By Jordana Bieze Foster
A national strategy of risk stratification in Scotland significantly decreased the incidence of amputation within the first years of its implementation, according to unpublished data presented in March at the Diabetic Foot Global Conference (DFCon) in Los Angeles.
Amputation incidence per 1000 patients with diabetes fell by 29.8% from 2004 to 2008, according to Graham P. Leese, MD, chairman of the Scottish Diabetes Foot Action Group. A diabetes foot action plan, which aims to eventually identify the risk of foot ulceration for every patient with diabetes, was first implemented in 2006.
Amputation prevalence has also decreased since implementation of the action plan, from 0.8% in 2003 to 0.5% in 2009, according to the 2009 Scottish Diabetes Survey. Interestingly, duration of diabetes has actually increased slightly even as amputation rates have decreased, indicating that patients are living longer with the disease, Leese said.
Currently more than 248,000 patients with diabetes have been screened, and 86% have been risk stratified, Leese said. By comparison, only 25% of patients with diabetes were risk stratified in 2007.
Leese GP, Stang D, McKnight JA, et al. A national strategic approach to diabetic foot disease in Scotland: changing a culture. Br J Diab Vasc Dis 2011;11(2):69-73.