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A limb lost every 3 hours: can Australia reduce amputations in people with diabetes?

Shan M Bergin, Jan B Alford, Bernard P Allard, Joel M Gurr, Emma L Holland, Mark W Horsley, Maarten C Kamp, Peter A Lazzarini, Vanessa L Nube, Ashim K Sinha, Jason T Warnock and Paul R Wraight
Med J Aust 2012; 197 (4): . || doi: 10.5694/mja10.10837
Published online: 20 August 2012

Increased foot problems due to diabetes means a national focus on coordinated foot care is essential

Data from the Australian Institute of Health and Welfare (AIHW) suggest that one Australian loses a lower limb every 3 hours as a direct result of diabetes-related foot disease (DRFD).1 Further data suggest there has been a 30% increase in diabetes-related amputations in Australia over the past decade, with 8% of diabetes-related deaths being attributable to foot disease.1,2 These statistics are especially disappointing given the exponential growth in knowledge, research and published guidelines on managing DRFD.3,4 In order to reduce this significant burden, several complementary measures are therefore urgently required.


  • Australian Diabetes Foot Network, Australian Diabetes Society, Sydney, NSW.


Correspondence: paul.wraight@mh.org.au

Acknowledgements: 

The ADS receives funding from the National Diabetes Services Scheme.

Competing interests:

Bernard Allard and Jason Warnock are owners of the Indigenous Diabetic Foot Program, which charges consultancy fees to organisations to use their program.

  • 1. Australian Institute of Health and Welfare. Diabetes: Australian facts 2008. Canberra: AIHW, 2008. (AIHW Cat. No. CVD 40; Diabetes Series No. 8.) http://www.aihw.gov.au/publication-detail/?id=6442468075 (accessed Mar 2012).
  • 2. Payne CB. Diabetes-related lower-limb amputations in Australia. Med J Aust 2000; 173: 352-354. <MJA full text>
  • 3. International Diabetes Federation; International Working Group on the Diabetic Foot. International consensus on the diabetic foot and practical and specific guidelines on the management and prevention of the diabetic foot. Noordwjerhout, Netherlands: IDF, 2011.
  • 4. National Health and Medical Research Council. National evidence-based guideline on prevention, identification and management of foot complications in diabetes (part of the guidelines on management of type 2 diabetes). Canberra: NHMRC, 2001. http://www.nhmrc.gov.au/guidelines/publications/di21 (accessed Mar 2012).
  • 5. Menz HB. Utilisation of podiatry services in Australia under the Medicare Enhanced Primary Care Program, 2004-2008. J Foot Ankle Res 2009; 2: 30-35.
  • 6. Lavery LA, Higgins KR, Lanctot DR, et al. Preventing diabetic foot ulcer recurrence in high risk patients: use of temperature monitoring as a self-assessment tool. Diabetes Care 2007; 30: 14-20.
  • 7. Wraight PR. Improving clinical outcomes for patients with diabetes related foot complications [PhD thesis]. Melbourne: The University of Melbourne, 2005.
  • 8. Sydney Health Projects Group, School of Public Health. Chronic and complex priority healthcare programs: evaluation of the Diabetic Foot Disease Program. Sydney: University of Sydney, 2004.
  • 9. Santamaria N, Carville K, Ellis I, Prentice J. The effectiveness of digital imaging and remote expert wound consultation on healing rates in chronic lower leg ulcers in the Kimberley region of Western Australia. Primary Intention 2004; 12: 62-70. http://www.awma.com.au/journal/1202_01.pdf (accessed May 2012).
  • 10. Norman PE, Schoen DE, Gurr JM, Kolybaba ML. High rates of amputation among Indigenous people in Western Australia [letter]. Med J Aust 2010; 192: 421. <MJA full text>

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