1 in 5 diabetics died within a year of leg amputation: Study

Data for 2005-2014, involving 2,170 TTSH diabetics, shows that regular foot check-ups are vital

The decade between 2005 and 2014 saw one in five diabetics at Tan Tock Seng Hospital (TTSH) dying within a year of having part of their legs amputated due to the condition.

Researchers from the National Healthcare Group (NHG) - to which TTSH belongs - noted that this includes people who had minor surgery involving their toes, as well as those who had surgery to remove the limb up to the knee or hip.

The findings were revealed at an NHG press conference yesterday.

They drive home the importance of regular foot check-ups for diabetics, said Associate Professor Daniel Chew, head of TTSH's endocrinology and diabetes department.

"We have difficulty convincing the people who are well to do preventive care," he said. "The fact is, if you look after your diabetes well you can be complication-free for many years."

The NHG study, which looked at data from 2,170 TTSH diabetics who underwent amputations over the 10-year period ending in 2014, found that the average age of this group was 64.

  • Foot care tips for diabetics

  • Do:

    •Check your feet every day, including between your toes, around the heel, and the sole. Look out for cuts, swelling or blisters.

    •Make sure your shoes are comfortable and fit well. Check the insides for sharp objects, such as stones.

    •Clean any wound with normal saline and dry the area carefully. After that, apply an antiseptic and cover it with a clean, dry dressing. See a doctor if the wound does not become better after two days.

    Do not:

    •Soak your feet in very cold or very hot water. Instead, wash them with mild soap and warm water, and dry them well.

    •Use moisturiser between your toes, unless instructed to do so by a doctor. Moisture between the toes can lead to the growth of fungus.

    •Wear open-toe slippers as this increases your chances of getting small cuts that might go unnoticed.

    Linette Lai

In Parliament earlier this month, Health Minister Gan Kim Yong announced that his ministry will be waging war against diabetes.

More than 400,000 people in Singapore have diabetes, a third of whom are not even aware that they have the condition.

If untreated, the chronic condition can lead to complications such as blindness, heart attacks and amputations. This is because diabetes can damage blood vessels and nerves, leading to loss of feeling, especially in the feet. So diabetics may not know if they have cuts or ulcers, which could turn gangrenous and result in amputation.

Dr Sadhana Chandrasekar, a senior consultant in TTSH's surgery and medicine departments, said: "Very often, they've had this problem for some time, but they've neglected it because they're scared or for other reasons.

"By the time they come to us, it has become an emergency."

Local hospitals perform roughly 1,500 diabetes-related amputations a year, or about four a day.

Dr Darren Seah, a family physician-consultant at NHG Polyclinics, said all diabetics should visit their doctor at least once a year to check that they have not lost sensation in their feet.

In addition, they should check their feet daily for ulcers or small breaks in the skin. "Some of our patients don't look at the soles of their feet - they think that they will be able to feel if they have ulcers but that's not always true," he said.

Tackling apathy and diabetes

A version of this article appeared in the print edition of The Straits Times on April 27, 2016, with the headline '1 in 5 diabetics died within a year of leg amputation: Study'. Print Edition | Subscribe