Podiatry services manage diabetes fallout
A Fremantle-based study has revealed the incidence of foot ulceration in patients with type 2 diabetes has remained stable over the past 15 years, due to community and hospital-based improvements in foot care.
University of Western Australia researchers analysed data from the longitudinal observational Fremantle Diabetes Study (FDS) and compared the results from 1993 to 1996 (Phase I) with those collected from 2008 to 2011 (Phase II).
Results revealed 16 foot ulcers among a cohort of 1,296 patients in Phase 1 and 23 ulcers in a cohort of 1,509 patients in Phase II.
UWA Podiatric Medicine Unit researcher Mendel Baba says she and her colleagues had expected the prevalence of ulceration to be higher in the second phase.
"We were surprised to discover no statistical difference between the two periods, so our findings suggest the increased use of podiatry services may have prevented the development of foot ulcers in susceptible patients."
Ms Baba says diabetes sufferers can develop foot ulcers due to a combination of events.
"Damaged nerves in the feet can reduce protective sensation [peripheral sensory neuropathy], meaning patients might not feel injuries that could lead to the breakdown of skin," Ms Baba says.
"Also, narrowing of arteries supplying blood to the feet [peripheral vascular disease] can result in poor healing of ulcers.
"We found strong associations between foot ulcers and peripheral sensory neuropathy and peripheral vascular disease, as well as the length of time someone has had diabetes."
Ulcers likely among Aboriginal and older patients
Patients with a foot ulcer were also more likely to be older, Aboriginal and have been diagnosed at a younger age.
They were significantly less likely to be in paid employment or married and they were more likely to be smokers.
Ms Baba also credited the Australian Government program Moorditj Djena (Strong Feet) which was created in 2012 to offer free podiatry and diabetes education service for Aboriginal people in the Perth metropolitan area.
"Moorditj Djena is very well utilised and we are seeing improvements in the health of those with diabetes through initiatives such as this," Ms Baba says.
The FDS will continue to collect data until 2017.