Counting the cost of preventable diabetes-related lower limb amputations at a single district hospital in KwaZulu-Natal: what does this mean, what can be done?

References

• Sahadew N. An explorative review of the distribution, incidence, prevalence, diabetes related amputations and defaulters of patients with diabetes mellitus and podiatrists in the public health care sector of KwaZulu-Natal. (Thesis) Master of Medical Science in Infectious Diseases. University of KwaZulu-Natal, Medical School 2015. http://hdl.handle.net/10413/13729
   Google Scholar
• International Diabetes Federation (IDF.ORG) IDF. Clinical practice recommendation on the diabetic foot: a guide for healthcare professionals (2017). [cited 2020 Jan 6]. Available from https://idf.org/our-activities/care-prevention/diabetic-foot/clinical-recommendations.html
   Google Scholar
• Pillay S, Mahomed F, Aldous C. Improvement noted after a multifaceted approach to diabetes mellitus management. JEMDSA. 2016;21:8–12. http://dx.doi.org/10.1080/16089677.2015.1129704.
   Google Scholar
• Patout CA, Birke JA, Horswell R, et al. Effectiveness of a comprehensive diabetes lower-extremity amputation prevention program in a predominantly low-income African American population. Diabetes Care. 2000;23:1339–42. http://dx.doi.org/10.2337/diacare.23.9.1339.
   PubMed Web of Science ®Google Scholar
• Rogers LC, Lavery LA, Armstrong DG. The right to bear legs — an amendment to healthcare: how preventing amputations can save billions for the U.S. health care system. J Am Podiatr Med Assoc. 2008;98(2):166–8. http://dx.doi.org/10.7547/0980166.
   PubMed Web of Science ®Google Scholar
• Shavelson D, Steinberg JS, Bakotic BW. The diabetic foot. In: Poretsky L, editor. Principles of diabetes mellitus. Boston, MA: Springer; 2010. p. 381–99.
   Google Scholar
• Lavery LA, Hunt NA, LaFontaine J, et al. Diabetic foot prevention: a neglected opportunity in high-risk patients. Diabetes Care. 2010 Jul 1;33(7):1460–2. http://dx.doi.org/10.2337/dc10-0310.
   PubMed Web of Science ®Google Scholar
• Rönnemaa T, Hämäläinen H, Toikka T, et al. Evaluation of the impact of podiatrist care in the primary prevention of foot problems in diabetic subjects. Diabetes Care. 1997 Dec 1;20(12):1833–7. http://dx.doi.org/10.2337/diacare.20.12.1833.
   PubMed Web of Science ®Google Scholar
• Plank J, Haas W, Rakovac I, et al. Evaluation of the impact of chiropodist care in the secondary prevention of foot ulcerations in diabetic subjects. Diabetes Care. 2003 Jun 1;26(6):1691–5. http://dx.doi.org/10.2337/diacare.26.6.1691.
   PubMed Web of Science ®Google Scholar
• Sowell RD, Mangel WB, Kilczewski CJ, et al. Effect of podiatric medical care on rates of lower-extremity amputation in a Medicare population. J Am Podiatr Med Assoc. 1999 Jun;89(6):312–7. http://dx.doi.org/10.7547/87507315-89-6-312.
   PubMed Web of Science ®Google Scholar
• Fylkesnes K. Determinants of health care utilization—visits and referrals. Scand J Public Health. 1993 Mar;21(1):40–50. http://dx.doi.org/10.1177%2F140349489302100107.
   Google Scholar
• Leese GP, Schofield CJ. Amputations in diabetes: a changing scene. Prac Diabetes Int. 2008 Oct;25(8):297–9. http://dx.doi.org/10.1002/pdi.1282.
   Google Scholar
• Sakka KE, Fassiadis N, Gambhir RP, et al. An integrated care pathway to save the critically ischaemic diabetic foot. Int J Clin Pract. 2006;60:667–9. http://dx.doi.org/10.1111/j.1368-5031.2006.00953.x.
   PubMed Web of Science ®Google Scholar
• Dargis V, Pantelejeva O, Jonushaite A, et al. Benefits of a multidisciplinary approach in the management of recurrent diabetic foot ulceration in Lithuania: a prospective study. Diabetes Care. 1999;22(9):1428–31. http://dx.doi.org/10.2337/diacare.22.9.1428.
   PubMed Web of Science ®Google Scholar
• Van Gils CC, Wheeler LA, Mellstrom M, et al. Amputation prevention by vascular surgery and podiatry collaboration in high-risk diabetic and nondiabetic patients. The Operation Desert Foot experience. Diabetes Care. 1999;22(5):678–83. http://dx.doi.org/10.2337/diacare.22.5.678.
   PubMed Web of Science ®Google Scholar
• Meltzer DD, Pels S, Payne WG, et al. Decreasing amputation rates in patients with diabetes mellitus - an outcome study. J Am Podiatr Med Assoc. 2002 Sep;92(8):425–8. http://dx.doi.org/10.7547/87507315-92-8-425.
   PubMed Web of Science ®Google Scholar
• Larsson J, Stenström A, Apelqvist J, et al. Decreasing incidence of major amputation in diabetic patients: a consequence of a multidisciplinary foot care team approach? Diabet Med. 1995;12(9):770–6. http://dx.doi.org/10.1111/j.1464-5491.1995.tb02078.x.
   PubMed Web of Science ®Google Scholar
• Frykberg RG. Team approach toward lower extremity amputation prevention in diabetes. J Am Podiatr Med Assoc. 1997 Jul;87(7):305–12. http://dx.doi.org/10.7547/87507315-87-7-305.
   PubMed Web of Science ®Google Scholar
• Lipscombe J, Jassal SV, Bailey S, et al. Chiropody may prevent amputations in diabetic patients on peritoneal dialysis. Perit Dial Int. 2003 May-Jun;23:255–9. http://www.pdiconnect.com/content/23/3/255.short
   PubMed Web of Science ®Google Scholar
• Clarke E, Tsubane M. The role of the podiatrist in managing the diabetic foot ulcer: podiatry. Wound Healing Southern Africa. 2008;1(1):40–2. http://reference.sabinet.co.za/sa_epublication_article/mp_whsa_v1_n1_a6
   Google Scholar
• Bashir AA, Kong VY, Weale RD, et al. Quantifying the burden of trauma imaging on the CT scan service at a major trauma centre in South Africa. S Afr J Surg. 2019;57(1):9–14. http://dx.doi.org/10.17159/2078-5151/2019/v57n2a2836.
   Google Scholar
• Kong VY, Odendaal JJ, Bruce JL, et al. Quantifying the funding gap for management of traumatic brain injury at a major trauma centre in South Africa. S Afr J Surg. 2017 Nov;55(4):26–30. PMID: 29227053 https://www.ncbi.nlm.nih.gov/pubmed/29227053
   PubMed Web of Science ®Google Scholar
• Kong V, Aldous C, Handley J, et al. The cost effectiveness of early management of acute appendicitis underlies the importance of curative surgical services to a primary healthcare programme. Ann R Coll Surg Engl. 2013;95(4):280–4. http://dx.doi.org/10.1308/003588413x13511609958415.
   PubMed Web of Science ®Google Scholar
• Discovery Health Medical Scheme. Online portal for healthcare professionals. [cited 2020 Jan 6]. Available from https://www.discovery.co.za/portal/provider/dh-rates
   Google Scholar
• South African Legal Information Institute. Example of quantum for loss of lower limb. J obo S v Road Accident Fund (76324/2014) [2017] ZAGPPHC 369 [cited 2017 Apr 11]. Available from http://www.saflii.org/za/cases/ZAGPPHC/2017/369.html
   Google Scholar
• Automobile Association of South Africa, 2019. Online vehicle running cost calculator. [cited 2019 Dec 12]. Available from https://www.aa.co.za/calculators/vehicle-rates-calculator
   Google Scholar
• Maphumulo WT, Bhengu BR. Challenges of quality improvement in the healthcare of South Africa post-apartheid: a critical review. Curationis. 2019;42(1):9. http://dx.doi.org/10.4102/curationis.v42i1.1901.
   Google Scholar
• Thompson AT. Peripheral Arterial Disease in Diabetes – aspects of preventable foot loss in KwaZulu-Natal. Doctoral study in progress, Clinical and Professional Practice, School of Clinical Medicine, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
   Google Scholar
• Steyn K, Levitt NS, Patel M, et al. Hypertension and diabetes: poor care for patients at community health centres. J Endo Metab Diab South Africa. 2008;13(2):64–70. http://dx.doi.org/10.1080/22201009.2008.10872172.
   Google Scholar
• Igbojiaku OJ, Harbor OC, Ross A. Compliance with diabetes guidelines at aregional hospital in KwaZulu-Natal, South Africa. African J Prim Heal Care Fam Med. 2013;5(1):1–5. http://dx.doi.org/10.4102/phcfm.v5i1.447.
   Google Scholar
• Dikeukwu RA, Omole OB. Awareness and practices of foot self-care in patients with diabetes at Dr Yusuf Dadoo district hospital, Johannesburg. J Endo Metab Diab South Africa. 2013;18(2):112–18. http://dx.doi.org/10.1080/22201009.2013.10872314.
   Google Scholar
• Goie TT, Naidoo M. Awareness of diabetic foot disease amongst patients with type 2 diabetes mellitus attending the chronic outpatients’ department at a regional hospital in Durban, South Africa. Afr J Prm Health Care Fam Med. 2016;8(1):a1170. http://dx.doi.org/10.4102/phcfm.v8i1.1170.
   Google Scholar
• SEMDSA Type 2 Diabetes Guidelines Expert Committee. Society for Endocrinology, Metabolism and Diabetes of South Africa (SEMDSA) 2017 Guidelines for the Management of Type 2 diabetes mellitus. J Endo Metab Diab SA. 22(1(Supplement 1));1–196. Available from http://www.jemdsa.co.za/index.php/JEMDSA/article/view/647
   Google Scholar
• Albright RH, Manohar NB, Murillo JF, et al. Effectiveness of multidisciplinary care teams in reducing major amputation rate in adults with diabetes: a systematic review & meta-analysis. Diab Res Clin Prac. March 2020;161; http://dx.doi.org/10.1016/j.diabres.2019.107996.
   PubMed Web of Science ®Google Scholar
• de Godoy JMP, Braile DM, Buzatto SHG, et al. Quality of life after amputation. psychology. Health Med. November 2002;7(4):397–400. http://dx.doi.org/10.1080/1354850021000015212.
   Google Scholar
• Horgan O, MacLachlan M. Psychosocial adjustment to lower-limb amputation: a review. Disabil Rehabil. 2004;26(14/15):837–50. http://dx.doi.org/10.1080/09638280410001708869.
   PubMed Web of Science ®Google Scholar
• Rybarczyk B, Nyenhuis DL, Nicholas JJ, et al. Body image, perceived social stigma, and the prediction of psychosocial adjustment to leg amputation. Rehabil Psychol. 1995;40(2):95–110. http://dx.doi.org/10.1037/0090-5550.40.2.95.
   Web of Science ®Google Scholar
• Bhuvaneswar CG, Epstein LA, Stern TA. Reactions to amputation: recognition and treatment. Prim Care Companion J Clin Psychiatry. 2007;9(4):303–8. http://dx.doi.org/10.4088/pcc.v09n0408.
   PubMedGoogle Scholar
• Beyaz S, Güler ÜÖ, Bağır GŞ. Factors affecting lifespan following below-knee amputation in diabetic patients. Acta Orthop Traumatol Turc. 2017;51(5):393–7. http://dx.doi.org/10.1016/j.aott.2017.07.001.
   PubMed Web of Science ®Google Scholar
• Alves Costa MS, Pereira MG. Predictors and moderators of quality of life in caregivers of amputee patients by type 2 diabetes. Scand J Caring Sci. 2018 Jun;32(2):933–42. https://doi.org/10.1111/scs.12528. Epub 2017 Sep 22
   PubMed Web of Science ®Google Scholar
• Zidarov D, Swaine B, Gauthier-Gagnon C. Quality of life of persons with lower-limb amputation during rehabilitation and at 3-month follow-up. Arch Phys Med Rehabil. 2009;90(4):634–45. http://dx.doi.org/10.1016/j.apmr.2008.11.003.
   PubMed Web of Science ®Google Scholar
• Spiess KE, McLemore A, Zinyemba P, et al. Application of the five stages of grief to diabetic limb loss and amputation. J Foot Ankle Surg. 2014;53(6):735–9. http://dx.doi.org/10.1053/j.jfas.2014.06.016.
   PubMed Web of Science ®Google Scholar
• Thorud JC, Plemmons B, Buckley CJ, et al. Mortality after nontraumatic major amputation among patients with diabetes and peripheral vascular disease: a systematic review. J Foot Ankle Surg. 2016 May-Jun;55(3):591–9. https://doi.org/10.1053/j.jfas.2016.01.012. Epub 2016 Feb 19.
   PubMed Web of Science ®Google Scholar
• Norvell DC, Thompson ML, Boyko EJ, et al. Mortality prediction following non-traumatic amputation of the lower extremity. Br J Surg. 2019;106(7):879–88. http://dx.doi.org/10.1002/bjs.11124.
   PubMed Web of Science ®Google Scholar
• Thanni LO, Tade AO. Extremity amputation in Nigeria – a review of indications and mortality. Surgeon. 2007 Aug;5(4):213–17. http://dx.doi.org/10.1016/s1479-666x(07)80006-0.
   PubMed Web of Science ®Google Scholar
• Masoetsa RBM. Positioning of podiatric medicine within the South African health care system. (Masters dissertation). Johannesburg: University of Johannesburg; 2005. uj:7087. http://hdl.handle.net/10210/3650
   Google Scholar