Every four hours, there is one amputation in Ontario as a result of a diabetic foot ulcer.
In 2016, more than 1.6 million people in Ontario are living with diabetes, and another 2.3 million people have prediabetes. The increasing rate of diabetes and its complications pose a serious burden on the province’s publicly funded health-care system and our economy.
Among these complications are diabetic foot ulcers, which currently impose direct health-care costs of $320-400 million and indirect costs of $35-60 million in Ontario.
The Canadian Diabetes Association (CDA) estimates that funding such devices could save the Government of Ontario between $48-75 million a year, compared to when the public has no access to these devices.
The CDA recommends that the Government of Ontario increase funding for these devices that include total contact casts, custom braces and orthoses.
Download the Ontario report
Diabetes is the leading cause of non-traumatic lower limb amputations
Did you know?
In Ontario, there is one amputation every four hours as a result of a diabetic foot ulcer.
Diabetic foot ulcers are serious wounds that are common, debilitating and the most feared consequence of diabetes.
Of the 1.5 million people with diabetes in Ontario, between 16,600 and 27,600 are expected to have a diabetic foot ulcer in one year alone.
Each year, close to 2,000 Ontarians with diabetes have a lower-limb amputation, and those amputations are associated with 800 premature deaths.
Most of these amputations can be prevented if properly treated.
Foot examinations by health-care providers should be an integral component of diabetes management and should be performed at least annually and at more frequent intervals in those at high risk.
When a diabetic foot ulcer heals properly, a person spends approximately five days in the hospital, ER and clinics.
With lower limb amputations, a person spends approximately 86 days in the hospital, ER and clinics—dramatically increasing the burden on people with diabetes and our health-care system.
Prevention is so important
More than 40 years ago, Charlene Lavergne’s life was changed when she was diagnosed with type 2 diabetes at the age of 16. Every day since then, she has had to manage her diabetes 24/7 to stay healthy. She worries about diabetes-related complications; her vision has been affected by diabetes and with every cut on her feet, she worries about infections or diabetic foot ulcers that could lead to amputation.
“There is very little financial support for people with diabetes in Ontario. The statistics on foot care and amputations are proof of that. I often have to choose between food and medications as I am on disability and have a very limited drug plan. Even the co-pay is often beyond my budget,” says Lavergne from Oshawa, Ontario.
“Prevention from foot ulcers along with ulcer and eye care are so important. I live with the fear that I may lose a foot or my sight. Diabetes is not just about blood sugar control—it’s about feet, eyes and the effect it has on every aspect of my life.”
Currently, there is no consistent public funding for any devices that relieve pressure in Ontario.
Real numbers have been put to a real problem
Sherry Green, a registered nurse who works with people with diabetes, has seen the lifesaving difference that devices that relieve pressure can make for patients with a diabetic foot ulcer.
"This report puts real numbers to a real problem," says Green.
"Every day, we at the London Diabetes Foot Clinic see the impact that devices that relieve pressure have on improved patients. They foster faster closure of ulcers, but only for those who can afford the significant out-of-pocket cost for these devices. After working exclusively with persons with diabetes who have foot ulcers for the past six years, it’s clear to me that closure of foot ulcers is not dependent on the dressings you put on the ulcer, but the pressure that’s taken off. It’s imperative for the Ontario Ministry of Health and Long-Term Care to fund these devices as a way to ensure social justice and fair access for all persons with a diabetic foot ulcer."
Dr. Joseph Stern, podiatrist and president of the Canadian Podiatric Medical Association, agrees: “I have worked with many patients with diabetes and the results are extremely positive when we are able to treat a diabetic foot ulcer with a device that relieves pressure. They cut down considerably on the number of amputations reducing health-care costs. That’s why I’m pleased that the Canadian Diabetes Association is making this issue a priority."
More information can be found in the Impact of Offloading Devices on the Cost of Diabetic Foot Ulcers in Ontario report.