Experts Raise Alarm on Increased Rate of Diabetes Foot Amputations

Martins Ifijeh

Stakeholders in the management of diabetes have expressed worry over the increasing rate of amputations due to diabetes foot ulcer, a major complication of diabetes mellitus and called on the federal government to accelerate efforts towards the adoption of a policy guideline 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. AfokeIsiavwe, 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 communique, diabetes foot is now the most common cause of amputation of the lower limbs and is responsible for more hospitalisation in patients with diabetes than other complications put together.

“There is a general lack of awareness both among the populace and healthcare 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 caregivers 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 the average patients.

“Although diabetes care is obtained at the primary, secondary and tertiary levels of healthcare 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 participants said.

The communique 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 to manage the increasing cases of diabetes foot ulcer in all parts of the country as no Nigerian medical school offers podiatry training.

The communique 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 DM 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 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 revascularisation and intervention cardiologist and the media urged doctors to emphasise the importance of foot care to patients right from the time diabetes is first diagnosed, adding that this should be reinforced at regular intervals.