World Diabetes Day

As usual, World Diabetes Day for this year 2005 is going to be celebrated on November 14. With this article I would like to welcome this year World Diabetes Day.

World Diabetes Day is the Primary global campaign for raising public awareness of diabetes. It aims to inform the public of the causes, symptoms, complications and treatment associated with the condition. World Diabetes Day serves as an important reminder that the incidence and prevalence of diabetes is increasing all over the world and will continue to do so unless action is taken immediately.

World Diabetes Day was introduced in 1991 in response to concern over the escalating incidence of diabetes around the world. Since then, it has grown in popularity every year and now brings together more than 350 million people worldwide children and adults with and without diabetes, healthcare professionals, decision makers and the media.

World Diabetes Day is celebrated every year o n 14 November. The date was chosen as it is the birthday of Frederick Banting who, along with Charles Best, first conceived the idea which led to the discovery of insulin in October 1921. Insulin is a hormone produced from pancreas and it plays an important role in the pathgenesis of diabetes mellitus. It is also important medication for the treatment of diabetes mellitus.

Each year World Diabetes Day is centered on a unifying idea, a theme which is the focus of special attention. Topics covered in the past have included diabetes and human rights, diabetes and lifestyle, and the costs of diabetes. Since 2001 particular attention has been paid to diabetes complications. Recent and future themes include:

2002 Your Eyes and Diabetes: Don't lose sight of the risks

2003 Diabetes could cost you your kidneys: Act now!

2004 Fight Obesity Prevent Diabetes

For this year 2005 the mean focus is on one of the common diabetic complications: Diabetes Foots and its consequence, i.e., amputations. The theme for this year is Diabetes and Foot Care: Put Feet First Prevent Amputations

The activities carried out on World Diabetes Day vary from country to country and they are aimed to inform, educate but also provide enjoyment. The objective of this year's campaigns are to:

* inform people of the extent of diabetic foot problems worldwidetake action

* persuade healthcare decision maker that action is both possible and affordable

* warn healthcare decision markers of the consequences of not taking action

* inform people with diabetes of the measures they can take to prevent foot complications.

Lower extremity amputations are usually preceded by a foot ulcer in people with diabetes. The most important factors related to the development of these ulcers are peripheral neuropathy, foot deformities, minor foot trauma and peripheral vascular disease. The spectrum of the lesions varies in different regions of the world due to differences in socioeconomic conditions, standards of foot care and quality of footwear.

Foot problems are common in diabetes patients. The importance of foot problems in diabetes is highlighted by the following data and facts.

* Every 30 seconds a leg is lost to diabetes somewhere in the world.

* Up to 70% of all leg amputations happen to people with diabetes.

* In developed countries, up to five per cent of people with diabetes have a foot problem.

* Foot problems are the most common cause of admission to hospital for people with diabetes.

* In developing countries, it is estimated that foot problems may account for as much as 40% of available healthcare resources.

* The direct cost of an amputation associated with the diabetic foot is estimated to be between US$30,000 and US$ 60,000.

* Most amputations begin with a foot ulcer.

* One in every six people with diabetes will have a foot ulcer during their lifetime. Each year 4 million people worldwide get a foot ulcer.

* In most cases diabetic foot ulcers and amputations can be prevented. It is estimated that up to 85% of amputations could be avoided.

* Significant reductions in amputations can be achieved by well-organized diabetic foot care teams, good diabetes control and well-informed self care.

Foot complications are one of the most serious and costly complications of diabetes. However, through a care strategy that combines: prevention; the multi-disciplinary treatment of foot ulcers; appropriate organization; close monitoring, and the education of people with diabetes and healthcare professionals, it is possible to reduce amputation rates by between 49% and 85%. It is this objective that should motivate the advocacy work of those fighting to make a difference for those living with diabetes around the world.

I would like to take the opportunity to disseminate health education on diabetes foot to the diabetes patients, their families and relatives and also to the public, by mentioning things to do and things to avoid to prevent foot complications in diabetes patients, in this article.

Things To Do

* Check your feet daily for cuts, blisters, bruises or coiour changes, swelling and open sores. Report them to your healthcare team without delay,. Use a mirror to see the soles of your feet or, if this is difficult, seek help from someone else.

* Always protect your feet. Wear suitable footwear inside and outside your home to avoid injuring your feet.

* Check inside your shoes for stones, sharp objects and rough places before putting your shoes on.

* Buy new shoes late in the day. This is because feet become more swollen towards the end of the day and you can be more sure that your shoes are not too tight and fit well.

* Wearing socks can help to prevent injury. Make sure they are not too tight and wash them daily. Make sure they have no holes.

* Always wash your feet with soap water. Take care to wash between your toes. Dry your feet carefully, especially between the toes. Use oil or lotion to keep your skin soft.

* Cut toe nails straight across and file any sharp edges.

* Have your feet checked periodically by a healthcare professional.

* Keep any wounds covered with clean dressings.

Things to avoid

* Avoid pointy-toe shoes, high heels, stilettos and strapless and backless shoes.

* Don't wear tight socks.

* When washing your feet be careful that the water is not hot enough to burn them.

* Don't use a heater or hot water bottle to warn your feet.

* Avoid Walking barefoot whenever possible. If this cannot be avoided because of cultural or religious reasons, you must be extremely careful and avoid the risk of burns from hot surfaces in hot climates.

* Never try to treat your own feet with corn medicines or razor blades. Always seek help from a professional if you have a problems.

* Avoid becoming overweight.

* Don't smoke-smoking damages the supply of blood to the feet.

* Don't wear jewellery on your feet.

Remember that even if foot problems are pain less they can still be serious.

Warning Signs

Everybody would accept the fact that prevention is better than cure. Accordingly, it is important to know the warning signs in order to identify the foot at risk. These include:

* Swelling of the foot or ankle

* Very cold feet or legs

* Colour changes; red, blue or black discolouration

* Pain in legs at rest or while walking

* Open sores, no matter how small

* Non healing wounds

* In-growing toe nails

* Corns and calluses

* Lack of hair growth on the foot

Management of the diabetic foot

Needles to mention that the proper management of diabetes foot are equality important The ideal management for the prevention and treatment of diabetic foot problems includes:

* Regular inspection of the diabetic foot

* Identification of the foot at risk

* Education of people with diabetes and healthcare professionals

* Appropriate footwear

* Rapid treatment of all foot problems

It is imperative that we increase awareness among carers at all levels of healthcare services worldwide. It is imperative that we reduce the unnecessary suffering that foot complications can bring. It is imperative that we act now!
 

Author :  Dr Tint Swe Latt