At a rough estimate, about 10% of the population has diabetes. Diabetes is related to various complications, of which foot ulcers require the most days of hospital care. Approximately one in five patients with diabetes will develop a foot ulcer during their lifetime. About 20% of these cases will result in the amputation of a lower limb. The final cause of an amputation is often tissue necrosis due to circulatory disturbance or a difficult infection. Amputations are often preceded by foot ulcers.
Preventive treatment has an essential role in foot care and a lot more should be invested in it in Finland. The early signs of changes on the soles of the feet, such as corns and calluses, should be noticed as soon as possible.
When an ulcer appears, it should be treated with determination using a patient-specific multidisciplinary approach. Depending on the nature of the ulcer, treatment may require the expertise of several specialists (e.g. diabetologist, vascular surgeon, infectious-disease specialist, orthopedist, and plastic surgeon). The skills of, for example, a wound care nurse and chiropodist or a prosthetist and orthotist are also needed.
In Finland, the problems with the treatment of diabetic ulcers are that, firstly, primary care has a limited ability and capacity to take the necessary preventive measures. Secondly, it is often difficult to get an evaluation by multidisciplinary foot teams in hospitals and the waiting time for treatment is long. This leads to unnecessary exacerbation of ulcers and likely to unnecessary amputations. On the other hand, private healthcare has not, to date, been able to provide actual multidisciplinary treatment for diabetic foot problems either.