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By Emmanuel T. Erediano

SAIPAN, CNMI (Marianas Variety, Oct. 30) - Physical therapists have played a key role in reducing major limb amputations in the Commonwealth of the Northern Mariana Islands by 80 percent.

Dana MacFadden of the Commonwealth Health Center’s physical therapy department yesterday disclosed that they have seen an 80 percent reduction in the rate of major limb amputations since physical therapists have taken on the role of diabetic foot care educators.

Statistics from 2004 show that there were 5.3 new wound patients per month and 2.6 major limb amputations.

But while the number of patients went up to 14.3 in 2005, the amputation rate was down to 1.3.

In 2006, of 23 patients who showed up in the hospital per month, less than one amputation a month was carried out.

MacFadden said this dramatic reduction rate of amputations in the Commonwealth of the Northern Mariana Islands is the goal of other countries that are members of the International Diabetes Federation.

[PIR editor’s note: According to their website, the International Diabetes Federation (IDF) is a non-governmental organization in official relations with the World Health Organization. It is the only global advocate for people with diabetes and their healthcare providers. Beginning in 1950, we have evolved into an umbrella organization of over 190 diabetes associations in more than 150 countries.]

"When we started out with this, we didn’t have specific goals. We just kept working to do everything we could to help people in the community and reduce the impact of amputations here in the Commonwealth of the Northern Mariana Islands," she said, adding that these significant reductions took place as more physical therapists were coming on board.

The increase in the patient census means that more diabetic people who might not have been aware of their condition - or might have been aware but had not seen a doctor yet - have started showing up for early treatment.

The diabetic foot clinic out of the physical therapy department was launched in January, 2004.

Major limb amputations may lead to death.

MacFadden said in 2003, 60 percent of amputation cases resulted in deaths. In 2004, it was 80 percent and in 2005, 44 percent.

Major limb amputations are associated with increased morbidity and mortality as the overwhelming majority of amputees are left wheelchair bound.

U.S. studies have found that an estimated 60 percent will die within five years.

MacFadden said the rate is significantly higher for Pacific islanders.

Major limb amputation means below-knee amputation or above knee amputation.

Since toe and partial foot amputations leave the patient with a functional limb for ambulating, Commonwealth Health Center did not include these in its statistics.

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