Experts call for 3000 diabetic foot clinics across Pakistan to prevent amputations

There is an urgent need to establish around 3000 diabetic foot clinics with telehealth facilities throughout the country, 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 the type 2 diabetes. Of them, thousands of people face amputations of lower limbs annually in Pakistan. Thousands of amputations can be prevented with 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 Baqai Institute of Diabetology and Endocrinology (BIDE), Karachi is being held for last several years at various cities of Pakistan and it was addressed by leading diabetologists and endocrinologists who shared 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 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 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, trainings 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 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 the 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 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 can 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.