Pakistan is facing a rapidly escalating diabetes crisis. Currently, over 7 million individuals are living with diabetes, and projections estimate this number will surge to more than 16 million by 2025. Effective diabetes management and prevention hinge significantly on comprehensive diabetes education, a concept regrettably lacking in Pakistan. Compounding this issue, a substantial 6-7% of Pakistani diabetes sufferers experience diabetic foot problems. The absence of a coordinated National Foot Care Program leaves many without essential organized foot care, tragically leading to preventable amputations.
To address this critical healthcare gap, the Baqai Institute of Diabetology and Endocrinology, a leading institution within the Baqai Medical University, is spearheading a vital project. This initiative aims to establish a foundational national foot care program framework by enhancing diabetes awareness, promoting preventative measures, and significantly improving diabetes care, with a strong emphasis on foot care, within under-resourced and underserved communities throughout Pakistan. Leveraging their existing network of 8 peripheral diabetes clinics, with plans for further expansion, the institute is uniquely positioned to drive this change.
This comprehensive project operates on two integrated fronts. Firstly, it directly engages the public and individuals living with diabetes through impactful awareness campaigns. These programs deliver crucial diabetes self-care education and emphasize preventive foot care strategies – a cornerstone of any effective national foot care program. Secondly, the project focuses on strengthening healthcare infrastructure by establishing new diabetes clinics and providing rigorous training for healthcare professionals.
A core component of this national foot care program initiative is the training of 60-75 dedicated diabetes educators. These educators will be equipped to deliver essential knowledge to people with diabetes and their families, covering all aspects of diabetes management, including the prevention and management of diabetic foot complications. Furthermore, they will conduct broader public awareness programs, extending the reach of this vital health information. The training regimen for these educators involves an intensive three-month foundational course at the Baqai Institute, followed by a nine-month practical internship within a peripheral diabetes clinic, ensuring both theoretical knowledge and practical skills are developed. Annual training courses will ensure a continuous pipeline of 20-25 newly qualified educators each year, steadily expanding the reach of the national foot care program.
Public awareness forms a large part of this national strategy. Large-scale public awareness programs, expecting over 500 participants per event, will be conducted 3-4 times annually. These full-day events will offer comprehensive information on diabetes prevention, healthy living with diabetes, managing chronic complications, including diabetic foot issues, and the importance of diet, exercise, and self-monitoring of blood glucose. Recognizing the importance of early intervention, a specialized awareness program targeting schoolchildren will also be implemented in collaboration with school authorities. This initiative aims to educate children about healthy diets and the importance of physical activity, directly addressing the roots of obesity and future diabetes risk, with a goal to reach 5,000 children.
To bolster healthcare delivery across Pakistan, the project includes extensive professional training. Over 75 doctors will participate in an intensive one-year specialized diabetes management course. Upon completion, these doctors are expected to establish new peripheral diabetes clinics, expanding access to specialized care. Further broadening the reach of expertise, 1,600 family physicians will participate in one-day training programs focused on the practical aspects of diabetes treatment within primary care settings. Diabetes camps will be conducted 3-4 times a year nationwide, actively screening approximately 3,000 individuals for undiagnosed or poorly managed diabetes. Identified cases will then be connected to the newly trained doctors and expanding network of clinics for ongoing care.
A critical element of this national foot care program is the direct improvement of diabetic foot care services. 120 foot care teams, each comprising a doctor and a nurse, will undergo specialized training using the “Step by Step” program, previously validated by the WDF funded project “Diabetes foot care – step by step” (WDF03-056). The initial three-day basic course will equip these teams with essential skills in preventing and managing common diabetic foot problems, as well as enabling them to train other healthcare professionals, thus multiplying the impact of the program. After one year of practical application, these teams will participate in an advanced course of similar duration, enhancing their expertise in managing complex foot care cases. Finally, to create a sustainable infrastructure for long-term national foot care, approximately 50 podiatrists will be trained, and 112 diabetic foot clinics will be established. These clinics will be strategically located in both major urban centers and remote rural areas, ensuring equitable access to preventative foot care for people with diabetes throughout Pakistan.
Upon completion, this ambitious project is projected to achieve significant and measurable results, laying a strong foundation for a sustainable national foot care program in Pakistan. Key outcomes include: 83 trained diabetes educators, 5,715 individuals educated through 16 public awareness programs, 6,017 children reached with healthy living messages in 12 school programs, 78 doctors graduating with a Diploma in Diabetology, 646 doctors participating in 18 Three Day CME diabetes courses, 3,031 people screened for diabetes in 15 screening camps, 178 foot care teams trained, and 115 foot care clinics established. These achievements represent a crucial step forward in combating diabetes and significantly reducing preventable amputations through a comprehensive and nationally focused foot care program.
