Diabetic amputations a major headache for health officials

diabetesActing Health Promotions Coordinator, Alison Samuel, says amputations due to diabetes have been a major headache for health officials but it can be avoided.

Samuel was addressing a one day workshop at the Princess Margaret Hospital (PMH) for doctors and nurses on Tuesday 14 April 2015 on diabetic foot care.

She said in Dominica diabetes continues to be the third leading cause of both mobility and mortality and it continues to be costly to individuals, family and the country by extension.

“Over the past eight years, amputations due to diabetes have been a major concern for us here in Dominica. Although in 2013 we saw a drop from previous years, the trend continued upwards again in 2014,” she said.

Samuel stressed that the fact that diabetes is chronic and needs to be carefully monitored and managed, makes it not only financially costly but also emotionally taxing and time consuming.

“One of the major complications in diabetes is neuropathy, which when severe can lead to limb amputation,” she stated. “Amputations related to diabetes remain an avoidable option, according to many experts in the field, and therefore as health care providers we should do all that we can in promoting and preventive medicine to assist individuals and their families to circumvent the surgeon’s knife.”

The Health Official said amputations do not only result in disabilities but have a deep psychological impact on both the individuals and families and for many clients the loss of a limb is akin to physical death and evokes the same feelings associated with the grieving process when a loved one has passed.

“This training today which targets our doctors and nurses from both the medical and surgical wards, brings together experienced, skilled health professionals who will provide information on how to assess and manage foot problems and make critical decisions in diabetics,” she said.

Also addressing the training, Country Program Officer at the Pan American Health Organization (PAHO) Shirley Augustine added that there are many costs associated with the illness.

“The cost of diabetes is very high, both at the direct and indirect cost,” she noted. “You have the cost of treating the patient, but there are other costs, you have the social cost, think of the person who can no longer work because of an amputation. So there are a lot of costs and high costs to diabetes.”

She said in the report of the Center of Disease Control states that good foot care education, risk assessment, and preventative therapy may decrease amputation rates by 45-85 per cent.

“That is very significant,” She said.

The training was done in collaboration with the Pan American Health Organization (PAHO) and the Ministry of Health and aimed to: accurately conduct foot assessments and documents to identify active foot problems that require referrals and to develop and implement foot care plans which will decrease the need for amputations.

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  1. Francisco Telemaque
    April 17, 2015

    One wonders why! It is impossible to be a diabetic, and exist with the disease without knowing they are diabetic. Once the patient is properly diagnosed and the appropriate medication is prescribe, and the patient maintains the regiment, there is no reason why the patient should not exists without any or, a minute number of complications.

    Untreated diabetes will cause complications such as heart, and kidney problems. Poor circulation in the lower extremities may lead to amputations which are not totally necessary. The most common indication for amputation of an upper limb is severe trauma. Blood vessel disorders such as atherosclerosis, often secondary to diabetes mellitus, account for the greatest percentage of leg amputations; other indications may include malignancy, infection, and gangrene.

    Atherosclerosis is far more likely to occur in diabetic persons than in normal people; the predisposition of diabetics of all ages to develop an accelerating atherosclerosis is not…

    • Francisco Telemaque
      April 17, 2015

      Atherosclerosis is far more likely to occur in diabetic persons than in normal people; the predisposition of diabetics of all ages to develop an accelerating atherosclerosis is not clearly understood. It is believed that diabetics inherit the tendency to develop severe atherosclerosis, as well as an aberration in glucose metabolism, and that the two are not necessarily related. There is evidence to substantiate that optimal control will mitigate the microvascular complications of diabetes, particularly in the young, and middle-age who are at greatest risk for developing complications involving the arterioles.

      Pathologic changes in the small blood vessels serving the kidney lead to nephrosclerosis, pyelonephritis, and other disorders that eventually result in renal failure. many of the deaths of persons with IDDM are caused by renal failure. The key to eliminate complications is the type of treatment. Some people prefer oral hypoglycemic agents. Nevertheless, these agents are…

      • Francisco Telemaque
        April 17, 2015

        Nevertheless, these agents are sulfonylureas, relatives of the sulfonamide antibiotics, and though they stimulate beta cells to secrete more insulin, after using such treatment for a short period they become ineffective, the body rejects them.

        Hence the use of insulin and in particular human insulin is a more effective treatment whiles maintaining a balance diet, avoiding the consumption the starchy foods we eat in Dominica.

  2. Jack
    April 17, 2015

    That is typically of many Dominicans..Their first reactions to education is ignorance!….That is why a whole bunch of them are sitting like fools waiting for the government to do for them..Because they are too lazy to want to learn alternative facts…
    Do not worry your soul G.B on such small minded persons..They live inside a shoebox..

  3. April 15, 2015

    I am addressing the minister of health ,the prime minister and all the other responsible health institution in dominica ,,,
    Make a special lab. in order to make sterile flies reproduce in a very clean environment..The sterile flies should be fed of clean animal’s liver …then by doing so the flies reproduces sterile magots or worms ,that can be placed on the patient’s sore with a sterile cloth tied on…this process should be renewed weekly..the dead flesh is eaten away by the magots then the sore heals gradually by growing new health flesh…
    Hope my advicewill not fall on death ears because i have the proof of what i have advised,,,makes your own research about what i have just said…

    • sense
      April 15, 2015

      you are either a raving lunatic ( forgivable if you are off your meds) or a genuine idiot . In either case we will pray for u hon

      • R.Linton
        April 15, 2015

        Sense !
        It is so sad that people like you are always there to ridicule others. When one decides to keep him/herself in a coocoon, their ignorance always comes out in the public where he/she is seen as the raving lunatic or the genuine idiot.

        Go google up what G.B said, or I have made it easier for you.. check this link up

      • April 16, 2015

        DNO please allow my answer to be seen by “sense”…and the public..Only a genuine idiot can call someone that they do not know a genuine idiot …I am a dominican living abroad…I know what i know and I am happy with myself…The prayer that you are deciding to say for me say it for yourself because you really need it .In this day and age ,how can a human being who can write and read say such crap…my friends just read what you wrote ,they all laughed and said ;is this fool still living in a cave or the bush ? I met a man with 2 almost rotten legs,I got written permission from him to add magots or worms on his legs,after 3 weeks this man saw a big change,he could only sit up ,now he walks ..the worms eat the rotten flesh leaving the way for new flesh growth,strict hygiene is needed and good healthy foods to help the immune system ..SENCE ..Shut up ,sit back,listen,read ,research and pray for yourself ,children and family if you have any..Poor you…

    • Francisco Telemaque
      April 17, 2015

      G B, I do not see anything you say here has anything to do with diabetes, and the cause of amputations among people with diabetes.

      In the first place diabetes is not a communicable diseases of which the causative agents can be carried from one person to another, therefore the notion that they should build this thing you are talking about fly’s is irrelevant. If DNO release the comments I written on the subject of diabetes, which I think is highly educational, if you endeavor to understand what I wrote; you will discover the cause of amputations among diabetic patients.

      If you need a more simple scientific, and medical explanation , feel free to contact me via FETelemmaque@aol.com

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