Government urged to establish diabetic foot clinics across Pakistan

KARACHI: National and International experts have recommended to the federal and provincial governments to establish diabetic foot clinics throughout the country and ensure provision of customised footwear for every person with diabetes in Pakistan on subsidised rates to reduce lower-limb amputations due to diabetic foot ulcers.

They said around 2.5 million people are faced with diabetic foot ulcers every year in Pakistan and of them, 10 percent of diabetics get their feet and legs amputated annually to save their lives.

"Every year, three to four hundred thousand lower limbs of people with diabetes are amputated but these amputations can be prevented by providing customized footwear to each and every person with diabetes", said Dr. Zahid Miyan, President, National Association of Diabetes Educators of Pakistan (NADEP) while speaking at the closing day of Nadep Diabetes Footcon 2019.

Hundreds of physicians and experts from different cities of Pakistan as well as international health experts from Europe, Africa and Middle Eastern countries attended the two-day international moot in Karachi and pledged to provide specialized care and services to the people to prevent their feet and legs from amputation due to diabetic foot ulceration, which is the major cause of permanent disability around the globe these days.

Speaking on the concluding session of the foot conference, Dr. Zahid Miyan who is the Vice President of Diabetic Foot International (D-Foot Int.), deplored that data suggests 70 percent of the people whose legs are amputated due to diabetic foot ulcers, die within five years of the amputations as they acquire other diseases and ailments in addition to diabetes and its complications.

He maintained that amputations and disability due to diabetic foot ulcers had become a global health concern and experts were coming with applicable and cost-effective solutions of this problem to reduce global burden of disability.

"The message we want to convey today through this conference is that people with diabetes should take care of their feet more than their faces and try to prevent their feet from injury. One of the best way to avoid injuries and foot ulcers is use of customised footwear, which prevents amputations up to 80 percent", he added.

Italian diabetologist and foot expert Dr. Roberto Anichini said every person with diabetes must have his or her feet examined by a specialist every time they visit a healthcare establishment so that any lesion, blister or injury could be detected and taken care of and added that in Italy, legs and feet of thousands of people had been saved just by creating awareness about diabetic foot ulcers among common people and the doctors.

"There is also a need for promoting customised footwear among people with diabetes. Unfortunately, people in low income group pay least attention to their feet which carry burden of their entire body and are prone to injury a lot earlier as compared to other organs", he added.

Eminent physician Dr. Asim Bin Zafar gave a detailed presentation on Peripheral Arterial Disease (PAD) among people with diabetes, saying it is the biggest cause of foot ulcers in diabetics but added that now with the help of latest technology and use of intervention radiology, this condition could be treated and lower limbs could be prevented.

Tanzanian diabetic foot expert Dr. Zuliqar G. Abbas was of the opinion that like in Asia, people in African countries were also in the habit of delaying treatment and instead of approaching specialized healthcare professionals, they use homemade remedies, go to quacks and faith-healers but when situation gets out of control, they visit hospitals.

"There is a need to educate people with diabetes that they should not ignore health of their feet and take care of their lower limbs like their eyes and hands. In people with diabetes, time is tissue, longer they take to approach healthcare specialists, more are their chances of losing their lower limbs", he added.

Speaking at the closing ceremony, Prof. Abdul Basit, President International Diabetes Federation (IDF) MENA Region, urged the nutritionists to come up with diet plans in accordance with local needs and requirements of Pakistani people, saying food and stuff eaten in Europe could not be advised to people in Pakistan.

"We are soon going to come up with a recipe book which would be based on diets and recipes of food eaten locally. Diet control is essential element of diabetes control but it should be advised keeping in view the local norms, eating habits and needs of the people", he added.

Other national and international experts including Prof. Ejaz Vohra, Dr. Usman Faheem, Erum Ghafoor, Salma Meher from United Kingdom, renowned nutritionist Saima Rasheed, Dr. Saif-ul-Haq and others also spoke.