‘Covid-19 has led to neglect of patients of diabetes, other NCDs’

President International Diabetes Federation (IDF) Prof Andrew Boulton said Sunday diabetes is equally dangerous as cancer or heart disease, so many of diabetics who don’t take it seriously end up losing one or both of their legs as well as eyesight due to complications of the disease, especially diabetic foot ulcers.

“The Covid-19 pandemic led to neglect of many non-communicable diseases (NCDs), especially diabetes in the world, and in the first wave, people with diabetes suffered a lot as complications of their disease worsened as many could not visit hospitals and healthcare facilities due to restrictions and fear of contracting the infectious disease,” Prof Boulton said addressing the closing ceremony of the 8th Nadep Foot Con 2020 through video link on Sunday.

The two-day international foot conference, 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 last several years in 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.

The IDF president maintained that due to Covid-19, there was a huge backlog of non-Covid treatments, which was evident from the fact that one-thirds of the Covid-19 deaths in the United Kingdom had been those of diabetics. He added that there was a need to focus on all types of diabetes and the lifestyle disease should be given the attention it

deserved.

“There had been threats to diabetes care during the first wave of pandemic where all routine out-patient clinics were cancelled, all routine investigations including X-ray and other scans were suspended, the supply of medicines was affected, non-emergency surgeries were cancelled and even the transplant surgeries were cancelled or postponed indefinitely.”

Prof Boulton maintained Covid-19 posed many threats to the diabetics, which included the quality of their diet deteriorated, many of them abandoned exercise, their blood sugar controls worsened, they had psychological impacts and in addition to that they developed fear of going to hospitals due to the pandemic.

“But this pandemic also resulted in some good opportunities in diabetes care, which include expansion in telemedicine medicines, digital education and improvement of in-patient diabetes care services,” he said, adding that now people with mild to moderate complications, especially those having diabetic foot ulcers could be treated at home under the supervision of diabetologists and experts through telemedicine.

Addressing the concluding session of the conference, Secretary General Pakistan Diabetic Association Prof Dr Abdul Basit said it was the right time that efforts were made to prevent diabetic foot ulcers, in addition to training doctors, nurses and technicians in treating patients to reduce the rate of amputations across Pakistan.

“Our research and data has shown that the amputation rate can be brought down drastically with education, training, modern interventions and use of latest medications. At our centre, we have managed to bring down the amputation rate from 27 to three per cent, while at 150 foot clinics established by us across Pakistan, amputations were reduced up to 50 per cent,” Prof Basit added.

The organising secretary of the NADEP Foot Con 2020, Dr Zahid Miyan, spoke on the threats posed by the multi-drug resistant bacteria and pathogens in the treatment of diabetic foot ulcers, and added that the best strategy was to prevent the occurrence of the diabetic foot ulcers in patients with diabetes, saying that prevention was the best strategy in poor countries like Pakistan.

“Infections with multi-drug resistant bacteria and diabetic foot ulcers can be a very lethal combination and this can jeopardise the lives of diabetics even after amputations. So that best strategy should be to focus on prevention from diabetic foot ulcers.”

Another serious diabetologist, Dr Muhammad Saif-ul-Haq, and a young orthopedic surgeon, Dr Shaheer Ali, had a debate on what should be the best course of treatment for the people with diabetic foot ulcers. Dr Saif said 50 to 60 per cent of the lower limbs of the patients could be saved with the help of antibiotics and other interventions.

The conference was also addressed by Secretary General NADEP Erum Ghafoor, Dr Asher Fawwad, Dr Khalid Abdul Basit, Dr Riaz Memon, Dr Zafar Abbasi, Barbara Eichorst and several others.