NEW HORIZONS IN DIABETES FOOT CARE IN NIGERIA

October 21st 2015

Afokoghene Rita ISIAVWE FACE

Medical Director & Consultant EndocrinologistRainbow Specialist Medical Centre

Lekki Phase 108030940649

www.rainbowspecialistMED.com

Outline

• Understanding the diabetes foot problem• The Diabetes Podiatry Initiative, Nigeria• Offloading• Wound Care• Summary• Acknowledgements

Understanding the Diabetes foot problem

Understanding the Diabetes foot problem

• Pivotal event • Marker of serious disease and co morbidities • May lead to amputation of the affected limb• Every 20 seconds a lower limb is amputated

due to complications of diabetes

St Vincent's Declaration

• A set of goals for the health care of persons with DM.

• Aim of improving diabetes care• The main target set for feet was to "reduce

the numbers of limb amputations for diabetic gangrene by 50% in a five year period" Preventing foot complications in diabetes

ACTION PLANS

Regular, systematic screening of feet and legsImmediate access to qualified foot care for

those at high risk. Systematic patient education in foot care. Establishment of multidisciplinary teams to

provide care for those with special needs.

What's New in Diabetes Foot Care in Nigeria

The Diabetes Podiatry Initiative Nigeria

DIABETES PODIATRY INITIATIVE NIGERIA

Supported by World Diabetes Foundation

Rainbow Specialist Medical CentrePodiatry Institute USA

2014 to 2017

A COLLABORATION

PODIATRY INSTITUTE USA• Rahn A. Ravenell, DPM –

USA Team Leader

RAINBOW SPECIALIST MEDICAL CENTRE

• Afokoghene R. Isiavwe FACE- Project coordinator

The World Diabetes Foundation

Objectives

• Building local capacity in diabetes foot care• Improving foot care in persons living with DM• Preventing diabetes related foot amputations

Target Audience

• Health Care Practitioners• Persons living with diabetes• Diabetes Peer educators• members of Diabetes Association of Nigeria

Selected Clinics and Hospitals

• General Hospital Marina• 2 Lagos State PHCs – Eti-osa & Ibeju Lekki• NNPC Medicals • Military Hospital• St Nicholas Hospital• Rainbow Specialist Medical Centre• St Kizito• Nigerian Ports Authority Clinic• Lagos University Teaching Hospital• National Orthopedic Hospital Igbobi

• Training of trainers • Patient Foot care Education

Approach

1. Initial monthly one day - 2 hour training ( 2CME Points)2. Providing foot care SCREENING kits to each trained

institution3. Annual 5 day DM foot care workshop by members of the

Podiatry Institute USA (10 CME points) – next in August 2016

4. Continuous monitoring and supervision of the selected institutions

5. Referring at risk patients for free foot care training6. follow up of patients with ulcer to heal or to amputation

1ST LAGOS PODIATRY & DIABETES FOOT CARE WORKSHOP – MARCH 2014

1ST LAGOS PODIATRY & DIABETES FOOT CARE WORKSHOP – MARCH 2014

1ST LAGOS PODIATRY & DIABETES FOOT CARE WORKSHOP – MARCH 2014

2ND LAGOS PODIATRY & DIABETES FOOT CARE WORKSHOP – AUGUST 2015

2ND LAGOS PODIATRY & DIABETES FOOT CARE WORKSHOP – AUGUST 2015

2ND LAGOS PODIATRY & DIABETES FOOT CARE WORKSHOP – AUGUST 2015

IMPACT SO FAR

• Regular foot screening at participating centers FOOT SCREENING MANUALS produced & distributed to

healthcare professionals nationwide; simple enough for nurses to administer.

Diabetes foot Care TRAINING MANUAL FOR HEALTHCARE PROFESSIONALS produced & distributed

FOOT SCREENING BAGS distributed to 11 participating hospitals in Lagos

Start up of foot care clinics at some of the different participating institutions

Patient foot care education charts and booklets distributed to participating centers and Lagos State DAN.

IMPACT SO FAR 2

• Establishment of multidisciplinary teams.Work in progress: participants in the last two

meetings have seen the need for synergy amongst the different stakeholders in the care of DMFS at the various participating institutions.

IMPACT SO FAR 3

Issues are being raised & successfully

addressed e.g. need for training of nurses on the art of

wound care ‘’wound care nurses’’ use of modern & effective wound care

products Offloading of ulcers

Offloading shoes and insoles

• Therapeutic shoes• Insoles • wound care shoes • locally available and

affordable

Wound care

• New and effective wound care products now locally available

summary

Conclusion

THANK

YOU