The First National And Regional Conference On Diabetic Foot Problems

20 Nov 2004

By Dr Balaji Sadasivan, Senior Minister of State for Information,Communications and the Arts and Health

Venue: National University Of Singapore, CRC Auditorium

Speech By Dr Balaji Sadasivan,Senior Minister Of StateFor Information, Communications And The Arts And Health, At The FirstNational And Regional Conference On Diabetic Foot Problems, 20November 2004, 9.00 Am At National University Of Singapore, CRCAuditorium

Mr Chua Song Khim, CEO, NUH

Associate Prof. Lim Yean Teng, Chairman Medical Board, NUH

Associate Prof. Aziz, Nather, Chairman, Organising Committee,

Dr Chionh Siok Bee, Co-chairman, Organising Committee,

Distinguished Guests,

Ladies and Gentlemen,

Introduction

I am delighted to be invited as the Guest-of-Honor to the FirstNational and Regional Diabetic Foot Conference. I am also impressed bythe turnout, as the success of this conference is a tribute to all ofyou - for your dedication, professionalism, passion and willingness toupgrade your knowledge and skills to serve our patients and community.I understand that participants of this conference include OrthopaedicSurgeons, Endocrinologists, Infectious Disease Specialists, VascularSurgeons, Reconstructive Surgeons, Podiatrists as well as GeneralPractitioners, Doctors and Nurses from Polyclinics and Nurses fromHospitals and Community Homes in Singapore - all with the common goalto share some of the latest information and developments in the careand treatment of diabetic foot.

This conference is also the first regional conference of its kind, withmany medical professionals from Malaysia, Indonesia, Hong Kong andIndia. We welcome all of you and we hope that in the spirit ofcollaborative learning and sharing, we will all collectively benefitfrom each others' wealth of knowledge and experience.

Diabetes - A growing problem in the young and old

Diabetes is reaching epidemic proportions worldwide and it is rankedthe 8th commonest cause of death in Singapore in 2003. According to the1998 National Health Survey, the prevalence of diabetes amongSingaporeans aged 18-69 years is 9%. This is high by global standards.Among the main ethnic groups, the prevalence is highest among Indians(15.8%), followed by Malays (11.3%) and Chinese (8.0%).

The cost of diabetes

Diabetes, if not managed well and controlled, can progress steadily tocause devastating complication such as blindness, nerve damage, kidneyfailure, heart disease, and limb amputations. In Singapore, the rate ofpatients presenting with diabetic foot problems has increasedsignificantly.

Standards of diabetic care

According to the Diabetes Care Audit carried out in 2002 by theMinistry of Health, there are good structural programmes, protocols andlinkages across the continuum of care at the hospital and polycliniclevel in the public sector. Monitoring of the processes and outcomes ofdiabetic care, such as HbA1c, blood pressure and weight were carriedout conscientiously, and this is to be commended.

Diabetes and diabetic foot problems 

This conference focuses on "A Multi-Disciplinary Approach toDiabetic Foot Problems" as care of diabetic patients is a teameffort. A good management programme calls for a multi-disciplinaryapproach. This conference brings together orthopaedic and vascularsurgeons, infectious disease physicians, endocrinologists, nurses,podiatrists, other allied healthcare staff as well as productspecialists in primary and acute healthcare settings. Patients,themselves, should be educated regarding their condition and encouragedto take on an active role in the management of their own condition.Life-long compliance is required from the patient and hence, self-careforms the cornerstone of treatment.

Fortunately, steps can be taken to prevent diabetic foot complicationsor limit its progression. Early detection, regular health screening,diabetic education and timely treatment at the primary and acute carelevel, have been shown by several studies to reduce lower limbamputation rates by up to 85%. With medical care and treatment forpatients with chronic diabetic foot problems becoming more advanced andevidence-based, clinicians and surgeons have more options to offer ourpatients in the management of diabetic foot problems. Our strategy mustbe:-

First, to prevent Diabetic Foot Problems from occurring by focusingmore on diabetic screening and diabetic foot education at primary carelevel in Polyclinics and Private Clinics,

Second, to treat Diabetic Foot Problems early by recognizing patientswho require urgent treatment by a Multi-Disciplinary Team with the aimof:

Increasing limb salvage rate;

Reducing the average length of stay and hospital costs and 

Reducing morbidity and mortality.

Conclusion

Hence, providing a multidisciplinary approach in the treatment ofdiabetic foot problems is essential in the primary and acute caresettings. I would, therefore, encourage everyone to take thisopportunity to make the most out of this conference.

I would like to thank Professor Aziz Nather and his Co-Chairman DrChionh Siok Bee, and the organizing team for taking the lead toorganise this event. I believe this conference will be truly beneficialand wish all of you a fruitful session ahead. With that, I would liketo declare open the First National and Regional Conference on DiabeticFoot Problems.

Thank you.