Healthway Medical Group brings together a multidisciplinary team including podiatrists to reduce diabetes-related amputations.

 

Healthway Medical Group has launched a new integrated and holistic foot care service for diabetics – Nobel Diabetic Foot Care.

Made up of a multidisciplinary team of orthopaedic surgeons from Island Orthopaedics and podiatrists from Straits Podiatry, Nobel Diabetic Foot Care’s mission is to “save time, save legs” by providing fast-track comprehensive care for diabetic foot conditions so as to reduce diabetes-related amputations in Singapore and across Asia. The team will also collaborate closely with vascular surgeons, and interventionalists under the Nobel Medical Group to ensure patients receive the necessary tailored care.

Singapore has the second-highest proportion of diabetics among developed countries after the US with more than 440,000 Singaporeans having diabetes in 2014. One in six diabetic patients develop diabetic foot problems, which is estimated to account for 15 to 25 percent of healthcare costs for treating diabetes. Diabetes mellitus costs Singapore S$1 billion in 2010, with diabetic foot patients having a healthcare expenditure three times that of the general population with hospitalization costs accounting for 73 percent of the increased cost.

Beyond healthcare costs for the nation, diabetic foot problems also affect lives and livelihoods. A simple ulcer on a toe could lead to the entire leg being amputated, with multiple operations and hospital admissions that affect the patient’s ability to work and his lifelong mobility. Singapore has one of the highest lower extremity amputations in the world.

As diabetic foot care involves multiple medical specialties, patients are often referred to see a number of providers over several widely spaced appointments, during which patients are likely to repeat their issues to each provider. This arrangement not only runs the risk of delaying care, but the lack of coordination could increase the patients’ risk of developing severe complications that may even lead to amputations.

Hence, a multidisciplinary approach is a research-proven strategy in managing diabetic foot conditions. Wound healing rates are increased and amputation rates drastically reduced. Diabetic patients commonly have a minor cut or blister that quickly escalates into a serious lower limb infection. As the infection can spread so rapidly, the course of action is often amputation. This is generally due to poor diabetic control and knowledge about proper preventative care.

Beginning with a thorough assessment of each patient’s condition, the multidisciplinary team formulates a detailed care plan including all-in-one appointments to minimise delays in treatment. Once the patients are on board with the plan, the team will deliver seamless, coordinated care throughout their treatment and recovery journey.

By working together, podiatrists and orthopaedic doctors will be able to present the best of both disciplines to help patients better manage their foot conditions. “For example, if a patient presents with a blister that is infected, the orthopaedic surgeon may have to intervene to remove and control as much of the infection as possible, while the podiatrist will continue post-surgical treatment with advanced wound care dressings in the short term,” said Jackie Tey, chief podiatrist of Straits Podiatry.

Saw Yu Ting, chief podiatrist of Straits Podiatry, added, “In the long term, podiatrists can prescribe custom insoles, braces or give footwear recommendations to prevent future recurrences. With a team-based approach and close communication within the team, patient care is carefully monitored and long-term outcomes can be optimised.”

For a start, Nobel will offer diabetic foot screening, foot ulcer treatment, infection management and foot pressure offloading at Island Orthopaedics (Mount Alvernia Medical Centre and Mount Elizabeth Novena Specialist Centre).

(** PHOTO CREDIT: Unsplash/Richard Sagredo)