Chennai: Lack of awareness and inadequate foot care contribute significantly to amputations among people with diabetes in low and middle-income countries, said Dr Frances Game, clinical director of R&D at University Hospitals of Derby and Burton, NHS Foundation Trust, England.
Game, who on Saturday delivered the 39th M Viswanathan Gold Medal Oration on strategies to eliminate preventable amputations, said a study in the 1990s revealed that 18 per cent of amputations are preceded by ulcers. “This was a revelation, as anyone with diabetes inevitably believed that they would get an amputation further down the line,” she said.
The process occurs in four stages, starting with diabetes, leading to neuropathy or peripheral artery disease, to ulceration, and amputation at the final step. “This can be averted by preventing the ulcer,” she said. It is important to identify people at risk of amputation by offering them frequent foot examinations, educating the patient and family, and ensuring they wear the appropriate footwear. “Treating risk factors for ulceration is the key element to prevent amputation for patients with diabetes,” she said.
The event also marked the launch of a white paper on diabetes care by Research Society for Study of Diabetes in India (RSSDI). The white paper outlines that with more than 101 million Indians diagnosed with diabetes and 136 million with pre-diabetes, there are challenges in care, awareness, and treatment adherence. RSSDI called for nationwide screenings, telemedicine expansion, and policy reforms to improve care.
Total diabetes treatment cost is projected to hit $12.8 billion by 2030, it said urging govt action to curb India’s growing burden. RSSDI is world’s largest organisation dedicated to diabetes care, with more than 12,000 members across 23 chapters in India. Half of diabetes patients still remain undiagnosed in India, said TN Dr MGR Medical University V-C Dr K Narayanasamy, who was the chief guest. Dr Vijay Viswanathan, head and chief physician of M V Diabetes and national president of RSSDI, agreed. In TN, diabetes prevalence is 15%-18% in cities and 6%-8% in rural areas, he said.
