Rise in diabetic foot ulcers in Nigeria in the last year worries expert

A medical expert, Professor Prisca Adejumo says there is anecdotal evidence suggesting a rise in cases of individuals with diabetes requiring amputation of their limbs in Nigeria in the last one year and a cause for worry.

Adejumo, a professor of Medical-Surgical nursing at the University of Ibadan, in a keynote address delivered at the 2022 Public Health Nurses’ annual workshop, said the risen cases of diabetic foot ulcer, a serious and potentially life-threatening complication of diabetes mellitus, is linked to COVID-19 and the lockdown implemented during the peak of the pandemic.

Professor Adejumo, who Dr Lucia Ojewale represented stated that in sub-Saharan Africa, Nigeria bears the highest burden of diabetes prevalence and about 25 per cent of people living with diabetes end up with diabetic foot ulcers.

According to her, “its incidence has increased due to COVID-19. As of 2019, more than one-third of patients had to undergo lower extremity amputation. Anecdotal evidence shows an increase in diabetic foot ulcers in the last one year.”

“Many countries recommended that persons with diabetes stay at home, maintaining physical distancing and optimising remote communication, including telehealth. In 2020, World Health Organization raised concern about the policy interfering with diabetes management and increasing the incidence of diabetes complications.

“It stated that while attention was more focused on COVID-19 infection, the attention needed by patients with diabetes was overlooked. In Indonesia, with a better health care system, 24.56 per cent of the total respondents had diabetes complications during the pandemic, with 7.38 per cent from diabetes foot ulcers.

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“In-depth interview among 25 patients with diabetes and other Non-communicable diseases (NCDs) in UCH, Ibadan on perceived impart of the pandemic indicated that many could not access care, many resorted to private hospital and pharmacies; some, particularly  with hypertension developed kidney failure and people with diabetes self-managed.”

Professor Adejumo added that “Effective diabetes control prevents the onset of complications, diabetes education remains the cornerstone of diabetes care, prevention, early identification and treatment of diabetic foot ulcer are possible when health care workers and patients are proactive Community resources and support need to harnessed to strengthen health system for patients with diabetes and prevent diabetes foot ulcer.”

Meanwhile, in a communiqué issued at the end of the 4-day training, the participants called for the provision of foot clinics that provide optimum care for people living with diabetes, public health awareness on diabetes and diabetes foot ulcers in communities and government ensuring that NHIS provides total coverage for the treatment diabetes.

They said that nurses should be trained on foot inspection of diabetic patients in the absence of podiatrists to enhance early detection and prompt report of any wounds that can lead to a diabetic foot ulcer.

Professor Otegbayo said that environmental health professionals were important to helping individuals and communities to stay safe and well by protecting them from threats to their health and wellbeing, and he urged them to translate the skills they had acquired during their training to improve the health of the population.