Doris Obinna
Experts have said diabetes education knowledge is low in Nigeria owing to the fact that symptoms can be quiet until complications sets in. Also, they say to reduce the burden of diabetes burden in Nigeria, there is the urgent need to implement ideas that would reduce the burden.
The Course Coordinator, Rainbow Specialist Medical Centre, Dr. Afokoghene Isiavwes, who stated this in Lagos during the 6th Annual International Diabetes, Podiatry and Diabetes Foot Care, said it was a sad realisation that diabetes mellitus (DM) was preventable, but presently causing non-traumatic lower limb amputation.
According to her, the theme for this year’s workshop was relevant and important, as having a strong diabetes foot care protocol at the primary care level would save more diabetes limbs and lives by ensuring primary health care workers are able to recognise the high risk diabetes foot and know how to promptly triage them.
Explaining further, she said a first responder is a person with specialised training who is among the first to arrive and provide assistance at the scene of an emergency.
According to her, “you would agree with me that diabetes is a global emergency, with associated complications. With the absence of podiatry training, which helps to reduce diabetes amputations, you would agree with me that our diabetes foot first responders must be trained to stand in the gap till formal university training begins.”
She stressed that an individual with initial “ray-amputation” (a surgical removal of a dead diabetes toe) could end up with repeated surgeries on the same limb, sometimes ending with an “above-knee amputation,” a surgical procedure performed to remove the lower limb at or above the knee joint when that limb has been severely damaged) in this case by diabetes mellitus.
In Nigeria, according to her, many people have little or no knowledge of diabetes and its complications.
Isiavwes said: “It is estimated that the rate of foot ulcer among people living with diabetes is between 8.3 per cent and 19 per cent in the different zones of the country.
“The rate of amputation is also estimated to be as high as 53.2 per cent in people with foot ulcer in some centres, thereby making diabetes foots the most common cause of non-traumatic amputation in the lower extremities in Nigeria.
“Diabetes foot disease is a leading cause of hospital admissions in Nigeria and the economic burden becomes quite significant, knowing most of the health expenditure in the country is from out of pocket expenses.
“It is interesting to know that this disease was previously not common in Nigeria and erroneously believed to be disease of the affluent. However, with globalisation and demographic transition the disease have become prevalent in all parts of the world and affect all segments of the population, rich and poor alike.”
Also speaking, the President, World Walk Foundation, Jamaica Chapter, Owen Bernard, said for every five seconds, a lower limb is lost to amputation as a result of complication from diabetes, which he noted is due to lack of education about the disease and the inability to identify its symptoms.
Bernard lamented that there are no enough health personnel on diabetes treatment and care in many countries across the world, noting that it is important to train as many personnel as possible in the health centres present in Nigeria, so as to salvage some of the disease problems at the primary care level.
He said the major aim is to help reduce the rate of diabetes and prevent amputation because there are so much burden it places on an individual, noting that Nigeria needs to spend more time and money to prevent loss of the limb/leg.
In her remark, Professor of Endocrinology and Diabetology, Department of Medicine, College of Health Sciences, University of Abuja Teaching Hospital, Felicia Anumah, stressed that diabetes has become a huge problem in Nigeria presently, with increasing complications, which are most times dangerous and could result to death of the affected individual, if not addressed on time.
According to Anumah who is also the Dean, Faculty of Clinical Science University of Abuja, the prevalence of diabetes foot right now varies from between 0.3 per cent and 19 per cent, depending on the type, with amputation rate as high as over 50 per cent.
She noted however, that the problem most time with the diabetes foot patient is that, by the time he/she gets to the health centre where the right and proper care can be given, it is usually late, as about 50 per cent of the only option to save that person’s life is amputation.