Diabetes and tobacco combined are not only killing around 566,000 people in Pakistan annually but they have also emerged as the leading risk factor for diabetic foot ulcers (DFUs), which are the main cause of amputation in Pakistan.
Highlighting these facts on Sunday, national and international experts called for learning from the experiences of developed countries in managing the epidemic of diabetes and its complications.
They said diabetes was killing 400,000 people annually in Pakistan while around 166,000 people were dying due to tobacco use in the country, adding that diabetics who were addicted to smoking were also at a greater risk of developing DFUs, which were the cause of 200,000 amputations in the country.
“Smoking causes dozens of diseases, including peripheral arterial disease [PAD], which is known to be a risk factor affecting the amputation of diabetic foot. PAD with the highest severity is associated with a 20-fold higher prevalence of amputation in patients with diabetes,” said World Health Organisation official Shahzad Alam.
He was addressing the National Association of Diabetes Educators of Pakistan (Nadep) Diabetes Footcon 2021, which concluded at a hotel in Karachi on Sunday.
International Diabetes Federation President Prof Andrew Boulton, experts from European, Middle Eastern and African countries, and many leading health facilities and research centres from Pakistan gave presentations during the three-day conference on DFUs, calling for a national programme for preventing diabetes and treating DFUs among diabetics.
Alam said that many Ulema consider tobacco use haram or forbidden, adding that diabetics should quit smoking and consuming other forms of tobacco as early as possible to save themselves from complications of the disease, including heart attacks, strokes and loss of lower limbs.
Nadep President Dr Saiful Haq said diabetics needed education and awareness to save themselves from complications of the disease, including heart attacks, strokes, renal failure, retinal detachment and DFUs, which often lead to amputations.
“We also need specialised clinics to deal with DFUs. Nadep is going to establish 300 of them in the country in the coming years, but we need 3,000 such clinics and centres for preventing amputations due to DFUs.”
Boulton said the prevalence of DFUs is around two per cent in Europe, while it is very high among diabetics in the developing countries, especially in the Middle East and North Africa region, due to a lack of awareness and access to diabetes care.
D-Foot International Vice President Prof Zahid Miyan said millions of diabetics in Pakistan were unaware that a little carelessness could deprive them of their lower limbs.
He advised diabetics to daily check their feet, never walk barefoot, not wash their feet with warm water and learn to trim their nails because this can often lead to foot ulcers, which in turn can lead to amputations if not treated.
“Like Europe, we can bring our DFU rate down from 10 per cent to two per cent and save thousands of limbs from amputation, but to do that we need to educate our people, and train our physicians and surgeons. Media can play an important role in saving people’s lives and preventing them from permanent disability.”