The cost of Diabetes

It’s been a week for bad news in Healthcare.  As well as the bad news about asthma mortality, are other items highlighting the increasing ineffectiveness of existing antibiotics and the high rate of hospital admissions for people with diabetes.  The last figure is really worrying.

Or is it?

Years and years ago, one of my heroes, Professor Rhys Williams headed a report which highlighted the spending of 5% of the NHS budget on the 1.5% of the population that had diabetes.

Since then the prevalence of diabetes has increased to about 6% and these people swallow up 10% of the NHS budget.  So the prevalence has quadrupled but the expenditure has doubled.  That’s actually an improvement, isn’t it?

However, in the middle of these statistics is one that the number of amputations is rising.  This is inexcusable.  It was proven years and years ago that proper foot care by podiatrists drastically reduces the number of amputations.  It is false economy to deny people with diabetes access to these teams.

Anecdotal evidence, they say, does not prove much.  Nevertheless I remember starting a Community Diabetes Clinic with Linda Goldie twenty years ago.  The second patient that we saw took off her shoes and socks and, lo and behold, there was a purple toe.  She was seen by the Vascular Surgeon the next day and, with careful care, the foot was saved.  This saved the NHS an amount of money equivalent to our entire budget for the first year.

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