Facts on foot care in India – one step ahead

Half of all people with diabetes experience different types of nerve diseases which often lead to amputations. The nerve diseases cause loss of sensitivity in the feet, which means that if the foot is injured, the patient will not notice it and will often omit to the wounds. The problem is particularly urgent in developing countries, where many people do not wear shoes. Many of these foot complications can be prevented if early diagnosis of risk factors is made and appropriate measures are taken. Prevention would reduce the economic burden of the hospitals and society at large. Five clinics planned The initial idea was to use the funds raised from the 2003 World Diabetes Day activity to establish a diabetes foot care service at the Dr. Ambedkar Institute of Diabetes, at the Kilpauk Medical College and Hospital in Chennai, India. The Kilpauk clinic was opened March 2004, and two additional clinics were inaugurated in Hyderabad and Ahmedabad in March 2005. Totally more than 120,000 US dollars were collected, which allows for five clinics to be opened. Disabling disease The average number of attendances per day at the Institute in Chennai has increased over the years and at present about 1000 patients attend the diabetic clinic every day, and at this point in time the department has over 25,110 people with diabetes registered.On an average 30 new cases are registered every day. About 200 patients have the blood sugar level checked daily. Among the effects of diabetes the diabetic foot presents the most serious disabling complications. On an average about 6% of the people with diabetes attending the clinic have foot ulcers and nearly 50% of the patients are at high risk of foot ulcers. Most patients have foot ulcers which could have been easily prevented with the help of a primary prevention program and provision of proper footwear. Since most of the patients attending this centre are poor and will not be able to buy special footwear themselves it is essential to provide free footwear for these patients. With the help from the World Diabetes Foundation fundraising activity on World Diabetes Day 2003 hundred people with diabetes will be screened for foot problems every day at Kilpauk alone. People with high-risk foot can be given proper education for prevention of foot ulcers and proper footwear can be provided. Patients with foot ulcers can be treated by the surgeon in the minor theatre and proper dressing and cast can be provided. Those requiring major amputation can be referred to the surgical department, but hopefully nearly all feet will be saved. Read about the first preventive foot care clinic that was established in March 2004 based on this fundraising event. View our video on foot care problems in India.