Preventing amputations in Karnataka

Somewhere in the world, a leg is lost to diabetes every 30 seconds. According to the International Diabetes Federation (IDF), people with diabetes are 25 times more likely to have a leg amputated than those without the condition. Worldwide, up to 70 percent of all leg amputations happen to people with diabetes. The good news however is that up to 85% of these amputations are preventable.

The World Diabetes Foundation (WDF) hopes to alleviate the tremendous burden and suffering of the diabetic foot by sponsoring an innovative and unique project in Karnataka, which is being launched by the Diabetic Foot Care Division, Jain Institute of Vascular Sciences (JIVAS), a unit of Bhagwan Mahaveer Jain Hospital, Bangalore. JIVAS is one of the leading centers in India, providing this much needed service and training of health care workers across the country in the field of the diabetic foot. The project has been named “PADASAMRAKSHANE” which in the local Kannada language means “protecting the feet”.

The project features a “Mobile Diabetic Foot Clinic”, which is completely equipped with all the latest technical facilities to conduct on location diabetes foot risk assessment during visits to rural areas within a radius of 100 to 150 kms from Bangalore. The project also aims to improve diabetic foot care by training personnel at the Diabetic Foot care Centre of JIVAS. A one-month course will be offered to paramedical worker, which will involve both didactic teaching and hands-on experience. The project aims to train 44 health care workers across India in Diabetic Foot Care over the next two years. In addition to the training component 10 diabetic foot care centres will be implemented across the state of Karnataka in semi-urban and rural areas.

“We aim to train nurses, ANM’s (Auxiliary Nurse Midwife), multipurpose health workers etc. mostly from semi-urban and rural areas in diabetic foot care and help them establish “diabetic foot care Centres” in their localities with help from their medical community. The mobile foot clinic will help us provide care in other under-served areas around Bangalore and continue educating health care workers. It also has the capacity to conduct diabetic foot screening camps and include patient and public education. The three components are complimentary to each other and represent efforts to achieve our main goal, which is to prevent and treat the existing epidemic of diabetic foot problems in Karnataka”, says Dr Kalkunte Suresh, Director of JIVAS. 

The preventative approach and awareness is crucial

Awareness of the diabetic foot is inadequate among both public and in some medical professionals. It is also a financially devastating problem, especially for the lower income patients, since the treatment is usually very prolonged, with loss of work and increasing health-care expenditure. The importance of a preventative approach is crucial in the developing world, in order to avoid the huge social and economic impact of the predicted diabetes pandemic. The need is particularly strong in societies undergoing rapid economic transition, such as India and China.

“Many of the complications of type 2 diabetes that contribute to the high cost of diabetes, such as foot ulcers are potentially preventable by early diagnosis and effective diabetes management.
The Diabetic foot is one of the most serious disabling complications caused by diabetes. Figures show that more than one million amputations are conducted every year. Up to 85% of these amputations are preventable. With the initial support from the WDF we hope to see a significant change in the area of training, public education and sustainable treatment of the diabetic foot and the related problems, especially in the rural areas in Karnataka”, elaborates Dr Anil Kapur, WDF Managing Director.

The economic impact of diabetic foot ulcers is quite huge in context with earning capacity of the Indian population. The cost of out patient treatment of a foot ulcer is about US$300 and this would be more than three-month earnings for at least a third of the population.

India today has a conservatively estimated more than 33 million people with diabetes mellitus, which is one of the highest in the world! This would mean more than 60 million feet at risk!