Karachi: Around 50 percent of people suffering from diabetic foot ulcers in Pakistan develop depression, while those who lose their limbs to the disease often sink into severe mental illness and even suicidal thoughts, national and international experts warned on Sunday at the concluding session of the International Conference on Diabetes and Diabetic Foot 2025.
“Half of those with diabetic foot ulcers suffer from depression, and the illness becomes far more severe when they undergo amputation,” said Dr. Zahid Miyan, Director of the Baqai Institute of Diabetology and Endocrinology (BIDE).
He called for classifying diabetic foot ulcers into categories and designing separate management plans for each type of wound to improve outcomes.
Speaking at the international conference, jointly organised by BIDE, Baqai Medical University and Diabetic Foot International, experts from Pakistan and abroad discussed the rising crisis of diabetic foot, the role of multi-drug resistant bacteria, the use of new drugs like semaglutide, and the urgent need to integrate psychological support into diabetes care.
The scientific sessions brought together clinicians, researchers and global specialists including Gulnaz Tariq from UAE, William Akiki from Lebanon and many others to share new findings and strategies on managing diabetes and its devastating complications.
Prof. Najmul Islam, senior endocrinologist from Aga Khan University, said depression is very common among diabetics, just like in other chronic diseases, and sometimes physicians themselves have to prescribe medication and provide counselling.
He warned that suicidal thoughts are a manifestation of severe depression and often emerge among patients with serious complications, stressing that such patients need urgent counselling in addition to medical treatment.
On the use of semaglutide, he added that Pakistani patients require safe and cost-effective biosimilar versions due to the high price of original drugs, cautioning that they would have to be taken for longer durations to prevent rebound of weight and disease.
Dr. Saif ul Haq, Deputy Director of BIDE, emphasised prevention and lifestyle modification as the most effective way to reduce the diabetes burden. He noted that exercise, healthy diet and weight control could prevent millions from falling into the vicious cycle of complications.
Dr. G. Abbas from Tanzania highlighted the psychological trauma faced by patients at risk of losing limbs, saying even the loss of a toe is unacceptable for many in sub-Saharan Africa. He stressed that counselling is essential to help patients accept treatment and prepare them for possible amputations.
Prof. Tariq Waseem, senior endocrinologist, said even the diagnosis of diabetes can trigger depression, while long-term complications such as neuropathy fuel chronic psychological distress.
He confirmed that many patients complain of suicidal thoughts but advised doctors to reassure them that diabetes is not a death warrant. With medication, counselling, and up to 15 percent weight loss, he said, patients could not only live a normal life but even reverse their condition.
Renowned medical expert Dr. Sonia Iqtidar also spoke at the conference, stressing the importance of early detection, patient education, and community-based awareness to tackle both the physical and mental burden of the disease. She said oral semaglutide was a better choice for diabetes and weight control while it was also cost effective as compared to injectable drugs.
The experts’ warnings echo recent research exposing the hidden mental health crisis of diabetes in Pakistan. A 2023 study in Karachi slums found that 30.8 percent of diabetics were clinically depressed and 20.4 percent had suicidal ideation, while over 11 percent had attempted suicide.
Adding to the scientific warnings, UAE-based expert Gulnaz Tariq outlined the deeper drivers of Pakistan’s diabetes epidemic, saying rapid urbanization, sedentary lifestyles, and a shift from traditional diets to calorie-dense fast foods and sugary drinks are fueling the crisis, compounded by rising obesity, genetic vulnerability among South Asians, and weak healthcare systems.
Poor awareness, late diagnosis, and lack of large-scale prevention programs have left millions undiagnosed until complications strike, she added.
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