KARACHI: A change in lifestyle and diet can put diabetes into remission, said Consultant Physician at the Diabetes and Endocrine Centre Professor Gerry Rayman, Ipswich Hospitals NHS Trust.
Talking to Pakistan Today on the sideline of the 6th Sanofi International Diabetes Conference 2019 at a local hotel on Tuesday, he said there is no doubt that amputations could be reduced by ensuring that patients’ feet are examined yearly so as to detect those who are at risk.
“If found to be at risk, they must know what preventive measures to take such as not walking barefoot and having their shoes properly fitted. They must examine their feet daily to check ulcers and if present must see immediate attention,” he added.
According to Gerry Rayman, the earlier the diabetic patients are treated the more likely the ulcer will heal. “Delay can result in the ulcer becoming larger and there is the risk of overwhelming infection which can go on to amputation,” he said.
“By ensuring that patient are screened yearly and that the care processes are in place to treat patients as soon as possible my team at Ipswich hospital reduced our amputation rates by 70% and indeed in many places in the UK similar improvement in amputation rates have been seen by following this process”, Gerry Rayman further said.
Elaborating further, Rayman said that in people with type 2 diabetes which is related to lifestyle and diet there is no doubt that change in behaviour can have a major influence on the condition. It is now know that such a change can put diabetes into remission.
“I will give you an example. I was referred a patient to start insulin injections as all oral drug treatments had failed. He weighed 140 kgs (308lb); I let him know that if he changed his behaviour and was able to significantly lose weight it is possible that insulin would be avoided but it would require supreme effort. He was determined to do this and indeed lost 40 kg (88lb) in 6 months. As a result his diabetes went into remission, he was able to stop all his diabetes treatments and his HbA1c fell from 13% to 5.6%. A big trial in the UK has demonstrated that such behaviour change can induce remission in 46% of patients and indeed nearly 90pc those who managed to lose more than 15kg went into remission”, Mr Rayman said.
Talking about the treatment practices in Pakistan, Prof Gerry Rayman said that the doctors should tell their patients what they found and the risk factor patients so that early treatment be started. The diabetic patients who have complications in the blood vessels should lower the intake of fat-filled food stuffs, do regular exercise, have controlled diet plans, lose weight etc.
Prof Gerry Rayman contributes to research into complications of diabetes, particularly foot complications, new technologies in diabetes care including devices and diabetes education. He has been the clinical lead for Diabetes UK’s ‘Putting Feet First’ campaign and has contributed to NICE guidelines on the diabetic foot (CG10, CG119 NG 19) and the NCEPOD recommendations on lower limb amputations and perioperative care.
He has been the NHS Diabetes Clinical lead for diabetes in-patient care and foot disease. He is the STP lead for diabetes in Suffolk and NE Essex. He also serves as an Honorary Professor at the University of East Anglia, Visiting Professor at the University of Suffolk and Associate Lecturer at Cambridge University.
He is the innovator and lead of the National Diabetes Inpatient Audit. He is past President of the Endocrine and Diabetes Section of the Royal Society of Medicine, Chair of DiabetesUK’s Clinical Study Group in Acute Care, Clinical lead of DiabetesUK’s inpatient initiative and the Getting it Right First Time co-lead for Diabetes aimed at improving diabetes care in England.