India was named the world’s “diabetic capital” at the International Diabetes Federation Conference in Copenhagen in November 2006. I learned this from a very informative piece by Ajit Kumar Varma MD and Stephanie C Wu DPM MsC, called Diabetic Foot Care: The State of Play in India. Here are some of the observations and facts in the article:

• Nearly 246 million people worldwide are diagnosed with diabetes with India accounting for almost 45 million of those diagnoses.
• In India there are very few organized diabetic foot-screening programs.
• Podiatric services are only available in major centers.
• Proper diabetic shoes and orthotics are not readily available.

One hopeful note: The Amrita Institute of Medical Sciences and Research Centre (AIMS) in Kochi, Kerala, India, is a large, tertiary, 850-bed super-specialty hospital. The Amrita Institute now has:

• A division of podiatric surgery (the largest in India) that focuses on diabetic lower limb surgical problems.
• A footwear factory near the center with trained staff making high-quality preventive, postoperative, and rehabilitative footwear.
• Amrita Diabetes Welfare Association (ADWA), a patient association with over 1,500 members and Diabeat, a patient education magazine.
• A low rate of major amputations – 9% – compared to 45% in developing countries and just under in developed nations.