The Program “Beat Diabetes” is an ambitious program which aims to screen for complications among persons with Type 2 Diabetes of 5 or more years duration in Ernakulam, parts of Alappuzha and Idukki. This remarkable initiative is expected to prevent diabetic end-organ damage through early detection, counselling and disease management.
Diabetes is a leading cause of morbidity and mortality the world over and particularly so in the southern state of Kerala which is leading the country in the epidemiological and demographic transition. The latest prevalence of Diabetes indicates that among every five persons one is affected by Type 2 diabetes. The challenge to take care of such a large number of patients can overwhelm even the most proactive of health systems such as that of Kerala.
This project, funded by Lions International, works at the interface of the people, health system, local self-government and Department of Community Medicine, Amrita Institute of Medical Sciences (AIMS), a leading tertiary care center providing cutting edge health care to millions of people. Through this project, high-end quality care for screening for foot and eye complications is made available at the doorsteps of people by skilled personnel from the various departments of AIMS.
Following training provided to ASHA’s, the high-risk patients are evaluated by the respective Primary Health Centre (PHC) team and referred to a diabetic camp for detailed evaluation. Early detection of retinopathy saves sight and detection of peripheral neuropathy and peripheral arterial disease helps to prevent amputations. A non-mydriatic handheld device is used to detect retinopathy by ophthalmologists and a point of care device is used to measure glycaemic control HbA1c (glycosylated Haemoglobin). A biothesiometer is used to measure vibration perception to detect neuropathy and a doppler is used to measure the ankle-brachial pressure index and peripheral arterial disease. Selected persons are also being screened for microalbuminuria and cardiological complications by taking ECG. About 4500 such patients have been screened to date in the Ernakulam district.
Amrita Institute of Medical Sciences and the Department of Community Medicine is the technical partner in the implementation of the screening program. Dr. Aswathy S. (Professor, Community Medicine), Dr. Joseph M. (Consultant Public Health), Dr. Vijayakumar K. (Professor & H.O.D.) and Dr. Beena K. V. were instrumental in developing this program. The Lion's District Governor of 318C Mr. Rajesh K., Mr. Das M. and Mr. Rajan have taken the theme of “Beat Diabetes” to the community by providing all the logistical support with the funding of the Lions International Group. Critical support from the District program manager of NHM, Dr. Mathews Numpelil, and the PHC and Community Health Centre (CHC) help in taking the program to the most deserving people. Thus, this program is also an excellent example of a public-private partnership.
The response of the people and local self- government has been phenomenal. This is also an example of how the public and private sectors can work together to respond to the challenges to take health care to the people. The diagnosed patients are referred to the nearest government or private care facility according to their choice. The neediest patients receive further support from the local Lions Clubs.
One of the men attending the camp remarked,"These tests are really useful, I thought this was just like the other camps”. This was echoed by other senior doctors attending the camp.