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WDF-funded project to set up 100 diabetic foot clinics in India
To reduce diabetes-induced leg amputations and create awareness about diabetic foot, 100 diabetic foot clinics across the country will be set up by a project funded by the World Diabetes Foundation (WDF). The project, Step by Step, costing 4,00,000 USD will have academic support from International Diabetes Foundation (IDF), International Working Group on the Diabetic Foot (IWDGF), Diabetic Foot Society Of India (DFSI) and Muhimbili University College of Health Sciences (MUCHS), Dar es Salaam, Tanzania.
Says Dr Sharad Pendsey, chairman and project in charge, Step-by-Step, “The clinics would provide education, diagnosis and therapy to the patients. The clinics would identify high-risk feet and minor lesions. The diagnosis of lesions through diabetic foot clinics would therefore help in prevention of 75 per cent of diabetic foot complications. With around 40,000 leg amputations taking place in India annually, the clinics will help reducing limb amputations due to diabetes by 50 per cent within a period of five years,” adds Dr Pendsey.
The project was conceived three years back by five international experts on diabetic foot. The project committee comprises Dr Sharad Pendsey, Dr Karel Bakker from the Netherlands, A V M Foster, chief consulting podiatrist, King’s Medical College, London and Sanjeev Shishoo, managing director, Novo Nordisk India Pvt Ltd, United Kingdom, Dr Zulfiqarali G Abbas, Tanzania and Dr Vijay Viswanathan, India.
The project will educate healthcare professionals involved in the running of diabetic foot clinics. These healthcare professionals in turn will educate patients on aspects of diabetic foot treatment. The clinics will have a dedicated team of pedicurists, podiatrists, nurses, diabetologists, surgeons (general, orthopaedic and vascular), neurologists, dermatologists, rehabilitation specialists and educators.
Trivial foot lesions precede 85 per cent of leg amputations. Training of doctors and nurses will thus help prevent majority of leg amputations. In all, a total of 115 teams of doctors and nurses from India(94), Tanzania(15), Bangladesh(3), Sri Lanka(2) and Nepal (1), were selected for training in diabetic foot care and offered basic course in 2004 and advanced course in 2005 in India and in Tanzania.
Around 100 Indian physicians have already been trained to set up the clinics. The training programme comprising Basic and Advanced Course in Diabetic Foot treatment was conducted in the month of September, 2004 to October, 2004 in the country. According to Ali Foster, consultant podiatrist, King’s College Hospital, London, “With only one training centre on podiatry at Amrita Institute of Medical Sciences (AIMS), Cochin, India need more training centres, which will now be set up by ‘Step by Step’ programme.”
Centres would be networked with each other depending on the zones. While Delhi would be linked with states of Punjab, Haryana, Himanchal Pradesh, Uttar Pradesh, Rajasthan and Jammu Kashmir, Kolkata will have linkages with centres in Bengal, Orissa, Bihar, Imphal, Darjeeling, Chennai will network with centres in Tamil Nadu, Kerala, Karnataka and Andhra Pradesh and Mumbai with centres in Gujarat, Karnataka and Maharashtra. “This will also help in advanced or complicated cases of diabetic foot like bypass surgery, leg amputation and Gangrene for referral to higher centres,” says Pendsey.
Early diagnosis assumes significance as the cost, both in terms of human health as well as economic burden associated with diabetic foot treatment is alarming. Says Dr Anil Kapur, vice chairman, WDF, “The treatment of diabetic foot is expensive with the direct cost accounting from Rs 4,000 to Rs 7,000 annually in the form of cost associated with the routine care and around Rs 12,000 annually as the indirect cost in the form of loss of manpower and man power hours.”
Diabetes is the most common cause of non-traumatic lower extremity amputation and concerted efforts in raising awareness, education, capacity building of healthcare professionals through this programme will go a long way in identifying and reducing diabetic foot complications. An estimated 34 to 35 million people suffer from diabetes in India, which is the highest in the world. Among the chronic complications of diabetes, diabetic foot is the most devastating and is the leading cause of leg amputation among diabetics. Experts pinpoint that the lack of awareness, practice of barefoot walking, home surgery, faulty footwear (Hawaii slippers) and delay in reporting further compound this problem. WDF is an NGO dedicated to prevention of complications of diabetes in the developing world through funding of sustainable projects in education, capacity building, distribution and procurement of essential drugs and monitoring. It has already funded over 30 projects in the developing world.
Sir, I Read About Your Diabetes Foot Clinic And Am Excited To Be A Part Of It.i Reside In Gulbarga,in Karnataka,india And Am Practising Diabetes.my Request Is -can You Set Up A Diabetic Foot Care Centre In My Place
Do you know when these clinics are to go ahead? Do they need volunteers? I am definately interested in going out for a period of time, as I work in a high-risk field, treating diabetics with ulcers, Rh A patients etc.