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White men in poorer areas “at highest risk” of amputation

White men living in poorer areas are the group with the highest risk of diabetes-related amputation, according to new research.

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The study, carried out by researchers across the UK, looked at data from 1.8 million people with diabetes in the National Diabetes Audit and found that being male; living in poorer areas; and being white were all associated with a higher risk of lower limb amputation.

There are 6000 diabetes-related amputations in England every year, which is why it is vital that everyone with diabetes, whatever their background, looks after their feet. But the latest findings suggest it is especially important to promote the foot care feet message to white men living in poorer areas.

Too often, people will only see a healthcare professional about their feet once it is already too late. Up to 80% of diabetes-related amputations are thought to be preventable and foot problems not being treated quickly enough is one of the main reasons there are so many unnecessary amputations.

Naomi Holman, the Yorkshire and Humber Public Health Observatory researcher who led the study, said: “It is important that everyone with diabetes takes good care of their feet. While we do not fully understand why white men living in poorer areas have a higher risk of diabetes-related amputation, our findings suggest that efforts to reduce amputations should focus particularly on this group.

“Certainly, the fact that they are more likely to have an amputation strongly suggests that even more amputations in this group could be prevented than in the rest of the population.”

Barbara Young, Chief Executive of Diabetes UK, said: “This study did not look at the reasons for the high amputation rate in white men living in poorer areas, but previous research has shown that this group may be less engaged with the healthcare system and take longer to seek medical attention if they have problems. It is vital that people understand the importance of going to their GP as soon as they notice any kind of foot problem because this really can be the difference between keeping your foot and losing it. It is a tragedy that every week in the UK, people with diabetes are having feet and legs amputated simply because they were reluctant to make a fuss and we need to bring this tragedy to an end.

“But good diabetes foot care is about much more than just getting problems treated quickly. Everyone with diabetes should be supported to manage their condition and have a thorough foot check at least once a year, whereas at the moment we hear too many stories about foot checks so cursory that the person is not even asked to take their shoes off. Then following their foot check, people should be informed of their risk status and, if at high risk, follow up action should be taken.”

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