Clinic helps save diabetics' feetSunday, 10 November, 2002, 01:07 GMT
Diabetes is a growing problem in India
Doctors in India are giving fresh hope to diabetics who face having one of their feet amputated.
An estimated 100,000 Indians with diabetes develop severe ulcers and are forced to have a foot partially or fully removed each year.
But a clinic in New Delhi is helping many to avoid surgery and to recover.
It is very, very important to actually teach the patient to care for themselves.
— Sir George Alberti
The podiatry clinic at the Max Healthcare Medcentre is the first of its kind in South Asia.
Dr Govind Singh Bisht, who works at the centre, says the clinic is offering real hope to patients.
He said staff there have already helped many people to retain feet that would otherwise have been amputated.
Recently, he provided vital medical care to a local man who already had one foot amputated and was facing having his second one removed too.
"I had a patient who had previously had an ulcer and that part of his foot was amputated because he wasn't getting proper care," he says.
"He came to me with an ulcer in the second foot and he was quite scared.
"It was not healing and he was scared that this foot might also have to be imputed."
After almost three months of intensive treatment, Dr Bisht's efforts paid off.
"It took me nearly 10 to 12 weeks until the ulcer healed up. It was a big relief for the patient and he was really happy."
There are currently 25 million diabetic patients in India. This is expected to increase to more than 30m over the next 10 years.
That predicted rise has raised concerns that more and more people will face the prospect of having feet removed.
One in four Indians with diabetes has foot problems and a quarter of these develop ulcers. One in four of these subsequently have a foot fully or partially removed.
The International Diabetes Federation is one of many groups working to tackle this problem.
Professor Sir George Alberti, its president, said teaching patients to care for themselves is seen as a key way to reducing amputations.
"It is very, very important to actually teach the patient to care for themselves," he says. "They have to be taught to keep the skin in good condition.
"Essentially, they need to soak their feet daily. They need to apply oils to the feet to keep their skin hydrated.
"They have to be particularly observant and look at their feet frequently throughout the day particularly if they are out working in the fields."
Patients are taught to look out for 'hot spots' on their feet.
"There are warning signs that there are problems building up in the feet and we teach them to look for those signs,". says Sir George.
"In the very early stages of ulceration, for example, it sometimes becomes apparent when a hotspot appears on the foot.
"It can be hot and red and swollen on the bottom of the foot. If people become aware that this could mean that an ulcer is developing then they have to be taught that they have to rest immediately and not let that get any worse."
Patients are also urged to seek medical advice. Doctors can assess the way they walk and prescribe a different type of footwear to help them avoid ulcers.
"A podiatrist can examine the way that the person walks, to adjust the footwear or put modifications in the footwear so that we can help the foot to function to the best of its capacity and, in that way, we can prevent focal points of pressure building up in the foot."
This story is featured in the radio programme Health Matters on the BBC World Service.