The incidence of diabetic foot complications in the Republic of Ireland is not known. A cross-sectional pilot study was undertaken to identify the prevalence of diabetic foot complications in a primary care setting in the west of Ireland, and to inform the design and feasibility of a larger community-based diabetic foot screening study in Ireland. Clinically important pedal neural dysfunction was detected in up to 30% of those screened, and vascular impairment was detected in some 17%.

Foot complications are considered to be the most costly diabetes-related complication, accounting for up to 20% of total healthcare resources available for diabetes in developed countries (International Diabetes Federation [IDF], 2009). A study carried out at St James Hospital, Dublin, reported that annual hospital expenditure on the treatment of diabetic foot ulceration amounted to €704 000 (Smith et al, 2004).

The prevalence of diabetes in the Republic of Ireland is estimated to be 4.7% of the population (Institute of Public Health in Ireland, 2006), but the condition's true prevalence is not known. Likewise, the true prevalence of diabetic foot complications in Ireland is not known. Current national and international guidelines (NICE, 2004; IDF, 2009; SIGN, 2010) recommend that people with diabetes should receive a comprehensive annual foot examination. Diabetic foot screening in the primary care setting is not routinely undertaken in Ireland.

The present study is a cross-sectional pilot, designed to identify the prevalence of diabetic foot complications in a general practice population in the west of Ireland. This pilot study was undertaken to inform the design and feasibility of a large community-based diabetic foot screening study in the west of Ireland.


METHODS
People (≥18 years of age; with type 1 or 2 diabetes) on the diabetes register of an urban general practice in the west of Ireland were invited to attend a foot screening examination. A letter was sent by the research team inviting them to make a foot screening appointment at the Community Podiatry Department, Primary Community and Continuing Care, Health Services Executive West.

This study was approved by the Research Ethics Committee of the Irish College of General Practitioners. All participants provided written consent to undergo foot screening.