Karachi: Infections caused by multidrug-resistant (MDR) bacteria are rapidly worsening the diabetic foot crisis in Pakistan, driving up treatment costs, leaving patients with fewer treatment options, and pushing amputation rates to alarming levels, experts warned at the international conference on diabetes and diabetic foot 2025 on Saturday.
“Around 74 percent of the diabetic foot ulcers are infected with more than one, usually three or more bacteria, which are multi-drug resistant and very hard to treat,” said Dr. Saif-ul-Haq, Deputy Director BIDE, while speaking on the opening day of the scientific sessions.
“Treatment of these wounds is not only difficult and expensive but often leads to amputations if the patient doesn’t reach out to tertiary-care health facilities.”
The meeting, organised by the Baqai Institute of Diabetology and Endocrinology (BIDE) in collaboration with Diabetic Foot International and Baqai Medical University, brought together leading specialists from Pakistan and abroad.
Dr. Saif noted that in the past five years the incidence of MDR bacteria in wound infections has been steadily rising, with the cost of treating a single case now requiring prolonged courses of injectable antibiotics costing between Rs. 150,000 and Rs. 200,000.
“Most patients cannot afford these medicines, and many abandon treatment halfway. That is when amputations become inevitable,” he deplored, urging doctors and the public to stop the reckless misuse of antibiotics that has accelerated resistance.
“Unfortunately doctors are to blame for overprescribing, while people also use antibiotics without prescriptions. Combined with the diabetes crisis, this is becoming one of Pakistan’s most serious health emergencies,” he warned.
Prof. Javed Akram, President of the Pakistan Society of Internal Medicine, said drug-resistant bacteria had become “a nightmare” in the country’s hospitals.
“In people with diabetes, neuropathy damages the nerves in the feet, meaning they don’t feel minor injuries. These wounds quickly turn into ulcers, and when infected with resistant bacteria, there is often no option left but amputation,” he said.
Prof. Akram emphasised that unchecked antibiotic use, weak regulation, and limited laboratory testing were fuelling resistance. “If we don’t act now, we will see a generation of diabetics losing limbs because our drugs have stopped working,” he cautioned.
Wound care specialist Gulnaz Tariq advised doctors to minimise antibiotic use and instead adopt antimicrobial sprays, ointments and dressings for diabetic foot ulcer management. She called for a major investment in education — not only for doctors but also for patients and families — so that early wounds are managed properly at home and do not progress to dangerous infections.
She also announced five wound care fellowships for Pakistani doctors at the University of Toronto, funded by her foundation, worth USD 25,000 in total.
International speakers also stressed the importance of early diagnosis and innovation in detection. Prof. Zulfiqar G. Abbass from Tanzania highlighted new tools to catch diabetic neuropathy in its earliest stages, saying timely screening could help prevent ulcers and reduce the risk of infection.
BIDE Director Prof. Zahid Miyan reiterated that diabetes has become one of Pakistan’s deadliest health challenges, not only because of heart disease, kidney failure and blindness, but also because of the growing burden of diabetic foot complications.
“These are not just statistics. These are lives being lost or permanently disabled. Without urgent reforms, the human and economic costs will keep rising,” he warned.
Ali Asghar of Liaquat National Hospital added that 50 percent of Pakistani diabetics remain uncontrolled despite available therapies, underscoring the need for wider use of insulin in managing the disease. “Unless we control blood sugar, no wound care or antibiotic strategy will succeed,” he said.
Several other leading experts, including Prof. Roberto Anichini from Italy, William Akiki from Lebanon, Prof. Uzma Khan from the United States, Prof. Erid Senneville from France, and Prof. Willbert Van Laar from the Netherlands, also shared insights on best practices and new technologies for preventing diabetic amputations.
Experts said local studies show resistant bacteria such as Pseudomonas, Klebsiella and MRSA are now common in foot infections, with one in three samples failing to respond to standard antibiotics. Poor blood supply to the legs, biofilm-protected bacteria, and delayed hospital visits make treatment even harder.
Doctors stressed that only early detection, proper foot care, and strict antibiotic stewardship can reduce the crisis. Without this, they warned, Pakistan’s already high amputation rates will climb further, devastating families and pushing more people into lifelong disability.
The conference will continue on Sunday, with more discussions on strategies to combat diabetic foot complications and antibiotic resistance.
Ends