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Experts alert to rising cases of diabetes foot amputations, proffer solutions

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Medical doctors and other stakeholders in the management of diabetes have raised alarm over the increasing cases of amputations due to diabetes foot ulcer, a major complication of diabetes mellitus.

To address the situation, the experts called on the Federal Government to accelerate efforts towards the adoption of policy guidelines to assist caregivers and people living with diabetes in preventing the problem.Rising from a recent Stakeholders meeting on Diabetes Foot care convened by the Diabetes Podiatry Initiative Nigeria Project (DPIN), the participants in a communique signed by the Medical Director of Rainbow Specialist Medical Centre, Lagos, Dr. Afoke Isiavwe, noted that Nigeria is currently recording unacceptable number of lower limb amputations and death resulting from diabetes foot ulcer in all parts of the country.

According to the communiqué, diabetes foot is now the most common cause of amputation of the lower limbs and is responsible for more hospitalization in patients with diabetes and other complications put together.

The participants which included representatives of the Federal Ministry of Health Abuja, Lagos State Ministry of Health, representatives of the Diabetes Association of Nigeria (DAN), Endocrine and Metabolism society of Nigeria (EMSON), endocrinologists/diabetes care physicians from the different geopolitical zones, limb revascularization and intervention cardiologists and the media urged doctors to emphasize the importance of foot care to patients right from the time diabetes is first diagnosed, adding that this should be reinforced at regular intervals.

The participants said: “There is a general lack of awareness both among the populace and health care practitioners in Nigeria about foot care for people living with diabetes. The practice of examining the feet of diabetes patients during visits to the clinic is yet to be embraced by a large number of doctors and other care givers in the country while patients lack basic knowledge to prevent foot ulcer. The practice of treating wounds and ulcers at home remains rampant.

“The cost of managing foot ulcer or performing amputation is enormous and always well beyond the reach of patients.“Although diabetes care is obtained at the primary, secondary and tertiary levels of health care in the country, a large number of patients with foot problems present too late to the tertiary facilities mostly at a stage where amputation remains the only option to save their lives.”

The communiqué further noted that the country has no guideline for the management of diabetes foot ulcer. Also, the participants noted, there’s a dearth of podiatrists, the specialists who diagnose and treat foot disorders, to manage the increasing cases of diabetes foot ulcer in all parts of the country as no Nigerian medical school offers podiatry training.

The communiqué therefore called on governments at all levels to embark on urgent public enlightenment and intensive foot care education to save more Nigerians from needless limb loss and death.

“This is crucial as research has shown that diabetes foot care education impacts greatly on the prevention of diabetes mellitus foot and also reduces the risk of lower extremities amputation and mortality. When offered early, foot care education remains the easiest, least expensive and most cost effective way to prevent foot ulcers and death.”

The participants urged doctors to emphasize the importance of foot care to patients right from the time diabetes is first diagnosed, adding that this should be reinforced at regular intervals.

Also, all tiers of governments were enjoined to, as a matter of urgency, establish specialized multidisciplinary foot clinics to ensure a more organized and better diabetes foot care needed to reduce the current “unacceptable” rate of diabetes foot, amputations and high morbidity.“There’s urgent need for Nigeria to incorporate podiatry in the medical schools’ curriculum. Similarly, there’s need to train more doctors and other relevant care givers on various aspects of diabetes foot management.”


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