vascular and endovascular
surgeon at Western Australia’s
Fiona Stanley Hospital,
performed all of Rod’s complex
surgeries, managing to save
both his legs. “Wound healing is
prolonged in diabetics because
blood supply is impaired and
infection is already present in
most wounds,” says Dr Ritter.
And it’s the existence of
infection that means surgery
wounds are often left open to
heal, a technique called ‘healing
by secondary intention’. “That
healing process can take several
months,” he says.
And, while losing toes or a
partial limb is life changing,
a below-knee amputation can
understandably have even more
of an impact. Melissa Noonan,
the CEO of Limbs 4 Life, an
organisation that provides
support to amputees, says
everything from your sense of
independence to your lifestyle
and family dynamics may
change. “You also have to
remember that you can’t even
consider being fitted for a
prosthesis until your wound
has healed,” she says.
“Even when you’re ready for
that step months down the
track, learning to walk safely ona prosthesis takes an enormous
amount of time and energy –
when you’re starting out, you’ll
only be able to wear it for 30
minutes at a time. And, because
walking with a below-knee
prosthesis requires about 45 per
cent more energy, it can have a
knock-on effect for your blood
glucose management.”
Then there’s the fact that once
you’ve had one amputation due
to diabetic foot disease, your
risk of it happening again is
significantly higher. Dr Ritter
explains: “Roughly 35 per cent
of diabetics will develop a foot
ulcer in their lifetime and
around 20 per cent of those
people will have some form of
amputation. And unfortunately,
one in two people who’ve had
one amputation will have
another at some stage.
“That’s partly because the
diabetic neuropathy which
makes you prone to developing
another ulcer doesn’t go away.
But it’s also because when you
alter the shape of the foot with
an amputation, you create new
pressure points that weren’t
there before, in places on the
foot that aren’t used to it. So,
in treating one problem, you
create another.”Diabetic
foot disease
costs
$1.6 billion
each year