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Low-Cost Management of Diabetic Foot

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Diabetic Foot Ulcer

Abstract

Diabetes rates are rising in Africa, so there is a related rise in complications of the diabetic foot. Diabetic peripheral neuropathy is the main factor in developing diabetic foot ulcers in the developing world, but at the same time with the development in the developing world people are changing lifestyle and an increase in urbanization leads to diabetic peripheral arterial disease in people with diabetes. Government funding in many developing countries is very limited, and health services are heavily burdened by diabetes and its complications. The outcome of diabetic foot is very poor and can be tackled without heavy financial spending. Education is the only tool we have in Africa and it should be cost-effective targeted at both health care workers and patients. Training programmes should be designed on diabetic foot care for health care workers with a particular interest in foot care and focussing to cascade the knowledge of foot care prevention and treatment to other health colleagues and patients. One of the unique educational programmes step by step foot care programme, which was piloted in Tanzania and India.

In conclusion in developing countries, educational programmes on prevention and management of diabetic foot are the way forward in the developing world. Multidisciplinary team approach is needed for the management of diabetic foot. Patients with diabetic foot presenting at a less serious and early stage will certainly lead to lower morbidity and death rates.

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References

  1. Abbas ZG (2013) Chapter 4: Contemporary management of diabetic foot. In: Pendsey S (ed) The global burden of diabetic foot, 1st edn. JP Medical Ltd, London., www.jpeedigital.com, pp 24–30

    Google Scholar 

  2. Abbas ZG, Archibald LK (2006) Chapter 34: The foot in diabetes. In: AJM B, Cavanagh P, Rayman G (eds) Recent international development: Africa, 4th edn. John Wiley & Sons Ltd, Hoboken, NJ., www.wiley.com, pp 379–385

    Google Scholar 

  3. International Diabetes Federation, Diabetes Atlas, 9th edition (2019) Available from: https://www.diabetesatlas.org/en/resources/. Accessed 24 June 2020

  4. Atun R, Davies JI, Gale EAM et al (2017) Diabetes in sub-Saharan Africa: from clinical care to health policy. Lancet Diabetes Endocrinol 5:622–667

    PubMed  Google Scholar 

  5. Abbas ZG (2016) Diabetic foot—an African perspective. JSM Foot Ankle 1(1):1005

    Google Scholar 

  6. Abbas ZG, Archibald LK (2007) Challenges for management of the diabetic foot in Africa: doing more with less. Int Wound J 4:305–313

    PubMed  Google Scholar 

  7. Abbas ZG, Archibald LK (2005) Epidemiology of the diabetic foot in Africa. Med Sci Monit 11:RA262–RRA70

    PubMed  Google Scholar 

  8. Abbas ZG, Viswanathan V (2007) The diabetic foot in Africa and India. Int Diab Monit 19:8–12

    Google Scholar 

  9. Abbas ZG, Gill GV, Archibald LK (2002) The epidemiology of diabetic limb sepsis: an African perspective. Diabet Med 19:895–899

    CAS  PubMed  Google Scholar 

  10. Abbas ZG, Archibald LK (2007) The diabetic foot in Sub-Saharan Africa: a new management paradigm. Diab Foot J 10:128–136

    Google Scholar 

  11. Abbas ZG, Lutale JK, Morbach S, Archibald LK (2002) Clinical outcome of diabetic patients hospitalized with foot ulcers, Dar es Salaam, Tanzania. Diabet Med 19:575–579

    Google Scholar 

  12. Tesfaye S, Gill G (2011) Chronic diabetic complications in Africa. African J Diabetes Med 19(1):4–8

    Google Scholar 

  13. Abbas ZG, Archibald LK (2000) Foot complications in diabetic patients with symptomatic peripheral neuropathy in Dar es Salaam, Tanzania. Diabetes Int 10:52–56

    Google Scholar 

  14. Abbas ZG, Lutale JK, Archibald LK (2009) Diabetic foot ulcers and ethnicity in Tanzania: a contrast between African and Asian populations. Int Wound J 6:124–131

    PubMed  Google Scholar 

  15. Morbach S, Lutale JK, Viswanathan V, Mollenberg J, Ochs HR, Rajashekart S, Ramachandran A, Abbas ZG (2004) Regional difference in risk factors and clinical presentation of diabetic foot lesions. Diabet Med 21:91–95

    CAS  PubMed  Google Scholar 

  16. Abbas ZG, Lutale JK, Archibald LK (2005) Rodent bites on the feet of diabetic patients in Tanzania. Diabet Med 22:631–633

    CAS  PubMed  Google Scholar 

  17. Hennis AJ, Fraser HS, Jonnalogadda R et al (2004) Explanation for the high risk of diabetes related amputation of black African descent and potential for prevention. Diabetes Care 27:2636–2641

    PubMed  Google Scholar 

  18. Abbas ZG, Bal A (eds) (2019) Pocket Guideline of diabetic foot 2019, 2nd edn. Jaypee Brothers Medical Publishers (P) Ltd, New Delhi

    Google Scholar 

  19. International Working group on the Diabetic Foot (IWGDF) (2019) The development of global consensus guidelines on the management and prevention of the Diabetic Foot 2019. www.iwgdf.org

  20. Cavanagh P, Attinger C, Abbas ZG, Bal A, Rojas N, Xu ZR (2012) Cost of treating diabetic foot ulcers in five different countries. Diabetes Metab Res Rev 28(Suppl 1):107–111

    PubMed  Google Scholar 

  21. Shobhana R, Rama Rao P, Lavanya A, Vijay V, Ramachandran A (2000) Cost burden to diabetic patients with foot complications—a study from Southern India. JAPI 48(12):1147–1150

    CAS  PubMed  Google Scholar 

  22. Ali SM, Fareed A, Humail SM et al (2008) The personal cost of diabetic foot diseases in the developing world—a study from Pakistan. Diabet Med 25:1231–1233

    CAS  PubMed  Google Scholar 

  23. Ndour Mbaye M, Sarr A, Diop SN, Diedhiou D, KA-Cisse M, Camara Y, Sidibe EH, Sow AM (2008) Etude descriptive du pied diabétique au Sénégal: à propos de 105 cas. Dakar Médical 53(3):205–212

    CAS  PubMed  Google Scholar 

  24. Edmonds M, Boulton A, Buckenham T, Every N, Foster A, Freeman D, Gadsby R, Gibby O, Knowles A, Pooke M, Tovey F, Unwin N, Wolfe J (1996) Report of the diabetic foot and amputation group. Diabet Med 13:S27–S42

    CAS  PubMed  Google Scholar 

  25. Jeffcoat WJ, Harding KG (2003) Diabetic foot ulcers. Lancet 361:1545–1551

    Google Scholar 

  26. Garoushi S, Johnson MI, Tashani OA (2019) A cross-sectional study to estimate the point prevalence of painful diabetic neuropathy in Eastern Libya. BMC Public Health 19(1):78

    PubMed  PubMed Central  Google Scholar 

  27. Khalifa WA (2018) Risk factors for diabetic foot ulcer recurrence: a prospective 2-year follow-up study in Egypt. Foot (Edinb) 35:11–15. https://doi.org/10.1016/j.foot.2017.12.004

    Article  Google Scholar 

  28. Awadalla H, Noor SK, Elmadhoun WM, Almobarak AO, Elmak NE, Abdelaziz SI, Sulaiman AA, Ahmed MH (2017) Diabetes complications in Sudanese individuals with type 2 diabetes: overlooked problems in sub-Saharan Africa? Diabetes Metab Syndr 11(Suppl 2):S1047–S1051

    PubMed  Google Scholar 

  29. Olamoyegun M, Ibraheem W, Iwuala S, Audu M, Kolawole B (2015) Burden and pattern of micro vascular complications in type 2 diabetes in a tertiary health institution in Nigeria. Afr Health Sci 15(4):1136–1141

    PubMed  PubMed Central  Google Scholar 

  30. Kuate-Tegueu C, Temfack E, Ngankou S et al (2015) Prevalence and determinants of diabetic polyneuropathy in a Sub-Saharan African referral hospital. J Neurol Sci 355:108–112

    CAS  Google Scholar 

  31. Khalil SA, Megallaa MH, Rohoma KH, Guindy MA, Zaki A, Hassanein M, Malaty AH, Ismael HM, Kharboush IF, El Kafash DN, Sallam HN, Desouky IA (2019) Prevalence of chronic diabetic complications in newly diagnosed versus known type 2 diabetic subjects in a sample of Alexandria population, Egypt. Curr Diabetes Rev 15(1):74–83

    PubMed  Google Scholar 

  32. Ogbera AO, Adeleye O, Solagberu B et al (2015) Screening for peripheral neuropathy and peripheral arterial disease in persons with diabetes mellitus in a Nigerian University Teaching Hospital. BMC Res Notes 8:533

    PubMed  PubMed Central  Google Scholar 

  33. Codjo HL, Adoukonou TA, Wanvoegbe A et al (2016) Prevalence of peripheral artery disease among diabetics in Parakou in 2013. Ann Cardiol Angeiol 65:260–264

    CAS  Google Scholar 

  34. Mwebaze RM, Kibirige D (2014) Peripheral arterial disease among adult diabetic patients attending a large outpatient diabetic clinic at a national referral hospital in Uganda: a descriptive cross sectional study. PLoS One 9(8):e105211

    PubMed  PubMed Central  Google Scholar 

  35. Isiguzo CM, Jac-Okereke C (2015) Diabetic foot ulcer—12 months prospective review of pattern of presentation at Enugu State university of technology teaching hospital, Parklane, Enugu: a basis for diabetic foot clinic? Niger J Med 24:125–130

    CAS  PubMed  Google Scholar 

  36. Ngim NE, Ndifon WO, Udosen AM et al (2012) Lower limb amputation in diabetic foot disease: experience in a tertiary hospital in southern Nigeria. African J Diabetes Med 1:13–15

    Google Scholar 

  37. Enweluzo GO, Giwa SO, Adekoya-Cole TO et al (2010) Profile of amputations in Lagos University Teaching Hospital, Lagos, Nigeria. Nig Q J Hosp Med 20:205–208

    CAS  PubMed  Google Scholar 

  38. Sié Essoh JB, Kodo M, Djè Bi Djè V et al (2009) Limb amputations in adults in an Ivorian teaching hospital. Niger J Clin Pract 12:245–247

    PubMed  Google Scholar 

  39. Abbas ZG, Lutale JK, Ilondo MM, Archibald LK (2012) The utility of Gram stains and culture in the management of limb ulcers in persons with diabetes. Int Wound J 9(6):677–682

    PubMed  Google Scholar 

  40. Abbas Z, Morbach S (2005) Diabetes foot damage in developing countries: the urgent need for education. Diabetes Voice 50:15–17

    Google Scholar 

  41. Abbas ZG, Lutale JK, Bakker K, Baker N, Archibald LK (2011) The ‘Step by Step’ Diabetic Foot Project in Tanzania: a model for improving patient outcomes in less-developed countries. Int Wound J 8:169–175

    PubMed  Google Scholar 

  42. Bakker K, Abbas ZG, Pendsey S (2006) Step by step, improving diabetic foot care in the developing world. A pilot study for India, Bangladesh, The “Step by Step” Diabetic Foot Project in Tanzania, 2004–2010 Sri Lanka and Tanzania. Pract Diab Intern 23:365–369

    Google Scholar 

  43. Pendsey S, Abbas ZG (2007) The step-by-step program for reducing diabetic foot problems: a model for the developing world. Curr Diab Rep 7(6):425–428

    PubMed  Google Scholar 

  44. Abbas ZG (2013) Preventing foot care and reducing amputation: a step in right direction for diabetes care. Diabetes Manag 3(5):427–435

    CAS  Google Scholar 

  45. Abbas ZG (2015) Reducing diabetic limb amputations in developing countries. Expert Rev Endocrinol Metabol 10(4):425–434

    CAS  Google Scholar 

  46. Abbas ZG (2014) Chapter 39: Preventive foot care programs. In: Hinchliffe RJ, Schaper NC, Thompson MM, Tripathi RK, Timaran CH (eds) The diabetic foot, 1st edn. JP Medical Ltd, London., www.jpeedigital.com, pp 24–30

    Google Scholar 

  47. Baker N, Van Acker K, Urbancic-Rovan V, Abbas ZG, Morbach S (2017) The worldwide implementation of the ‘Train the Foot Trainer’ programme. Diabet Foot J 20(2):71–76

    Google Scholar 

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Acknowledgments

We would like to acknowledge for the helpful discussion with all our colleagues during the genesis of this manuscript is appreciated. We are grateful to Shabneez Gangji and other staff in Dar es Salaam for their assistance.

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Authors and Affiliations

  1. Abbas Medical Centre, Dar es Salaam, Tanzania

    Zulfiqarali G. Abbas

  2. Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania

    Zulfiqarali G. Abbas

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  1. Zulfiqarali G. Abbas
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Correspondence to Zulfiqarali G. Abbas .

Editor information

Editors and Affiliations

  1. Department of Medical Microbiology, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia

    Mohammad Zubair

  2. Consultant, Diabetes & Endocrinology, Superspeciality Center, Aligarh, Uttar Pradesh, India

    Jamal Ahmad

  3. Ex-Chairperson-Department of Microbiology, Former Dean-Faculty of Medicine, J N Medical College & Hospital Faculty of Medicine, Aligarh Muslim University, Aligarh, Uttar Pradesh, India

    Abida Malik

  4. Research Associate, Bioanalytical Department, AXIS Clinicals, Hyderabad, Telangana, India

    Mallikarjuna Rao Talluri

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Abbas, Z.G. (2021). Low-Cost Management of Diabetic Foot. In: Zubair, M., Ahmad, J., Malik, A., Talluri, M.R. (eds) Diabetic Foot Ulcer. Springer, Singapore. https://doi.org/10.1007/978-981-15-7639-3_14

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  • DOI: https://doi.org/10.1007/978-981-15-7639-3_14

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-7638-6

  • Online ISBN: 978-981-15-7639-3

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