Australian first study finds massive diabetic foot disease costs


New research from QUT shows preventable hospitalisation from diabetic foot disease is costing Australia hundreds of millions of dollars each year.
Image: Thickly bandaged foot; Copyright: Day

The importance of early prevention of diabetic foot disease was never more important than today; © Alice Day

Senior Research Fellow at the Queensland University of Technology and co-chair of Diabetic Foot Australia, Peter Lazzarini, said the importance of early prevention of diabetic foot disease was never more important. Mr. Lazzarini led the Australian-first study published in BMJ Open finding one in every 22 patients in our hospitals have active diabetic foot disease.

"Our study, which investigated a representative sample of hospitalized patients in five hospitals across metropolitan and regional Queensland, found 4.6 percent of all patients had active diabetic foot disease and nearly half of those were in hospital because of their diabetic foot disease. This equates to 27,600 hospitalizations each year caused by diabetic foot disease in Australia, which puts diabetic foot disease easily in the top 20 causes of hospitalization in Australia."

He said this amounted to an annual direct cost to Australia for hospitalization alone of 350 million dollars. "This figure is much higher than we previously thought and is still very much a conservative estimate, because this cost only relates to patients admitted because of their diabetic foot disease in public hospitals," he said.

Mr. Lazzarini said diabetic foot disease does not stop with hospitalization and that it also causes 4,400 amputations and nearly 1,700 deaths in Australia each year. "If diabetic foot disease is left untreated it can quite easily result in hospitalization, amputation and even death," he said.

"Unfortunately, we also found that people hospitalized because of diabetic foot disease had rarely received the recommended multi-disciplinary foot care needed to properly treat their disease in the year prior to their hospitalization. This seems to confirm our thoughts that people with diabetic foot disease that do not see a multi-disciplinary foot disease team are more likely to end up in hospital."

However, Mr. Lazzarini offers a message of hope: early prevention. "We know from our previous research in Australia that when people with diabetic foot disease receive this recommended multi-disciplinary foot care we can prevent around half of the hospitalizations, amputations and costs that would have occurred without this care. Diabetic foot disease is a readily preventable disease if diagnosed and treated early."

Mr. Lazzarini, and a national expert team from Diabetic Foot Australia, are advocating for a national multi-disciplinary approach this National Diabetes Week to help end avoidable hospitalization and amputation from diabetic foot disease.

"Our study, and similar research from Europe and the US, firstly recommends everyone with diabetes presenting to a hospital needs to have their feet screened for diabetic foot disease. This would help identify nearly everyone who presents to an Australian hospital that needs treatment for this disease but does not necessarily know it.

"Secondly, everyone who is found to have diabetic foot disease needs to be seen by a multi-disciplinary foot disease team both in and out of hospital. In the UK they are up in arms that 20 percent of their hospitals do not have these teams. We estimate only 20 percent of our hospitals in Australia actually have these teams and this needs to significantly improve.

"Thirdly, people with diabetes need to see their GP or podiatrist at least every year for a foot screen. Unfortunately, people with diabetes can lose feeling in their feet and left unchecked diabetic foot disease can develop in the form of sores, infections and poor circulation. We know that about 50 percent of the over one million Australians with diabetes have a foot screen each year. This means we do not know if diabetic foot disease has affected the other 50 percent and sometimes it is too late when we do. If we can pick up diabetic foot disease early and refer people to these multi-disciplinary foot teams we can prevent thousands of hospitalizations, amputations and even deaths.

"We know these simple preventative measures can save our hospital system millions and millions of dollars each year, but most importantly, change the lives of thousands of Australians with diabetes by empowering them to keep both their feet firmly on the ground and out of hospital."; Source: Queensland University of Technology

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