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By Jane Elliott
Health reporter, BBC News
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Anna finds balance difficult
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This article contains a graphic image of an infected limb. When Anna Levis developed blisters on her feet she was worried, but doctors told her it was simply a case of wearing the wrong shoes. Anna, who has diabetes, had her wounds treated and dressed. But it was not until after she had part of her foot and her little toe amputated, that she was finally referred to a podiatrist. Experts warn that millions are spent each year on diabetic foot amputations like Anna's, but say that most could have been avoided with better foot care. New figures show that the NHS spends £600m a year on treating foot problems in people with diabetes, and £252m of this is spent on amputation. Avoiding amputations
Foot problems commonly develop in people with diabetes, who are at risk of damage to the nerves and blood supply to their feet. Both can lead to foot ulcers and slow-healing wounds which, if they become infected, can result in amputation.
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Whilst it's only a part of my foot that's been amputated, it has affected so much of my life
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But Nita Parmar, of the Society of Chiropodists and Podiatrists (SCP), said most serious problems could be avoided with regular access to foot services, rather than simply the annual foot check. "Each amputation costs the NHS around £13,500 with long hospital stays, yet up to 85 per cent of all diabetic amputations can be prevented with specialist podiatrist foot care," she said. Diabetes UK's Bridget Turner added: "The longer problems are left untreated, the greater the risk of deterioration and loss of the limb, which has devastating effects on a person's mobility and mood, causing disfigurement and reducing independence." Problems can escalate Anna, who has had Type 1 diabetes since the age of four, said she felt her worries had not been taken seriously. When Anna, from Dagenham, developed a blister on each of her feet in 2006 her GP sent her to the surgery chiropodist who dressed her feet and told her to come back in three months.
Diabetics have to take care of their feet
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But after a few days the blister on her left foot started to worsen and she was sent her to hospital. A doctor told her that her blisters had been caused by ill-fitting shoes and she was sent home with a course of antibiotics. Four weeks later she became very ill and her right foot began to turn black. She was taken back into hospital and had an emergency amputation of her little toe and of a part of her foot. Anna said: "After the operation the hospital diabetes consultant came to see me and said I should never have been left just with the antibiotics. "He said that if I had been directed to the diabetes consultant straight after being admitted, my amputation would not have been necessary. "It's clear that poor communication and a lack of understanding of diabetes foot care at my hospital led to me losing part of my foot unnecessarily. "I am convinced that had I seen the right people at first they would have saved my foot." "Whilst it's only a part of my foot that's been amputated, it has affected so much of my life, from having to go to a podiatrist every week to having problems walking, balancing and wearing normal shoes. "Things I like doing like swimming I can't do because I can't get the dressing wet. It hinders you in lots of ways. I used to do karate, but I can't do that. You can't risk hurting your foot in any way - a simple scratch could turn into something nasty." Let down Anna, 38, says she feels let down by the system. "They say diabetics should take more notice, but you are making a pain of yourself going to the doctor," she said. "I had my annual foot check, but I do not think that is good enough because infection can take hold and you are really stuck. "When you are a child you have an appointment with the diabetic clinic every couple of months and a health visitor comes to see you, but when you reach 18 all that stops."
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