The Tribune

By RIEL MAJOR

DIABETES mellitus is the fifth leading cause of death in The Bahamas, according to Health Minister Dr Duane Sands.

The Bahamas Podiatric Medical Association underscored the devastating impact of diabetes on feet during a conference at the University of the Bahamas yesterday.

“Foot complications are the source of major patient suffering, high emotion and financial costs to the individual and health care system," Dr Sands told the conference.

“We have seen the prevalence of diabetes increase from 6.7% to 9.2% in 2005 now to epidemic proportions of 13.6% in 2017. 37.9 deaths per 100,000 persons are due to diabetes.

Dr Sands continued: “Foot ulcers are the most prevalent problem, with a yearly incidence of around 2 - 4% and a lifetime incidence between 15 and 25%. The most important factors underlying the development of foot ulcers are peripheral sensory neuropathy, foot deformities related to motor neuropathy, minor foot trauma, and peripheral artery disease.

“Once the skin is ulcerated, it is susceptible to becoming infected, an urgent medical problem that can result in amputation or even death. Only two thirds of foot ulcers eventually heal, and up to 40% can reoccur and 28% may result in some form of lower extremity amputation.”

Dr Sands said the prevention of foot ulcers is very important and has been a long time priority. Each year more than one million people with diabetes lose at least a part of their leg, translating to a lower limb being lost to diabetes, every 20 seconds somewhere in the world.

“Eighty-five per cent of all amputations are preceded by an ulcer and can be prevented,” said Dr Sands. “The five year death rate following a diabetic foot ulcer or amputation is almost 50% and higher than in persons with prostate cancer and breast cancer.”

The American Diabetes Association's position statement on preventative foot care in people with diabetes suggests that all persons with diabetes should get at least one foot examination annually. The Department of Public Health, Diabetes management protocol also orders every diabetic to receive an annual comprehensive lower extremity examination.