Abstract
BackgroundWith growing global prevalence of diabetes mellitus, diabetes-related foot disease (DFD) is contributing significantly to disease burden. As more healthcare resources are being dedicated to the management of DFD, service design and delivery is being scrutinised. Through a national survey, this study aimed to investigate the current characteristics of services which treat patients with DFD in Australia.MethodsAn online survey was distributed to all 195 Australian members of the Australian and New Zealand Society for Vascular Surgery investigating aspects of DFD management in each member’s institution.ResultsFrom the survey, 52 responses were received (26.7%). A multidisciplinary diabetes foot unit (MDFU) was available in more than half of respondent’s institutions, most of which were tertiary hospitals. The common components of MDFU were identified as podiatrists, endocrinologists, vascular surgeons and infectious disease physicians. Many respondents identified vascular surgery as being the primary admitting specialty for DFD patients that require hospitalisation (33/52, 63.5%). This finding was consistent even in centres with MDFU clinics. Less than one third of MDFUs had independent admission rights.ConclusionsThe present study suggests that many tertiary centres in Australia provide their diabetic foot service in a multidisciplinary environment however their composition and function remain heterogeneous. These findings provide an opportunity to evaluate current practice and, to initiate strategies aimed to improve outcomes of patients with DFD.
Highlights
With growing global prevalence of diabetes mellitus, diabetes-related foot disease (DFD) is contributing significantly to disease burden
Vascular surgeons were identified as the primary target group for such a survey as they are an integral part of a functioning multidisciplinary diabetes foot unit (MDFU) and in many hospitals people with DFD complications are admitted under the care of vascular surgery
Thirty-five vascular surgeons identified themselves as working in tertiary metropolitan hospitals (35/51, 68.6%)
Summary
With growing global prevalence of diabetes mellitus, diabetes-related foot disease (DFD) is contributing significantly to disease burden. Diabetes is recognised as the world’s fastest growing chronic condition, with an estimated global prevalence of 422 million [1]. Diabetes-related foot disease (DFD), which affects approximately 6% of the world population [3], contributes significantly to individual patient morbidity and mortality, and impacts heavily upon the wider public health system. DFD manifests as ulcers, infection, and Charcot foot in the presence of peripheral neuropathy and/ or peripheral arterial disease [4]. Compared to those without diabetes, patients with diabetes are ten times more likely to require an amputation [5]. The economic costs and mortality rates exceed that of many common cancers [7]; the 5-year mortality rate of patients with diabetic foot infections is approximately 50% [8]
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