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A two-week training programme in diabetic foot care, conducted by a four-member Canadian team of podiatrists, concluded yesterday at the Georgetown Public Hospital’s Diabetic Foot Centre.Twenty doctors, nurses and technicians from the GPHC and the Ptolemy Reid Rehabilitation Centre benefited from the training, which aims at developing an integrated foot care programme to improve the lives of diabetics by reducing the number of amputations. This will be done through early detection and treatment of foot ulcers.The training is a component of the $22M one-year project between the government and the Canadian Cooperation Fund (CCF),Jean-Sebastien Giguere, a branch of the Canadian International Development Agency (CIDA).The complications of diabetes – foot disease, visual impairment, kidney problems and accelerated risk of heart attack and stroke – cause a large amount of suffering and premature death in Guyana.One of the most important is diabetic foot ulcers which are the single most common reasons for admission to a surgical bed at the Georgetown Public Hospital Corporation. These represent 10 per cent of all admissions.Diabetics are 15 times more likely to suffer an amputation than other persons and foot ulcers precede amputation in 85 per cent of cases.Preventing the development of foot ulcers in diabetics and more effective treatment of those that do occur are important measures to improve the health of the people of Guyana.The overseas team consisted of project coordinator and retired surgeon, Dr. Brian Ostrow; team leader, Professor at the University of Toronto and Wound Care Expert – Dr. Gary Sibbald; Professional Nurse Ms. Marjorie Fierheller; and Chiropodist Ms. Laura Lee Kozody.According to Ostrow, the trainees were divided into four teams consisting of doctors and nurses from the GPHC and rehabilitation technicians from the Ptolemy Reid Rehabilitation Centre.They were trained in techniques of screening which will detect patients who are high risk, caring for the foot which included wound care which has been proven to prevent ulcers, and how to educate patients on taking care of their feet in ways such as wearing the correct shoes.Mr. Ostrow explained that high risk patients are those without ulcers but who may have blisters, calluses and a previous history of foot ulcers.Additionally, the specialists introduced enhanced methods of ulcer management, including the use of devices to reduce the pressure on the patients’ feet. This is an important component which is necessary for ulcer healing.He said that the team was very impressed with the way the local persons responded to the training and commended the enthusiasm they showed throughout. Two more visits for training purposes are planned before the project ends.Last April, local doctors began a screening process for patients and some 700 of them were identified. Over the two-week period, 66 persons were seen at the clinic and the local doctors will continue treating patients.In keeping with the Ministry of Health’s recommendations for diabetic care, the GPHC opened a Diabetic Foot Centre in September last year and was later awarded $15M from the CCF to further improve diabetic foot care. The other $7 million is funded locally.Persons can visit the centre Mondays to Fridays but must have a referral from the GPHC medical outpatient department, regional hospitals or health centre.