EMSON at the just concluded 44th Annual General Meeting and Scientific Conference (AGMSC), held in Port Harcourt, Rivers State, said the burden of diabetes foot ulcer (DFU) is high globally, especially in Africa and Nigeria in particular.
EMSON, in a communiqué jointly signed by the President, Prof. Aihanuwa Eregie; Secretary General, Dr. Oluwarotimi Olopade and Public Relations Officer, Dr. Michael Olamoyegun, said the burden and debilitating effects of diabetes foot ulcers reflect the need for strategic interventions to prevent and/or manage the condition.
The communiqué reads: “Diabetes-related foot ulceration is recognised as a leading cause of hospital admission and amputation globally and in Nigeria
Amputation rates due to diabetic foot ulcers (DFU) in Nigeria are high. Every 20 to 30 seconds a limb is lost to diabetes mellitus foot syndrome and the lifetime risk of developing a diabetic foot ulcer is 19 – 34 per cent.
“Most of our patients (80 per cent) in Nigeria pay out of their pocket as opposed to other climes where most of the cost is borne by the government. The burden of diabetes foot ulcer is worsened by poor knowledge and practice of foot care, poor health-seeking behaviour, religious and cultural beliefs and misconceptions. Many of the patients presenting with DFU present late or in the advanced stages of DFU.”
To address the situation, EMSON recommends multidisciplinary care in diabetic foot ulcer management as a global best practice and is associated with shortened wound healing time, reduced amputation rate and reduced cost of DFU care. The endocrinologist said podiatry care, an essential component of diabetic foot management, is non-existent in Nigeria.
EMSON resolved to create awareness of the role of multidisciplinary care and specialised services in diabetes mellitus and its complications such as diabetic mellitus foot syndrome. The endocrinologists said there is a need for infrastructure and involvement of institutions in the setting up of the multidisciplinary teams (MDT) which should be coordinated by an endocrinologist.
The association calls for more government involvement and funding as well as collaborations with Non-Governmental Organisations (NGOs) and corporate bodies in the setting up and implementation of MDT in institutions.
It said there is a need to train and employ more podiatrists for the MDT management of DFU with the establishment of podiatric medicine training programmes.
EMSON said there is a need to improve healthcare providers’ capacity for the prevention and management of diabetic foot ulcers. It said patient education, specialist care, clear referral pathways, use of multidisciplinary/professional teams and other strategic interventions will help reduce the incidence of diabetic foot ulcers and eventual lower limb amputation.
EMSON said there is a need for standardisation of diabetic foot care in Nigeria.
The endocrinologists recommend that health care practitioners (HCPs) should regularly assess persons living with diabetes for risks of foot problems when diabetes is diagnosed and at least yearly thereafter.
They said the association will continue its advocacy as a major stakeholder in shaping and implementing policies for endocrine and metabolic health among adults and children in Nigeria, especially diabetes care.
The association calls for more awareness campaigns and targeted community education of the public on basic diabetes foot care, saying there is a need for a programme for post-amputation care for amputees.
The association calls for incorporating telemedicine in the management of DMFS and virtual foot diabetic foot training, saying the 45th Annual General Meeting and Scientific Conference of Nigeria’s Endocrine and Metabolism Society will be held in Abeokuta, Ogun State, Nigeria in September 2024.
The theme of the AGMSC was ‘Diabetes Mellitus Foot Syndrome: Multidisciplinary Care Approach-Where are we now?’ The sub-themes were- Diabetes mellitus: transition from Paediatric to adult care; Endocrine Reproductive Abnormalities: PCOS and DM; Adrenal disorders: Challenges in the tropics; and Hyperglycaemia in pregnancy, Dyslipidaemia: Current trends in Management.
