National diabetic foot prevention model, China

Objectives

With an adult population of more than a billion people and diabetes prevalence of 9,7% (IDF Diabetes Atlas, 2013), China has the highest incidence of diabetes in the world. Only one third of the population is aware of diabetes and most of those living with the condition do not receive proper treatment. This results in needless amputations caused by diabetic foot ulcers complication.

Initiatives for prevention of the diabetic foot are nearly absent in smaller communities across the country. Diabetes care is mostly concentrated in large cities and healthcare professionals lack sufficient skills, which raises barriers for access to adequate and timely treatment.

It is possible to reduce amputation rates considerably through a care strategy that combines prevention, multi-disciplinary treatment, proper education of people with diabetes and training of health care professionals (HCPs).

This project aims at promoting diabetes foot care and prevention at primary level by implementing a pilot project in China.

Approach

This project proposes a model to be tested in two pilot cities from remote communities in China. The local district government, as well as the health bureau, will actively provide support during the development and implementation phases of the project.

The first activity will be the enhancement of skills from HCPs in diabetes foot screening, care and prevention. The training will be optimised by the elaboration of specific textbooks and other course materials.

A toolkit including a manual covering a range of topics within diabetes foot care and another including patient self-care guidelines will be developed by an expert panel. This toolkit will be used for grading the health education of people from the communities and for assessing the risk of development of diabetic foot ulcers. Patients graded with low, medium or high risk will receive health education, self-management guidance and consulting support service.

In order to reach a large number of people, information on diabetes will continually be published on the local newspapers.

Lastly, the results of the project will be evaluated accordingly so it can be later scaled up to national level.

Results at completion

- 283,900 people reached through awareness programmes on diabetes and diabetes foot care
- 2,528 patients surveyed
- 2,528 patients screened for foot complications
- 216 HCPs received training
- 333 people with diabetic foot complications or high risk feet received foot care education and follow up care
- 421 NCD professionals trained in diabetes care