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The Guyana Diabetes and Foot Care Project: Improved Diabetic Foot Evaluation Reduces Amputation Rates by Two-Thirds in a Lower Middle Income Country
Joint Authors
Lowe, Julia
Sibbald, R. Gary
Taha, Nashwah Y.
Lebovic, Gerald
Rambaran, Madan
Martin, Carlos
Bhoj, Indira
Ostrow, Brian
Source
International Journal of Endocrinology
Issue
Vol. 2015, Issue 2015 (31 Dec. 2015), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2015-05-19
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Background.
Type 2 diabetes is the fourth leading cause of death in Guyana, South America.
A complex, interprofessional, quality improvement intervention to improve foot and diabetes care was rolled out in two phases.
Methods & Findings.
Phase 1: Establishment of an Interprofessional Diabetic Foot Center (DFC) of Excellence to improve foot care and reduce diabetes-related amputations at the national referral hospital.
Phase 2: Regionalization to cover 90% of the Guyanese population and expansion to include improved management of diabetes and hypertension.
Fourteen key opinion leaders were educated and 340 health care professionals from 97 facilities trained.
Eight centers for the evaluation and treatment of foot ulcers were established and 7567 people with diabetes evaluated.
3452 participants had foot screening and 48% were deemed high risk; 10% of these had undocumented foot ulcers.
There was a 68% reduction in rate of major amputations (P<0.0001); below knee amputations were decreased by 80%, while above knee amputations were unchanged.
An increased association of diabetes with women (F/M = 2.09) and increased risk of major amputation in men [odds ratio 2.16 (95% CI 1.83, 2.56)] were documented.
Conclusions.
This intervention improved foot care with reduction in major amputations sustained over 5 years.
American Psychological Association (APA)
Lowe, Julia& Sibbald, R. Gary& Taha, Nashwah Y.& Lebovic, Gerald& Rambaran, Madan& Martin, Carlos…[et al.]. 2015. The Guyana Diabetes and Foot Care Project: Improved Diabetic Foot Evaluation Reduces Amputation Rates by Two-Thirds in a Lower Middle Income Country. International Journal of Endocrinology،Vol. 2015, no. 2015, pp.1-6.
https://search.emarefa.net/detail/BIM-1065881
Modern Language Association (MLA)
Lowe, Julia…[et al.]. The Guyana Diabetes and Foot Care Project: Improved Diabetic Foot Evaluation Reduces Amputation Rates by Two-Thirds in a Lower Middle Income Country. International Journal of Endocrinology No. 2015 (2015), pp.1-6.
https://search.emarefa.net/detail/BIM-1065881
American Medical Association (AMA)
Lowe, Julia& Sibbald, R. Gary& Taha, Nashwah Y.& Lebovic, Gerald& Rambaran, Madan& Martin, Carlos…[et al.]. The Guyana Diabetes and Foot Care Project: Improved Diabetic Foot Evaluation Reduces Amputation Rates by Two-Thirds in a Lower Middle Income Country. International Journal of Endocrinology. 2015. Vol. 2015, no. 2015, pp.1-6.
https://search.emarefa.net/detail/BIM-1065881
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1065881