The diabetic foot stamp

”Tanzania has a huge burden of non-communicable diseases, not the least being diabetes and its complications like the diabetic foot, which is on the increase and cannot be ignored” said, Dr. Zulfiqarali G. Abbas, Chairman of the Step by Step foot project for Africa when talking at a recently held seminar to launch a postage stamp that highlights the problem of the diabetic foot.

Indeed the stamp, which was launched at the seminar of the Step by Step diabetic foot project for the developing world is one good example of the awareness campaign against the high rate of amputations. “The Stamp has  a denomination of  350/= Shs  the denomination which has the widest circulation in the country as it caters for the basic postage rate for domestic letters”, says Mr. Protas N. Mwagini, The Postmaster General, Tanzania Post Corporation.

Research done by Dr. Abbas and colleagues have shown an increased rate of amputation for diabetic patients with diabetic foot ulcers. It has been seen that 33 per cent of admitted cases at Muhimbili National Hospital end up with an amputation. More than 50% of the patients have died with foot problems as they report late for medical treatment.

The major adverse outcomes of diabetic foot problems are foot ulcers and amputation. Approximately 40-60 per cent of all non-traumatic amputations of the lower leg are performed on patients with diabetes. Foot ulcers are documented as preceding approximately 85 per cent of all diabetic amputations. In most cases, the amputation had to be performed because of a combination of deep infection, loss of sensation and decrease in blood supply. People with diabetes spend more time in hospital with foot ulcers than with any other of the complications of diabetes.

Good footcare can prevent ulcers and amputations

 “The main danger of sensory neuropathy is loss of feeling in the feet, especially if you do not realize that this has happened. Then it becomes a high risk foot, and the patient can develop an ulcer easily through a minor trauma. If you were to lose feeling in your feet, you might develop a problem without being aware of it. For example you may not notice that your shoes are rubbing, as you might not feel any discomfort. If this is not properly treated, it could become infected or be further irritated. Eventually it is likely to develop into an ulcer. An ulcer will provide a way for infection, which will lead to a non-healing wound, eventually to a gangrene that ends up with needing an amputation”, explains Dr Abbas.

Diabetes can also affect the circulation by clogging up the arteries. This may affect the heart and other blood vessels, especially those supplying the feet. Without a good blood supply, one may have problems with skin and nails, with cuts and sores that do not heal very well. Good foot care can prevent this happening. This is why it is so important for people with diabetes to look after their feet, to have regular checks, and to get expert help when there is a problem and not treat foot problems themselves.

From left; Dr. Z. G. Abbas, Consultant Physician and Chairman of Step by step foot project in Africa, Mr. Ulrik Uldall Nielsen from World Diabetes Foundation and Dr. Karel Bakker, Chairman of International Working Group on the Diabetic Foot

”Tanzania has a huge burden of non-communicable diseases. Diabetes and its complication like the diabetic foot is an increasing burden and cannot be ignored. The increasing rate of amputation in diabetic patients with diabetic foot ulcers is alarming. We are very pleased to see the Step-by-Step project is benefiting the population of Tanzania, where the local authorities has taken up ownership and creating nation wide awareness with this stamp, and the challenge to reduce the rate of amputations”, explains Mr Ulrik Uldall Nielsen, WDF Project Coordinator.

The Step by Step project aims to reduce amputations resulting from the diabetic foot in target areas by 50%, which means 600 legs saved in Tanzania.