‘Marginal’ investment could help 300 diabetes patients avoid amputations

MORE than 300 diabetes patients could be spared the pain of amputation each year if the Health Service Executive (HSE) invested in more footcare specialists, according to doctors who treat the condition.

In addition, the cost of employing 20 additional podiatrists would cost the Exchequer just marginally more than the current cost to the State of carrying out amputations on patients whose diabetes has not been controlled.

A study by the Diabetes Expert Advisory Group (DEAG) estimates that each podiatrist could be employed at a cost per post of €63,452 and equipped at a cost of €15,000. This would bring the total cost for 20 footcare specialists to €1.57 million per annum. Last year 338 amputations involving diabetes patients cost the HSE €1.1m. The cost of one patient with one foot ulcer who was hospitalised for treatment was €30,000.

The need for podiatrists at diabetes clinics around the country has been highlighted by the Diabetes Federation of Ireland in the lead-up to World Diabetes Day next Saturday. Today, at a presentation in Leinster House, the federation will argue that the need for amputations could be avoided altogether with regular screening of diabetes patients at risk of foot complications. This would involve early intervention by podiatrists in those patients requiring specific treatments.

At the presentation, consultant endocrinologist Dr Sean Dinneen of Galway University Hospital (GUH) will outline to TDs a proposed model of care that would see a podiatrist linked to each diabetes clinic.

This podiatrist would train the local GP practice nurses to undertake routine foot screening.

Dr Dinneen believes this can be done on a cost-neutral basis.

“We are not looking for new money here,” Dr Dinneen said. “All we are asking is for the Department of Health and the HSE to seriously look at this model of care as a creative option.”

The report of the HSE’s DEAG, published last November, recommended immediate priority be given to funding one podiatrist post in each hospital diabetes centre around the country, a total of 20 new positions.

Ireland has the lowest manpower in podiatry for diabetes in Europe; there are only two full-time hospital posts here.

Dr Diarmuid Smith, Consultant Endocrinologist and Chair of the Diabetes Section of the Irish Endocrine Society said:

“If this money was spent as a preventative measure rather than as a reactionary measure, diabetes patients would be so much healthier.”

Labour TD Ciaran Lynch, who organised today’s presentation said he would be raising the matter with Health Minister Mary Harney as a priority.

The annual cost of treating diabetes in Ireland is estimated at 6.4% of overall annual health expenditure.

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