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Hundreds of diabetics could have avoided loss of limbs

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By Eilish O'Regan Health Correspondent

Tuesday October 30 2012


HUNDREDS of people with diabetes had lower limbs amputated last year — even though the radical surgery may have been preventable.

New figures show 389 people with the disease had below-the-knee amputations in 2011, only a slight fall from 392 in 2010, the worst year for these kind of procedures.

Of these, 159 were of working age, leaving them with a disability which could threaten their chances of staying in a job and ending up depending on the State for social welfare.

A lack of services to treat foot complications, which diabetespatients are prone to, has been blamed in the past for leaving so many people going on to have surgery and suffer this needless disability.

The HSE promised to tackle this in 2011 and said it would employ 16 new podiatrists, who specialise in foot care, to look after at-risk patients.

However, by September this year, only eight of the posts were filled and a recruitment clampdown since July has meant many areas of the country do not have enough of these foot specialists.

Areas where posts are not being filled include Kerry, Kilkenny, Mullingar, Waterford and Drogheda. A post for a podiatrist in Beaumont hospital in Dublin has been put on hold.


People with diabetes are vulnerable to foot amputation because of reduced blood flow to the feet. Also, they can have nerve disease, which reduces sensation.

Loss of feeling often means the person may not even feel a foot injury and they could walk around all day with one and not be aware of it.

Between 2005 and 2009, an estimated 1,579 people with diabetes in Ireland underwent a below knee amputation and nearly 6,000 patients with the disease developed a foot ulcer requiring in-patient treatment. In 2010 Ireland was found to have the lowest level of these foot specialists in Europe and this has not changed since.

Over the the past six years the HSE has spent €260m treating diabetic foot disease. But this cost of treating diabetic foot disease only relates to direct in-patient hospital costs and it does not take account of the cost of dressings, antibiotics or social welfare.

Diabetes Action which was set up to lobby for better services said the cost of employing one podiatrist to work with diabetes patients is offset by preventing just three hospital admissions for foot ulcers.

– Eilish O'Regan Health Correspondent






PV Mayer

Dr. Perry Mayer is the Medical Director of The Mayer Institute (TMI), a center of excellence in the treatment of the diabetic foot. He received his undergraduate degree from Queen’s University, Kingston and medical degree from the Royal College of Surgeons in Ireland.

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