The Hindu : Tamil Nadu / Chennai News : This campaign's theme: `Put feet first, prevent amputations'

Online edition of India's National Newspaper
Friday, Nov 04, 2005

Tamil Nadu

Tamil Nadu - Chennai

This campaign's theme: `Put feet first, prevent amputations'

M. Dinesh Varma

A slew of initiatives to be launched to increase awareness of diabetic complications Grassroots campaigns highlighting prevention of diabetic foot complications will mark the run-up to World Diabetes Day on November 14

CHENNAI: Are you aware that somewhere in the world, a leg is lost to diabetes every 30 seconds or that up to 70 per cent of all leg amputees are diabetics?

Did you know that in India alone, 40,000 legs are amputated every year because of a foot infection complicated by diabetes?

This year's World Diabetes Day campaign for November 14 has chosen this disturbing backdrop to drive home the point that nearly 85 per cent of amputations can be avoided.

The `Put Feet First; Prevent Amputations' theme will be taken across the world by the International Diabetes Federation and World Health Organisation.

In Chennai, the MV Hospital for Diabetes and Diabetes Research Centre (DRC), a WHO collaborating centre for research, education and training in diabetes in India, will launch a slew of initiatives to increase awareness on preventing diabetic foot amputations. The programmes would include grassroots campaigns focusing on the prevention of foot complications, a spokesman said.

Amputation is the commonest complication of diabetes and the amputation rate is very high among diabetics in India, according to diabetologists at the DRC. Going by one study, the amputation rate among diabetics in Germany was 7.5 per cent against 18.7 per cent among diabetics in India. In Germany the cause was reduced blood flow and in India it was due to late reporting of complications.

Alongside the focus on effective treatment of complication, the DRC has charted a new line of emphasis in building awareness about prevention across various institutions and levels of society.

Prevention, which needs less involvement of medical intervention, can also lower the healthcare costs — which is of high relevance in India which now accounts for over 35 million diabetics and is forecast to have a staggering 73 million patients on account of increased life expectancy, sedentary lifestyle and dietary patterns by 2025. "Not only is the impact of amputation devastating on people's lives, it is also one of the costliest complications of diabetes," said Vijay Viswanathan, joint director of DRC.

It is estimated that treatment cost for foot infection, amputation and an artificial limb could be over Rs. 1.50 lakhs not accounting for the emotional trauma and the decline in quality of life, whereas the cost of detecting problems in feet would be only Rs. 2,000 a year.

In a study published in the May 2005 edition of the international journal Diabetes Care, researchers at DRC established that intensive treatment and education for diabetic patients with high risk diabetic status greatly helped in preventing foot amputations.

A one-year follow-up of around 4,800 patients with foot infections found that only seven per cent of patients who understood and complied with the advice had foot ulcers, while 27 per cent of those who failed to comprehend or comply developed ulcers.

The DRC runs an "Amputation Prevention Initiative" where patients are given intensive education and high-risk diabetics are motivated to have early diagnosis of foot problems and provided right type of footwear (with the collaboration of the Central Leather Research Institute).

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