The foot-health of people with diabetes in a regional Australian population: a prospective clinical audit

A three month prospective clinical audit was undertaken by the publically-funded podiatric services of a large regional area of Victoria, Australia. The primary variables of interest were the University of Texas (UT) diabetic foot risk classification of each patient and the incidence of new foot ulceration during the study period. Age, gender, diabetes type, duration of diabetes and the podiatric service the patients attended were the other variables of interest.Five hundred and seventy six patients were seen during the three month period. Over 49% had a UT risk classification at a level at least peripheral neuropathy or more serious diabetes-related foot morbidity. Higher risk at baseline was associated with longer duration of diabetes (F = 31.7, p < 0.001), male gender (χ2 = 40.3, p < 0.001) and type 1 diabetes (χ2 = 37.3, p < 0.001). A prior history of foot pathology was the overwhelming predictor for incident ulceration during the time period (OR 8.1 (95% CI 3.6 to 18.2), p < 0.001).The publically funded podiatric services of this large regional area of Australia deal with a disproportionally large number of people with diabetes at high risk of future diabetes-related foot complications. These findings may be useful in ensuring appropriate allocation of resources for future public health services involved in diabetic foot health service delivery in regional areas.Diabetes-related foot complications pose a significant burden to health care systems and can be devastating to an individual [1]. People with diabetes can develop complications such as peripheral neuropathy, skin ulcerations on the feet and lower limb amputations [2]. Other complications due to diabetes can include Charcot neuropathic osteoarthropathy [3] and peripheral arterial disease [4]. It is estimated that diabetes-related foot ulceration resulted in nearly 10,000 Australian hospital admissions for the year 2004-2005 [5], and the number of diabetes-related lower-limb amputations performed in Austr