South Tees Hospitals NHS Foundation Trust is taking part in an England-wide pilot that aims to identify heart problems in people with diabetes.
It will see people who have developed a foot ulcer because of diabetes receive an electrocardiogram (ECG) to check for problems with their heart.
Around 50% of people with diabetes who develop a foot ulcer die within five years and many of these deaths are attributable to heart problems. The pilot aims to identify these problems earlier and take action to manage them.
The pilot is being run by NHS Improving Quality’s Living Longer Lives programme, which aims to stop people dying too soon from illness or disease that could be prevented or treated.
Heart problems are commonly seen in people with diabetic foot ulcers for two main reasons. Firstly, diabetes causes narrowing of the blood vessels and damage to the body’s nerves. This narrowing of the blood vessels and nerve damage occur in the feet, causing foot ulcers, but also in the heart, reducing the blood supply and altering the electrical signals.
Therefore a foot ulcer may also signal heart damage. Secondly, some of the medication given to treat diabetic foot disease may alter electrical activity in the heart. Carrying out a quick and non-invasive ECG helps doctors identify those patients who either need to have changes made to their medication or who need to be referred to a cardiologist for further investigation.
It is hoped that the pilot will show that ECGs for patients with diabetic foot ulcer can help to prevent early death and that hospitals across England will begin to implement this approach.
Dr Simon Ashwell, trust consultant physician (diabetes and endocrinology) said: “Carrying out a simple ECG on a patient who has developed a diabetic foot ulcer is a quick and easy way for us to know if they are at risk of early death. I’m very pleased that we are taking part in this important pilot and keen to see the impact the ECGs have on our patients’ health.”
Hilary Walker, head of the Living Longer Lives programme at NHS Improving Quality said: “The job of the Living Longer Lives team is to find ways to prevent people dying from illness or disease that could have been prevented or treated. Carrying out ECGs for people with diabetes who have developed foot ulcers is a quick and easy way to spot heart problems before they become life threatening. If doctors know about these problems it is possible to treat them and ultimately save lives.”
Professor Jonathan Valabhji is the national clinical director for obesity and diabetes at NHS England, and is a consultant diabetologist at Imperial College Healthcare NHS Trust. His trust will be taking part in the pilot service-improvement project. Commenting on the pilot, he said:
“We see too many patients who have suffered diabetic foot disease dying too soon – often from heart problems that could have been treated. A person with type 1 diabetes might develop a foot ulcer in their 40s or 50s. It’s not acceptable for that person to then have a 50% chance of dying within five years, especially not from something we could have treated or managed if we’d known about it.”
The results of the pilot will be collected and analysed in July 2015, prior to the publication of the findings in a final report.