When a nation-wide report was released on the rising numbers of lower limb amputations due to diabetes, Toni Tilston-Jones, Executive Director of Youville Diabetes Centre, started to receive media inquiries. She had much to share with journalists, including how a simple and affordable solution could drastically reduce amputations and other complications due to diabetes: consistent screening.
“Right now, there are many, many people living with diabetes who are not getting screened for eye, foot and kidney complications,” explains Tilston-Jones. “Without preventative care, the impacts of diabetes on these organs can be life changing. We’re talking about the risk of losing vision, of having an amputation or being on dialysis.”
While the desire for screening is motivated by better outcomes for patients, Youville has also created an estimate of the financial impact that simple screening could have on diabetes care in Manitoba. “With the help of a Réseau Compassion Network Inspiration Grant, we were able to determine that if we can screen and prevent amputation 10 times a year, the clinic would pay for itself. If we can screen properly, we can get patients to the right place to get treatment that will drastically improve their quality of life over time.”
The equipment needed to conduct screening would be a one-time cost of $155,000, and Tilston-Jones estimates the clinic would need approximately $390,000 in operation costs per year. In Manitoba, a lower limb amputation costs, on average, $47,000 to complete. So far, there is no plan in place to fund the new services but Tilston-Jones is hopeful that a donor or a new agreement with health funders will make the screening possible.
That said, Tilston-Jones stresses that while she can make the argument for screening on a financial basis, the impact of an amputation to patients and families truly cannot be estimated. “Let’s say you lose a leg due to complications,” she says. “Who can calculate what that really costs? You have to retrofit your home, you can’t work for an extended period of time, everything changes for you, these are literally foundation shifts to your life. What is the cost to your mental health? The impacts of screening will be so far reaching that it’s a no-brainer to me.”
Because Youville Centre already operates the Diabetes Centre, the addition of screening equipment to their space makes good sense. “We’re creating an ecosystem of care,” continues Tilston-Jones. “We already have 5,000 to 6,000 patients coming through our doors to treat their diabetes. Now we could also be helping to prevent or delay a lot of these secondary complications.”
The complications and strain on the healthcare system are also a factor in lack of proper screening, explains Tilston-Jones. “The way we practice medicine is by specialties. When we look at eyes, feet and kidneys, those are all different specialties, so it’s hard to coordinate screening through those areas. Add to that the fact that the healthcare system has been in crisis since COVID, we understand that everyone is doing the best they can, and family physicians have a lot to manage, as well. Our community-based approach allows us to find different ways to serve and care for folks.”
Youville Centre is hoping to live out its community values even through the delivery of a screening program. “We have so many wonderful partners in the sector who have already reached out to us to see how we can work better together and create better outcomes for all,” she concludes. “We know we can cross-train our staff, work with podiatrists and other specialists and make a real difference in the lives of those living with diabetes.”