Major differences in the rate of foot amputations for people with diabetes in England are incredibly concerning, patient groups say.
Such amputations are a sign patients have not received adequate care, as poorly controlled diabetes increases the risk of foot ulcers and infections.
One in 10 areas had "significantly higher rates", government data shows.
There was nearly a five-fold difference between the best and worst when taking into account risk factors such as age.
Diabetes UK said the figures "shined a light on the scale of the crisis facing diabetes care" and it warned access to support was likely to have become worse during the pandemic.
A report produced by the charity earlier this month said lives would be needlessly lost because of disruption to services over the past two years.
The government data – published by the Office for Health Improvement and Disparities – looked at the three years leading up to the pandemic.
It found 13 out of 135 local areas in England had significantly higher rates of foot amputations. Harrow was estimated to have the lowest rate at 3.5 per 10,000 people with diabetes, while Blackpool had the highest at 16.8.
It is believed up to 80% of foot amputations could be avoided with better care.
When diabetes – both Type 1 and Type 2 – is present for many years, especially if it is poorly controlled, it can cause complications such as reducing blood flow to vessels in the feet and nerve damage which reduces sensation. This increases the risk of ulcers and infections which may lead to amputation.
Diabetes UK chief executive Chris Askew said the latest figures were "incredibly concerning".
"The majority of these major amputations are preventable, but many people living with diabetes are struggling to access the care they need – and in areas of higher deprivation, people are experiencing worse outcomes. These inequalities must be addressed."
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Diabeets
13/10/2022