Title: Barriers to the effective management of diabetic foot in the middle east
Abdul Hakeem Hamza obtained his medical degree from the Manipal Academy of Higher Education, India and further postgraduate qualifications from the Royal College Of General Practitioners, UK. During this period he also served as one of the lead family physicians in Liverpool Primary Care Trust. After almost 11 years experience in UK, he is currently undertaking a role of consultant family medicine in the Primary Health Care Corporation in Qatar. His keen interests lie in the fields of diabetes, diabetic research and medical education and he is a trainer for the MRCGP International candidates.
The incidence and prevalence of Type 2 Diabetes is increasing worldwide but developing economies will bear a disproportionate share of this burden. The expected alarming increase in the prevalence of Diabetes in this region also increases the risk of Diabetic complications such as Diabetic Foot. Diabetic foot ulcers are the most common cause of lower limb amputations worldwide as well as in the Middle East. 1 in 4 diabetic patients risk developing foot ulcers, half of them will become infected and 1 in 5 will require an amputation. The odds of developing this risk in the Middle East population is even higher due to higher prevalence of Diabetes, social and lifestyle characteristics of the population, lack of understanding in patients and professionals leading to defective screening and identification at primary care level. Within the remit of the available evidence we identify various barriers to the effective management of diabetic foot in the Middle East region. These factors range from patient perspectives and beliefs, lack of awareness among healthcare professionals, scarcity of services, expertise and a lack of understanding in priority setting and resource allocation at the organizational level. A massive up scaling of services and expertise in the Middle East region is urgently required to prevent a rise in amputation levels and to lessen the future health and economic burden. We shall explore and discuss these barriers, challenges in counteracting them and the grave consequences or expected outcomes if these barriers are not overcome.