Ayr doc hopes for foot clinic

Nov 7 2008 by Lisa Boyle

MORE than 200 amputations have been carried out on diabetes sufferers in Ayrshire and Arran since 2003.

Toes, feet, legs and hands have all had to be cut off after major complications.

But one specialist in the field is bidding to wipe out the need for such a drastic measure.

Dr Iqbal Malik, a consultant based at Ayr Hospital, hopes to have a dedicated foot clinic set up in Ayrshire as early as next year.

It means that difficulties would be spotted and treated sooner rather than later.

Figures released to the Ayrshire Post through the Freedom of Information Act show that there have been 222 amputations in the last five years.

However, some patients have required more than one operation.

In Ayrshire and Arran 15,500 people suffer from diabetes.

That compares to just 8000 people five years ago. However, Dr Malik insists part of the apparent hike in the number of cases is due to better reporting.

People with diabetes often lose feeling in their feet and may not even notice if they damage their feet and end up with an open wound.

This can lead to infection and in extreme cases, amputation.

Diabetes can also affect blood supply to and within the feet, delaying healing and increasing the risk of infection.

Dr Malik said: “What we really need is a dedicated foot clinic in Ayrshire. At the moment people come along for a check up and are seen by a team of health professionals. Getting their feet checked is just a part of that.

“We need to be treating foot ulcers as aggressively as we can. Unfortunately, once you have to start amputating toes, a patient may need further amputation further and further up their leg over the following years.

“Often people will come home from their holidays with an infection in their foot but they haven’t even noticed. We call that diabetic holiday foot syndrome.

“People are walking about the beach barefooted, they stand on something or they stub their toe and they don’t feel a thing.

“By the time they come home they have a bad infection.”

Dr Malik says that it is not unrealistic to work toward a zero amputation rate.

He continued: “Some amputations are down to poor control of diabetes but some people are just unlucky and get infections.

“But if we get a dedicated foot clinic up and running, and we ensure people are controlling the condition properly we can reduce the number of amputations.

“Last year there were 33 amputations in Ayrshire and Arran, as far as I’m concerned that’s 33 too many.”