When Francis Woodhouse noticed symptoms that had previously led to the amputation of five of his toes, he feared a similar operation could be necessary on his other foot.
The 80-year-old Carrajung resident developed diabetes in his 50s.
But about four years ago, he began losing circulation in the bottom part of his legs and feet — a common complication of the disease.
By the time he saw a podiatrist, who then referred him to a GP, it had been months and he was told he had an infected foot ulcer that needed to be operated on.
Over a period of six months, all of his toes on his left foot were amputated, with one to two toes being removed each time.
"I think their medical care came a bit too late, but it was also difficult to get into the high-risk foot clinic," Mr Woodhouse said.
"Very often I couldn't get to see a podiatrist or the podiatrist was spread over five different locations.
"If your feet are bad you often can't drive."
When a high-risk and public foot clinic opened in Traralgon, Mr Woodhouse was relieved to have all the necessary healthcare workers at one site.
Latrobe Valley's high-risk foot clinic
The clinic, located at Latrobe Regional Hospital, is staffed with an endocrinologist, physicians and surgeons, a podiatrist, diabetes educators, nurses and GPs.
Mr Woodhouse has been attending the new clinic since it opened in August and is currently receiving treatment for a new wound that was spotted on his right foot.
"I have found it exceedingly good … they have a doctor on site who has changed some of my medications for my diabetes and my diabetes control has become much better," he said.
"They're able to see you quickly and they're able to treat you straight away ... I don't expect to have any more amputations."
Endocrinology registrar Scott McNeil opened the clinic after noticing inequity in the treatment of diabetic foot disease between regional and metropolitan patients.
He said foot complications were a result of poor diabetes management and it was important to provide the adequate healthcare to decrease mortality.
"Regional centres weren't able to access what we consider the basic standard of care for all patients with diabetes," Dr McNeil said.
"The only options [before] were either going privately to a service, which cost quite a lot of money … or travelling to the closest public high-risk foot clinic, which is at Monash in Clayton."
Long travel times
Dr McNeil said some patients were travelling to Melbourne for more than five hours from East Gippsland to access public services, which was also putting more stress on metropolitan centres.
Gippsland has the second-highest prevalence rate of diabetes out of every primary health network in the country, with 63 out of every 1,000 people having the disease, according to Diabetes Australia.
Dr McNeil said the control of diabetes was worse in Gippsland compared to metropolitan Melbourne, which meant people in the region also had a higher risk of developing other chronic conditions.
"It equates to about 15 per cent increased risk of heart disease and stroke, purely secondary to diabetes," he said.
Dr McNeil said the time taken to present to hospital for ulcers and foot-related disease was an average of 63 days in Victoria.
He said his clinic was able to reduce this time by two weeks.
Mortality rate high
Research has shown the overall mortality of people with diabetic foot ulcers is high, with nearly 50 per cent mortality within five years.
But Dr McNeil said it was a curable condition and 86 per cent of amputations related to foot conditions were preventable.
"The fact that we were able to save [Francis' right] foot speaks to the quality of the clinic," he said.
"The long-term implications of losing a foot is so huge, not only to the patients, because they can no longer mobilise, but also the the Australian taxpayer."
Mr Woodhouse said his whole right foot would have had to be amputated if he was not treated in time because the ulcer was further up from his toes.
Dr McNeil hopes more doctors can come up with innovative ideas to bridge the gap in healthcare between regional and metropolitan areas.
