Foot complications more than rose from 98 to 285 per 100 000 people aged over 15 years in Australia. United States is also not doing well. Primary health care systems should use evidence-based care to prevent foot complications among people with diabetes.
Prevention of diabetic foot complications must be improved, say investigators at the Australian National University, Canberra, Australia and at the Centre for Remote Health, Alice Springs, Australia.
They point to a marked increase during the 1990s in central Australia in the burden of hospital care for diabetes and diabetic foot complications.
"It is very unlikely that these conditions are being over-diagnosed or that the hospitals are over-utilized." Rather, the investigators suggest, changes in prevalence, primary care utilization, detection and rates of hospital access or re-admission might be responsible.
They conducted a study to guide service provision for the prevention of diabetic foot complications. They analyzed data on hospital separations (end of hospital stay due to discharge or death) among adults known to be diabetic and those with diabetic foot complications in central Australia from 1992 to 1997.
Separations with diabetes more than doubled, from 352 in 1992 to 796 in 1997. That represented a rise from 1,232 to 2,521 separations per 100 000 people aged over 15 years.
Separations with foot complications more than trebled, from 28 in 1992 to 90 in 1997. That represented a rise from 98 to 285 per 100 000 people aged over 15 years.
Foot complications were almost all of the more acute type. They were thus amenable to early intervention.
Australian Journal of Rural Health 2002;9(6):275-279