The lives of persons with diabetes in Guyana are being improved thanks to an award-winning program based at the University of Toronto’s Faculty of Medicine.
The Guyana Diabetes and Foot Care Project, which recently won the Journal of Wound Care’s 2013 Best Research from a Developing Country award, was initiated by Professor Gary Sibbald of the Department of Medicine and Dr. Brian Ostrow of the Department of Surgery.
“In Guyana, 15 per cent of the adult population suffers from diabetes. The country also faces the largest outmigration of people with post-secondary education per capita in the world. As a result, it has significant challenges in meeting the health care needs of its populations,” Ostrow says.
Diabetes affects vessels that supply blood to nerves in the foot, and as a result people lose protective sensation.
“Because of the loss of sensation, people don’t feel assaults on their feet. Diabetes also affects the foot muscles, leading to foot deformities that increase the risk of injuries,” Ostrow says. “That’s why people with diabetes are 15 times more likely to suffer an amputation.”
Ostrow and Sibbald wanted to improve diabetic foot care in the South American country, so they brought together experts from Canada and Guyana to establish a diabetic foot clinic at the national referral hospital. The team provides foot screening and treats diabetes-related complications. Their efforts have helped reduce diabetes-related amputations by 50 per cent despite an increase in hospital admissions.
The team has expanded its work to improve diabetes and hypertension care in an integrated manner. They have trained 275 health care workers and built seven new regional diabetes centres, increasing the range of services offered and making them available to 90 per cent of the population. .
Ostrow says that the project would not have been a success without the collaboration of professionals in Guyana, particularly a team of trained key opinion leaders and the Ministry of Health. They continue to train new health care professionals and distribute proper footwear to patients.
The lessons learned from the project are not specific to Guyana. There are an estimated 371 million people living with diabetes worldwide. Experts estimate that half a billion people will develop diabetes by 2030, with the majority living in developing countries where treatment and management is more difficult.
The program, which is now situated at the Banting and Best Diabetes Centre, is partnering with the Guyanese Ministry of Health and ORBIS International to address eye care and diabetes in pregnant women. It may expand the project to countries such as Ethiopia and Ghana.
Ostrow says Canadians can also benefit.
“We’re very proud of our health care system, but a large number of people with diabetic foot ulcers have trouble accessing the appropriate footwear or walkers. We’d like to take what we’ve learned in Guyana and find ways to apply it in Canada,” Ostrow says.