Diabetes study cuts ulcer deaths

A ground-breaking system which could halve the number of people dying from a diabetes-related condition has been developed in the Lothians.

New research shows patients suffering from a diabetic foot ulcer could win their battle if their heart health was also treated at the same time.

Royal Infirmary of Edinburgh experts discovered a system of heart monitoring combined with preventative medicine.

Dr Matthew Young said the key to their survival was their hearts.

A full cardiovascular assessment was carried out on each patient to gauge their blood pressure, cholesterol and heart function before prescribing a range of protective medicines in a unique tailor-made care package.

"If this was repeated across Scotland it would prolong the lives of thousands of patients and tens of thousands in the UK as whole"
Dr Matthew Young
Royal Infirmary of Edinburgh

Dr Young said: "By applying the principles of cardiovascular risk reduction, and by learning more about a patients' cardiac health, we were able to offer them a more specialised package of care.

"These improvements have halved this death rate to under a quarter of foot ulcer patients dying within five years of their ulcer.

"If this was repeated across Scotland it would prolong the lives of thousands of patients and tens of thousands in the UK as whole."

The team from the Diabetic Foot Clinic at the Royal Infirmary of Edinburgh carried out the research following the introduction of the new cardiovascular policy in 2001.

Foot ulcers are known to be associated with heart disease and the experts realised that the appearance of a foot ulcer pointed to arterial damage elsewhere in the body.

Risk assessment

They decided to give every patient, being treated after 2001, medicines to actively target heart disease even if they had no history of cardiovascular illness to protect them from future episodes.

Aspirin, statin therapy, ACE inhibitors and beta blockers were prescribed to all patients in the second group of the study.

Researchers then monitored the death rates in foot ulcer patients from both groups and compared their records.

A total of about 400 patients who developed a foot ulcer between 1995 and 1999 and about 250 patients who were diagnosed between 2001 and 2004 were monitored in the study.

The experts discovered that four-year mortality was cut in half by the new policy. In group one the death toll was 43.3%, compared to 21.9% in the second group who received the heart risk assessment and treatment.

Dr Young said the cardiovascular risk management system should be rolled out in clinics across the country.

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