About 300-450 Diabetic Foot Care Clinics to be established in three years-Zahid Miyan

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Amputation Free Sindh will be planned-Dr. Akram Sultan
About 300-450 Diabetic Foot Care Clinics
to be established in three years-Zahid Miyan
Diabetes Educators should be given recognition so
that they play their role effectively-Saiful Haque

KARACHI: Dr. Akram Sultan Director Health Services in Sindh Government has assured that the government will plan an Amputation Free Sindh by ensuring provision of primary, secondary and tertiary diabetes care to prevent diabetes, avoid diabetes complications including diabetic foot thus leading to possible Amputation Free Sindh Province. He was speaking in the inaugural session of the National Associate of Diabetes Educators Pakistan (NADEP) Diabetes Foot conference 2021 held at Karachi from November 5-7th 2021 where he was invited as a Chief Guest.

The word diabetes and Dr. both, he said, start with D and we need to educate the whole community to participate in prevention and management of this deadly disease. Diabetes leads to cardiovascular diseases, cerebrovascular diseases, peripheral artery disease and all have serious complications with increased morbidity and mortality. Obesity also leads to diabetes. We need to educate our children to eat smart healthy balanced food instead of junk food which leads to obesity. He also assured that he will take up the issue with the provincial government so that diabetes educators can be appointed in the healthcare facilities by passing a Bill in the provincial assembly. He also supported including a question about diabetes and metabolic disorders in the undergraduate examination. He also gave details of vaccination of children for various diseases and commended the provincial government efforts in managing the Covid Pandemic effectively. Let us all work together to prevent diabetes, he concluded.

Earlier Dr. Saiful Haque President of NADEP in his address suggested that Diabetes Educators were doing an excellent job in managing diabetes. It is high time that government gives them their due recognition so that they can play their role in prevention and management of diabetes effectively. We need to train individuals in community work. NADEP was established in 2008 and since then it has been active in creating awareness about diabetes and diabetes education in the community. To realize our goal we need to mobilize and motivate the entire community. Everyone who is interested can become a member of NADEP. BIDE started a one year’s course for Diabetes Educators and so far a large number of these professionals have been trained, he added.

Dr. Zahid Miyan Chairman of the organizing committee in his speech pointed out that this meeting was being organized in collaboration with BIDE, Baqai Medical University, Foot International, NADEP and Pakistan Working Group on Diabetic Foot. It is a part of Global Action against Amputation which is being celebrated during this week from November 7th to 14th 2021. We will introduce D. International Fast Track Programme in Paksitan in which between three hundred to four hundred fifty Diabetic Foot Care Clinics will be established all over the country in the next three years. This will be a sustained diabetes foot care initiative for Pakistan. It will consist of primary care, secondary care, and tertiary care with proper referrals. An attempt will be made to ensure that delayed referral for foot care which is the worst enemy can be avoided which will reduce or avoid amputations.

Prof. Abdul Basit Director BIDE and the moving spirit behind this whole diabetes care programme lived up to his reputation of presenting his State of the Art lecture disguised in vote of thanks. Whenever he gets a chance, he manages to say whatever he wants to say and in this session he touched almost every important aspect of diabetes in general and diabetic foot in particular and conveyed his message effectively. Our aim, he stated, was amputation free Pakistan. At present we have about two crore people suffering from diabetes, 10% of them suffer from diabetic foot which makes it twenty lac people. Of this about 10% of patients lose their leg due to amputation as such we are losing about two lac legs due to amputation every year. The story does not end here, 50-70% of the people who suffer from amputation due to diabetic foot ulcers die within five years. That is why we have been raising our voice and making noise about diabetes. Sindh Government he said has signed an MOU with BIDE and they have started following SOPs proposed by us for diabetes screening and care at its healthcare facilities in a phased programme for which credit goes to Sindh Health Minister and Director Health Services. We are in discussion about similar MOU with Government of Baluchistan and Punjab. Prof. A.H. Amar in KPK initiated provision of free Insulin to Type-I diabetics to the entire patient population there. Our colleagues have started free insulin for TIDM in Baluchistan and Dr.Salma in Multan. We had this programme in Sindh province for many year and provision of free insulin to four thousand Type-I diabetics in Sindh province for next five years. He further suggested that all diabetics must be put on statins, metformin and ACE Inhibitors without asking for any investigations. This is a cost effective approach. He also suggested that we need to train diabetes nurses and Nurse Practitioners as well. We have the talent and capability in Pakistan to produce all diabetes equipment including Glucometers as well provided there is cooperation and coordination between different institutions and organizations. Pakistan has proved its capabilities by producing equipment used in COVID like ventilators which we are now being exporting, he remarked.

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