THE number of persons with diabetes in Guyana has doubled over the last six years, increasing from approximately 30,000 in 2004, to a worrying 60,000 in 2010, triggering concerns in many quarters, particularly in the light that the local prevalence rate of 6%, stands proportionately on par with the global prevalence rate of 6.4 %.
Diabetes, though known to be a silent killer, and perhaps one of the most debilitating chronic diseases, can with timely intervention and efficient monitoring be controlled.  It is in this regard that Guyana has been making significant inroads with the establishment of its Inter-Professional Diabetic Foot Centre (DFC) at the Georgetown Public Hospital (GPH).  
Established in July 2008, through partnership with the Canadian International Development Agency (CIDA) and the Canada Caribbean Fund (CCF), the two phased Diabetic Foot Care Project has been able to bring about a marked reduction in the number of diabetic amputations at the GPH, and is now moving to take the initiative to six other administrative regions of Guyana, which constitutes Phase II of the Programme.   Phase I spans July 2008 to May, 2010, and Phase II – 2010 – 2013.
An assessment of the local situation done by Dr. Madan Rambarran, Director of Professional Services at the Georgetown Public Hospital in 2007 revealed that of the various diabetic related illnesses in Guyana, Diabetic Foot Diseases ranked as most troublesome.  And increasingly, these diabetic complications were leading to amputations. 
In fact, where the Caribbean rated as having some of the highest diabetic amputation rates in the world, at the GPHC in Guyana, according to Dr. Carlos Martin, who now heads the Inter-professional Diabetic Foot Centre (DFC), the problem, even though now under control, is ‘humongous’.
At the hospital in 2007, patients’ feet were not routinely examined and there was no screening or risk assessment.  With a high burden of diabetic foot disease, some 200 patients were seen weekly.
Concerned over this development, Dr. Madam Rambarran in 2007 did a needs assessment and found that diabetic foot disease constitutes a major problem at the GPH where 30 % of the patients admitted to the surgical wards have diabetic foot ulcers, and 42 per cent of those admitted to the Diabetic Foot Unit had amputations.  It is out of this vision that the establishment of a sustainable Diabetic Foot Care Clinic at the GPHC was birthed.
He entered into discussions with Dr. Brian Ostrow and a team of other Canadian doctors who had come to Guyana to run the Diploma in Surgery Programme and together they explored funding opportunities. The project has had the full support of Minister of Health, Dr. Leslie Ramsammy.
Now well on stream, the project has as its key focus the care of diabetic feet, with the ultimate aim of reducing lower limb complications and avoiding unnecessary amputations among people with diabetes.
This objective is being realized through the implementation of a sustainable, integrated and low-cost health care capacity for attending to the diabetic foot, with Phase I at the GPH, and Phase II  in six other administrative regions of Guyana, namely:  Regions 2, 3, 4, 5, 6,  and 10.
The project has been bringing about remarkable reductions in the lower limb complications and prevention of unnecessary amputations in people with diabetes.  Through the system also, people living with diabetes are empowered to take better care of their feet, constantly examining, observing and promptly reporting and seeking help from the DFC facilities.
Previously, the GPH recorded approximately 90 to 100 diabetic ampuations per year or about 8 legs per month. Following the establishment of the Inter-professional Diabetic Foot Centre, headed by Dr. Carlos Martin and assisted by an able team six- member team, there have been remarkable improvements. 
Overall there has been a more than 43 per cent reduction in the number of persons requiring major amputations (above the ankle) and a drop from 8 legs per month to four.
Meanwhile, testimony to the success of the project, 2010 seems to have been the record breaking year in terms of reducing amputations. With just two months to the end of the year, the number of amputations for the year now stands at 33, compared to 100 for previous years.
Are you, or anyone you know diabetic and having problems with your feet?  If so, we urge you, do not waste time, hurry to your nearest diabetic foot centre where you will be registered for the “60 second Screen for HIGH RISK DIABETIC FOOT” and treated accordingly. At GPH you will meet a warm and professional staff, comprising  Dr. Carlos Martin; Physiotherapist – Debita Harrypersaud; Nurses Melinda Thomas and Alexis Reid; Nutritionist Jackie Williams; and Secretary, Trisha Baldeo.
If you or anyone you know are diabetic and has even the mildest of problems with the feet, Dr. Martin is urging, as far as your legs can permit you, “Run to the diabetic Foot Centre, don’t walk”.  Time is of the essence, he advises.
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