CME on The Foot in Diabetes

The Department of Endocrinology, Diabetes & Metabolism hosted a CME on The Foot in Diabetes, at the Wheeler Hall, CMC Town Campus, on 12th December 2023, Tuesday between 3pm-5pm; the event was simultaneously broadcast as a live webinar to attendees from across the country via ZOOM. Dr. Jachin Velavan, Associate Director, Missions, CMC Vellore was the Chief Guest; gracing the webinar remotely. The proceedings began with a word of prayer from Chaplain Saramma, followed by the welcome address, delivered by Dr. Nihal Thomas, Senior Professor, Department of Endocrinology.

Dr. Zulfiqarali G. Abbas, President, D-Foot International, the apex body for insight on the diabetic foot, was the keynote speaker on the occasion, presenting a comprehensive lecture that served to accentuate “Insights into the guidelines for infection and the diabetic foot”. By means of a case scenario, Dr. Abbas extensively elucidated the protocol to manage the foot in diabetes, to a rapt audience. Dr. Abbas was followed by Dr. Prabhu Premkumar, Professor, Department of Vascular Surgery, who walked attendees through “The early diagnosis of peripheral arterial disease in diabetic foot infections”; Dr. Prabhu discussed the deadly triad of neuropathy, trauma and vascular disease and the effect of their interplay on the foot in diabetes, and highlighted the principle of ‘doing as much as required and as little as possible’, when it comes to surgical management of vascular disease in diabetes. Dr. Emmanuel Lazarus, Associate Professor, General Surgery, Unit-1, presented an overview on “Lower limb Necrotising Fasciitis” addressing the various aspects of this tricky condition, subtle in onset, that progresses rapidly and results in high mortality. Dr Emmanuel illustrated the importance of early intervention and approaching each case with a high index of suspicion. The next speaker Dr. Felix Jebasingh, Professor, Department of Endocrinology, began his talk on “The primary prevention of foot ulcers: it’s not that straightforward”, by emphasising that pain is a gift; a protective sensation that is lost to diabetes. Dr. Felix discussed the set of conditions affecting the skin, bone and nails that need to be identified and meticulously managed in order to arrest progression to ulcer formation and ultimately amputation, if left unchecked. The session ended with a presentation by Mrs. Bharathi, Charge nurse & Diabetes Educator, Department of Endocrinology, on the “Secondary prevention of ulcers: it’s what you wear”. Offloading was at the heart of this lecture; using visual aids, Mrs. Bharathi demonstrated the principles and practices that govern offloading of the diabetic foot, to improve the patient outcome. The take home message was that prevention is always better than cure.

The integrated management of the foot in diabetes, delivered by a multidisciplinary team, was a common theme that resonated throughout the session.

A panel of specialists presided over the CME event, supplementing the lectures with their expert commentary: the chairpersons included Dr. Cecil Thankachan Thomas, Professor & Ag HOD, Surgery Unit-1, Dr. Shashank Lamba, Professor & HOD, Plastic Surgery-1 and Dr. Bobeena Rachel Chandy, Professor of Physical Medicine & Rehabilitation.

The audience was actively engaged, with participants raising pertinent queries, both on site and via the Zoom chat, that were answered by the speakers and chairpersons.