Act fast or risk losing a limb, UAE amputee urges diabetics

An Emirati who had to be amputated below the knee is calling for others to get checked for diabetic foot to avoid the ordeal he went through.

Bader Al Yafei lost a foot to diabetes, but his early visits to doctors helped save his other one. Pawan Singh / The National
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Abu Dhabi // Bader Al Yafei, 66, was told he had Type 2 diabetes when he was just 35.

About two years ago he developed an infection in his right foot and had to have it amputated below the knee – surgery he underwent in Thailand.

However, when Mr Al Yafei developed problems with his left foot, about year ago, he was quick to seek medical attention and as a result it was saved.

Now confined to a wheelchair, he urged others to also act promptly.

“People should be committed to treatment and prevention. Prevention is better than cure,” said Mr Al Yafei, an Emirati from Abu Dhabi.

Dr Amit Kumar, a consultant vascular surgeon, who is now treating Mr Al Yafei, said if “diabetic foot” were treated in time the foot could be saved, but if left to fester the consequences could be devastating.

“His awareness of the left foot was much higher, and we have been able to salvage his left foot because of coming early and picking up the problem,” Dr Kumar said.

“By minimally invasive means we have increased the blood supply, by wound care we have healed the wound, and the best part is that none of this required an overnight admission in the hospital, nor general anaesthesia.”

The doctor would like more patients to have similar outcomes.

“Several times during my time in the UAE, I have had to perform amputations because of too late a presentation,” said Dr Kumar, who has worked in the country for six years.

The condition is characterised by an infection or a wound in the foot of a diabetic patient, who has a nerve or blood vessel affected by either Type 1 or Type 2 diabetes.

Poor blood supply and loss of feeling can mean the injury does not heal well and may also go unnoticed. If it is not treated in time, there can be no alternative to amputation.

“Worldwide, every 30 seconds an amputation is being performed. Of those patients, 70 per cent have diabetes,” he said.

He added that 85 per cent of those amputations that related to diabetic foot were preceded by an ulcer.

“Almost all of them can have something done to save the limb but they have to come early.

“What happens is due to poor control of diabetes, and with longevity of diabetics these days they are seeing the side effects of diabetes.

“And this region, being one of the fastest-growing regions on the planet for diabetics, is at exceptionally high risk of having this and we can see the complications already in the young population.

“We have seen typically patients from the age of 30 all the way up to the age of 75,” said Dr Kumar, who is a consultant vascular surgeon at Mediclinic City Hospital and BR Medical Suites in Dubai, and a general surgeon at Burjeel Hospital in Abu Dhabi.

A 48-year-old Emirati woman from Abu Dhabi, found to have diabetic foot three years ago, also had the lower limb saved thanks to treatment.

She urged other diabetics not to neglect their feet. “Even though you don’t have a wound, always check it,” she said.

As well as the impact on people’s lives, diabetic foot is also a costly problem.

“Of all the money spent on diabetics in the developed countries, up to 15 per cent is spent on diabetic foot. According to the international working group on diabetic foot, up to 40 per cent in the developing countries of the total budget [of treating diabetics], can be spent on diabetic foot,” said Dr Kumar, who is also an assistant professor in surgery at Columbia University in New York.

Prevention is vital. Diabetics should have the right footwear, check their feet every day and have regular appointments with a doctor.

“If you have a problem with the foot, like nerves, you should be seeing a physician every six months. If you have no problem with your sensation or your circulation, if you are a diabetic, you should still be seeing a physician at least once a year,” said Dr Kumar.

ecleland@thenational.ae