'3,000-foot clinics needed to control foot amputation ratio'

KARACHI: There is an urgent need to establish around 3000 diabetic foot clinics with telehealth facilities throughout Pakistan, especially at district, tehsil, and taluka levels, to prevent thousands of amputations that are annually performed due to diabetic foot ulcers in Pakistan, national and international experts said on Saturday.

"There are around 19.6 million people living with diabetes in Pakistan as per International Diabetes Federation (IDF), and of them, 1 to two million develop diabetic foot ulcers, which is a serious complication of 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 specialized diabetic foot clinics in Pakistan," said Prof Dr Abdul Basit, Secretary-General of the Diabetic Association of Pakistan (DAP), while addressing the 8th Nadep Foot Con 2020.

The two-day international foot conference, being organized 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 in preventing diabetic foot ulcers and saved hundreds of limbs," Prof Abdul Basit said in his talk titled "Pragmatic Approach to Diabetic Footcare."

The eminent diabetologist who has also served as the President of International Diabetes Federation (IDF) for the Middle East and North Africa (MENA) region claimed that 50 percent 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 are helping people with diabetes and added that now there is a need to replicate this project in entire Pakistan.

"In Karachi, we have managed to bring down amputations due to diabetic foot ulcers from 27 to 3 percent 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," Prof Abdul Basit said adding that with the use of technology and awareness, even the incidence of diabetic foot ulcers can be prevented to a large extent.

Dr Zahid Miyan, organizing secretary of the NADEP Diabetes Foot Con 2020, in his address told that with the help of multidisciplinary care, training, and awareness, around 50 percent amputations have been prevented as specialized foot clinics in Pakistan and called for using the technology to reach a maximum number people with diabetes to make them aware of its complications, especially diabetic foot ulcers.

"Due to COVID-19 restrictions, thousands of people with diabetic foot ulcers could not visit the specialized foot clinics, and this led to worsening to their wounds. This issue can be resolved by using technology", he said and added that they are conducting live workshops where experts are training doctors throughout Pakistan on cleaning, managing, and treating diabetic foot ulcers.

President of the National Association of Diabetes Educators of Pakistan (NADEP), Dr Saif-ul-Haq, said there is an urgent need to spread awareness among healthcare professionals as well as common people so that diabetic foot ulcers and other complications of diabetes could be prevented in Pakistan.

In addition to training doctors, there is a need to train thousands of nurses and take them on board in the management of diabetes in Pakistan, he said, adding that most of the complications of the lifestyle disease could be prevented by increasing awareness and educating the masses.

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 and breaking but added that early diagnosis of this condition could prevent further progression of the disease.

Several other experts including Prof Nicolass C Schaper, Chairman of the International Working Group on the Diabetic Foot, Prof Zaman Shaikh, Dr Asim Bin Zafar, Dr Asmat Nawaz, Prof Rayaz A Malik, Dr Awn Bin Zafar, and Prof. Karim Kammeruddin also spoke on the first day of the conference.

-MN Report