Short summary

Fod på Langeland offers residents of Langeland living with diabetes a screening for complications in their feet in order to prevent complications to occur or develop and/or to assess the need of treatment for existing complications. The screening takes place in a local setting at Langeland. Fod på Langeland is a quality project by afd. M-FAM OUH Svendborg Sygehus and Steno Diabetes Center Odense.

Rationale

Background: People with diabetes are at risk of developing diabetes-related diseases, which reduces quality of life and is associated with increased morbidity and mortality. Thirty-five percent of patients have comorbidities already at the time of diagnosis. Comorbidities such as cardiovascular disease, eye complications, and renal failure are the most serious. A particular challenge is the occurrence of diabetic foot ulcers, which arise as a consequence of diabetic neuropathy and are correlated with poorly controlled blood glucose levels. In conjunction with atherosclerosis resulting from elevated blood pressure and cholesterol, this condition is associated with a risk of amputation, inevitably leading to reduced quality of life and substantial socioeconomic implications. The lifetime risk of developing a foot ulcer is 15-25%, with an annual incidence of 2-3%, and a 50-70% probability of developing a new ulcer within five years. Eighty-five percent of all amputations in diabetic patients stem from a foot ulcer, with a subsequent five-year mortality rate ranging from 50-68%. The prevalence of diabetes in Langeland is 9.8%, being the highest in the Region of Southern Denmark. However, the wound outpatient clinic at Svendborg Sygehus, which offers treatment for people with diabetic foot ulcers, only treats very few people living in Langeland. Langeland is a municipality with a challenging socioeconomic and demographic profile, as well as health profile, ranking amongst the lowest of the country´s 98 municipalities. Out of the country's 98 municipalities, Langeland ranks 95th in terms of self-rated health, 87th in terms of alcohol consumption, 96th in terms of physical activity and severe obesity, and last as the municipality with the most smokers in the country. All of these observations calls for an intensified and dedicated effort to the people with diabetes living in Langeland. Thus, the project Fod på Langeland started, organized in a way that attempts to address the challenges that exist in Langeland. Fod på Langeland offers residents of Langeland living with diabetes a screening for complications in their feet in order to prevent complications to occur or develop and/or to assess the need of treatment for existing complications. The screening takes place in a local setting at Langeland. Aim: The study aims at investigating - if screening in a local setting finds people with diabetes with incipient complications or complications requiring treatment - facilitators and inhibitors to implementing screening-activity in a local setting - if the completed screenings gives rise to recommended adjustments to the patients treatment

Description of the cohort

Residents of Langeland living with diabetes (all types)

Data and biological material

Data is collected from the patient journals and covers data from the screenings, e.g. measures of biothesiometer, monofilament as well as biochemical data (HbA1c, LDL, eGFR, albuminuria), pharmacological data and data from discharge letter to general practitioner.

Collaborating researchers and departments

Afd. M-FAM OUH Svendborg Sygehus

• Lene Langhoff Clausen