KARACHI: Awareness, willingness stressed to control diabetes
KARACHI, Nov 13: Lack of will and dearth of awareness about prevention of diabetes has not only exposed the country to a constant surge in the disease incidence but is also contributory to aggravating complications including retinopathy leading to blindness and foot ulcers, enhancing risk to amputations besides several other fatal consequences.
Experts addressing a seminar ‘Put Feet First — prevent amputations’ organized by the Diabetic Association of Pakistan (DAP) and the WHO Collaborating Centre, here on Sunday to observe the World Diabetes Day, suggested need for a holistic approach to address the ailment which also has its socio-economic as well as psychological implications.
DAP President Prof A. Samad Shera, Prof Abdul Basit (Baqai Institute of Diabetology and Endocrinology) and Prof Moosa Murad (Aga Khan University) were the key speakers at the meeting’s scientific session.
Prof Abdul Basit in his presentation said diabetes was a serious and chronic disease, and foot problems and amputations were one of the most costly complications of diabetes besides being one of the most common cause of admission to hospital for diabetics.
“Most important factors for developing ulcers are peripheral neuropathy, foot deformities, minor trauma, infection and peripheral vascular disease,” he told the participants comprising general physicians and healthcare professionals.
Under the given conditions, he stressed that early detection and timely interventions were key to addressing the factors behind the continual increase in diabetes-related complications adding that 49 to 85 per cent of amputation rate could be prevented by identifying people at risk of diabetic foot complications.
Referring to community-based studies conducted by his institute, he said neuropathy was found in 36 per cent diabetic patients, 5.4 per cent of them had peripheral vascular disease, 10.4 per cent had foot ulcers, 2.5 per cent had to undergo below knee amputations and 1.9 per cent above knee amputations.
Amputations, he reminded, was due to delayed referral adding that doctors as well as patients needed to be extremely cautious in taking proper care of diabetic foot with provision for regular foot examination, providing education and self-care programme, appropriate foot care and good diabetes control.
The senior diabetologist also discussed the economic aspect of the ailment with direct bearing on financial capacities of local diabetic population.
It was mentioned that while an average urban Pakistani spent Rs260 per year under the head of health expenditure which grew by 25 to 35 per cent in case of Grade two to Five Foot Ulcers — manifested through depth of ulcers, involvement of bones and tendon, generalized gangrene and localized gangrene respectively.
The speaker also mentioned that foot ulcers not only developed due to neuropathy but trauma, wrong type of shoes, smoking and negligence of foot also led to serious conditions making necessary for people in general and diabetic in particular to ensure good hygiene and check their feet on a daily basis, wear comfortable and right type of shoes, avoid smoking and also opt for regular examination of their feet by doctors.
Dr Basit also discussed the importance of managing foot ulcers by pressure off-loading devices that facilitated healing.
He said an indigenous and cost-effective device had been developed for the purpose at his institute and was being used by many of the patients.
Dr Murad Moosa Khan in his presentation ‘Psycho-Social Aspects of Diabetes’ mentioned that not only the diabetics were prone to developing clinical depression but patients suffering from deep depression and other psychological conditions were extremely vulnerable to be inflicted with diabetes.
The fact, he regretted, was largely ignored at the expense of the patients concerned.
Elaborating his stance, the psychiatrist said depression led to a poor glucose control and eventually a higher frequency of diabetes complications.
He said diabetes, a chronic disease with high prevalence of mood disorder and depression, was closely linked to the fact that patients had to take on extra responsibilities in managing their health.
As for children, the psychiatrist said children with diabetes felt discriminated by their peers. Recognition of the psychological problems were said to be very important as treatment was essential to maintain good metabolic control and provide a good quality life.
Prof Murad Moosa Khan suggested close coordination among general physicians, diabetologists and psychiatrists to help address distress of diabetics.
Prof A. Samad Shera made an elaborate presentation on ‘New Insulins’. It was stated that insulin — a life savior medication, discovered in 1921 for diabetics — had experienced massive technological advancements.
Prof Samad Shera said that inhalable and oral insulin were still under trial.
The scientific session was followed by a public session for people with diabetes. It was chaired by former speaker of the National Assembly, Illahi Bukhsh Soomro.
It was an interactive session during which a panel of experts comprising Prof Shera, Prof Fatema Jawad, Prof Nadeem Rizvi, Prof Saleh Memon, Prof Zaman Sheikh, Dr Najmul Islam and Dr Obaid Hashmi answered questions raised by diabetics, their friends and relatives.—APP
KARACHI, Nov 13: Lack of will and dearth of awareness about prevention of diabetes has not only exposed the country to a constant surge in the disease incidence but is also contributory to aggravating complications including retinopathy leading to blindness and foot ulcers, enhancing risk to amputations besides several other fatal consequences.
