CMO: Hundreds of diabetic amputations annually

The content originally appeared on: Trinidad and Tobago Newsday

Chief Medical Officer Dr Roshan Parasram speaks during the Diabetic Foot Infection seminar at the Hilton Hotel, Port of Spain on Tuesday. – Photo by Roger Jacob

CMO Dr Roshan Parasram said between 2012 and 2018, approximately 600 amputations were done yearly as a result of diabetic foot disease. He said 14.8 per cent of Trinidad and Tobago’s population has Type Two diabetes, amounting to 148,900 people.

At a seminar on Diabetic Foot Infection: Moving Forward in Prevention and Management, at the Hilton Trinidad on Tuesday, Parasram said US$50 million is being spent annually on managing diabetes.

He said 3,586 amputations, or 85.87 per cent, were done at public institutions, and 590, or 14.13 per cent, at private institutions. He said the male-to-female ratio was 1.2 to 1.

“Afro-Trinidadian patients amounted to 47 per cent, or 1,962 amputations, while Indo-Trinidadian patients accounted for 42 per cent, or 1,899 patients, with others accounting for 11 per cent. Above-the-knee amputations took place in approximately 55.06 per cent, or 2,299 patients, with below-the-knee amputations, including toes and feet, taking place in 44.94 per cent, or 1,877 patients.”

Parasram said in 2018 there were some 352 amputations, with 30 per cent in the North West Regional Health Authority (NWRHA), 28 per cent in the North Central Regional Health Authority (NCRHA), 16 per cent in the Eastern Regional Health Authority (ERHA), and 26 per cent in the South West Regional Health Authority (SWRHA).

He said, in 2021 – during the pandemic – 449 amputations took place, with 39 per cent in the NWRHA, 18 per cent in the NCRHA, 14 per cent in the ERHA, and 29 per cent in the SWRHA.

Parasram said care can be accessed at primary health centres, with special diabetic foot clinics in Santa Cruz, El Socorro and Arima.

“We traditionally wait until someone has a disease before we intervene, and because there are so many people presenting in diabetic clinics, we spend very little time looking at their feet. We need to look at screening and prevention of disease, with testing being accessible and inexpensive.”

Health Minister Terrence Deyalsingh said one of his ministry’s strategic objectives over the next two to three years was coming to grips with the problem of non-communicable diseases (NCDs).

He said if TT continued to treat the symptoms of NCDs without treating the causes, the resources of the ministry would be depleted.

He said foot problems secondary to diabetes mellitus accounted for approximately 14 per cent of admissions and 29 per cent of bed occupancy at public health, approximately 900 beds.

“We need to engage TT in behaviour change. One of the reasons we are in this crisis is the medicalisation of health, where the solution to every problem is to pop a pill. This phenomenon, driven by pharmaceutical companies, is one of the worst things to ever happen to health, along with people’s abdication of personal responsibility for their health.”

Deyalsingh said one of the preventative measures being put in place by the government was the TT Moves programme, which encouraged the population to get moving and be more active, as well as drinking more water and eating more fruits and vegetables.