Around 3,000 diabetic foot clinics with telehealth facilities need to be established throughout the country, especially at the district, tehsil and taluka levels to prevent thousands of amputations that are annually performed due to diabetic foot ulcers in Pakistan.
This was stated by local and foreign experts said on Saturday as they spoke at the 8th NADEP Diabetes Foot Con 2020.
“There are around 19.6 million people living with diabetes in Pakistan as per the International Diabetes Federation (IDF) and of them, one to two million develop diabetic foot ulcers, which is a serious complication of the type 2 diabetes. Of them, thousands of people face amputations of lower limbs annually in Pakistan. Thousands of amputations can be prevented with the establishment of specialised diabetic foot clinics in Pakistan,” said Prof Dr Abdul Basit, the secretary general of the Diabetic Association of Pakistan (DAP).
The two-day international foot conference, being organised by the National Association of Diabetes Educators of Pakistan (NADEP) in collaboration with the Baqai Institute of Diabetology and Endocrinology (BIDE) Karachi, is being held for the last several years at various cities of Pakistan and it is addressed by leading diabetologists and endocrinologists who share their experiences in managing and treatment of diabetic foot ulcers and prevention of lower-limb amputations.
“Every year, three to four hundred thousand people lose their legs, feet or parts of their lower limbs due to diabetic foot ulcers in Pakistan but with better care, timely intervention and treatment as well as education and awareness, thousands of amputations can be prevented. For the last several years, we have trained hundreds of doctors, general practitioners and nurses to help people prevent diabetic foot ulcers and saved hundreds of limbs,” Prof Basit said in his talk titled ‘Pragmatic Approach to Diabetic Footcare’.
The diabetologist, who has also served as the president of the International Diabetes Federation for Middle East and North Africa region, claimed that 50 per cent of amputations due to diabetic foot ulcers were prevented at 150 foot clinics established by them throughout the country where podiatrists and technicians trained by them were helping people with diabetes. He stressed the need for replicating the project in the entire country.
“In Karachi, we have managed to bring down amputations due to diabetic foot ulcers from 27 to 3 per cent only, which means that hundreds of lives were saved as most of the people with diabetes die within a few years after losing their lower limbs,” the expert said.
Dr Zahid Miyan, the organising secretary of the NADEP Diabetes Foot Con 2020 said that with the help of multidisciplinary care, training and awareness, around 50 per cent of amputations have been prevented due to specialised foot clinics in Pakistan.
“Due to COVID-19 restrictions, thousands of people with diabetic foot ulcers could not visit the specialised foot clinics and this [worsened] their wounds. This issue can be resolved by using technology,” he said.
NADEP President Dr Saif-ul-Haq said there was an urgent need for spreading awareness among healthcare professionals as well as common people so that diabetic foot ulcers and other complications of diabetes could be prevented.
In addition to training doctors, he called for training thousands of nurses and take them on board in the management of diabetes in Pakista. He said most of the complications of diabetes, which was a lifestyle disease, could be prevented by increasing awareness and educating the people.
Tanzanian expert of diabetic foot ulcers Dr Zulfikar G. Abbass spoke on the charcot arthropathy, a condition in which bones and joints of the feet of people with diabetes start disintegrating. He said that early diagnosis of this condition could help prevent further progression of the disease.
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