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Date: 22 September 2021
"One-stop" shop for diabetes patients
Story posted/last updated: 22 January 2015
A "one-stop shop" for diabetic patients with foot problems is helping to prevent amputations at University Hospitals Birmingham (UHB).
The multidisciplinary diabetic foot clinic provides those patients deemed at risk of losing a lower limb with a dedicated team of specialists from across the Trust.
The team, which also performs a weekly diabetic foot ward round, is made up of a diabetologist (Dr Mujahid Saeed), a vascular surgeon (Mr Alok Tiwari), podiatrists (Mr Ian Wilson, Mrs Stephanie Owen and Ms Jayne Robbie), and, on occasion, a microbiologist (Dr Miruna David).
Mr Tiwari, Consultant Vascular Surgeon at UHB, said: “We have started a multidisciplinary diabetic foot clinic and ward round for this hospital.
“It is essentially a one-stop shop for patients with diabetic foot problems, as this has been shown to reduce the risk of major amputations, as well as the number of people being admitted to hospital.”
Around 5.5 per cent of the adult population of England has diagnosed diabetes, with a further two per cent of the population possibly having undiagnosed diabetes.
People with diabetes are more likely to be admitted to hospital than those without and are also at greater risk of complications and infections while in hospital.
In particular, disease of the foot remains a major threat to people with diabetes and results in around 70 amputations a week across the country, the majority of which are said to be potentially preventable.
Mr Tiwari added: “Diabetes is the leading cause of amputations in this country. In fact, amputations are 15 times more likely in patients with diabetes than other people.
“Usually, a major amputation is below the knee, but by having a multidisciplinary approach you can reduce this.”
As part of this new approach, the multidisciplinary team at UHB carries out a specialist diabetic foot ward round on Monday afternoons.
“We see diabetic patients with foot ulcers because you become high risk if you have an ulcer. They are a sign that the patient is at increased risk of amputation. Prevention is much better than cure.”
Mr Tiwari said there were major advantages to a multidisciplinary ‘one-stop’ clinic comprising specialists with relevant complementary skills.
He said: “What tends to happen is that a lot of people don’t realise what the patient is at risk of so, for example, you can miss a vascular disease. There is always a delay between diabetes and vascular clinics, so by seeing them in one place you can identify when someone might be at high risk.
“These are very high risk problems, with the average life expectancy for someone with a diabetic foot problem reduced by around 14 years.”
Dr Saeed, Consultant Physician and Diabetologist, and Diabetic Foot Lead, said it had been a major achievement to put the multidisciplinary team together, which he hoped would develop into a “truly world-class” diabetic foot service for their patients.
He said: “It is always exhilarating each time we prevent an amputation of a toe or toes, the foot, or the leg of patients seen by our service. We are now getting more and more people coming along from adjoining trusts and regions to make use of this service.
“We have also generated research and publications in peer-reviewed journals.”
Dr Saeed said it was always encouraging to receive positive feedback from patients, but he added: “We continue to aspire higher in providing best in care, which is the Trust’s vision.”
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