ABSTRACT
Aims: The National Institute for Health and Care Excellence recommend that all adult patients with diabetes should have a foot examination 'on any admission to hospital'. However, a 2013 Scotland-wide audit highlighted that this was not being done for over half of patients, with growing concern about hospital-acquired foot ulceration. A similar audit was conducted at a district general hospital in 2021, to assess for any improvement. Method: A 'snap shot' study was performed, identifying all inpatients with diabetes in the general medicine department at St John's Hospital, Livingston, on the 11th February 2021. Data were collected from patient notes including age, HbA1c, last documented foot risk, and any recorded inpatient diabetic foot examination up until the study date. 14 of these patients then underwent a diabetic foot examination. Results: 51 patients with diabetes were identified, 90% of whom had type 2 diabetes. The average age was 73.7 years (SD ± 13.9 years), and the average HbA1c was 65mmol/ mol (SD ± 18.7mmol/mol). 66% had low foot risk on last examination. Only 8% had a diabetic foot examination documented this admission. Of the 14 patients examined during this study, half had evidence of neuropathy, and two had active foot ulcers. Conclusions: This audit demonstrates that there is still much progress to be made in inpatient diabetic footcare. Furthermore, the covid-19 pandemic has likely had an impact both on foot screening and access to podiatry services, making it even more vital to be diligent with foot examinations.