Abstract

According to International Diabetes Federation (IDF), approximately 425 million people worldwide suffer from diabetes. 11.6 million deaths per year are directly attributed to it. Currently 39 million people in the MENA region suffer with diabetes. This region also has the second highest rate of increase in diabetes globally, where the number of people with diabetes is predicted to increase by 96.2% in 2035.315% of the U.A.E adult population are categorized as patients of type-2 diabetes mellitus (DM). Materials and Methods: This prospective cross-sectional study was conducted in the outpatient department of General Medicine in Tagore Medical College and Hospital, Rathinamangalam, Melakottaiyur, Chennai, wherein 50 to 60 patients with diabetes visit the OPD every day to get their weekly anti diabetic drugs. 100 such patients were screened. Inclusion criteria included a diagnosis of either type 1 or type 2 diabetes mellitus diagnosed at least six months prior. Patients underwent a detailed history and examination and investigations were done. Educational status of each respondent was assessed and classified as literate or illiterate. Literate participants were further classified as matric (high school), below (primary school) and beyond high school. Results: Of the 100 patients assessed, 63 were men. 11 (11%) of the 100 had a current or past history of foot ulcers. The mean age of the respondents was 46 years (range 16-83 years). Patients had diabetes for an average of 8.59 years (range 1-36 years). Nineteen percent of the 100 were illiterate. Primary school, High school and Beyond High school education was seen in 44.5%, 27.5% and 9% of the study population respectively. Only 23 patients had received either an educational session or reading material about foot care. 7 had similarly received an educational session or material about foot wear. Conclusion: Before diabetic foot care reaches the level desired by specialists in this field, many barriers must be recognized and overcome. Sound and cost-effective strategies need to be developed. Policymakers and health-care professionals should work together to remove the obstacles and facilitate the provision of adequate diabetic foot care. The impact of diabetic foot disease and amputations will only be reduced if sufficient attention is paid to the necessary preventive measures. This study emphasises that significant reductions in amputations can be achieved by well-organized diabetic foot care teams, good diabetes control and well-informed self-care. This study also stresses the need for opening patient centred diabetic foot care clinics for early diagnosis, treatment and prevention.

Description

According to International Diabetes Federation (IDF), approximately 425 million people worldwide suffer from diabetes. 11.6 million deaths per year are directly attributed to it. Currently 39 million people in the MENA region suffer with diabetes.1 This region also has the second highest rate of increase in diabetes globally, where the number of people with diabetes is predicted to increase by 96.2% in 2035.315% of the U.A.E adult population are categorized as patients of type-2 diabetes mellitus (DM). Trends in 2015 also indicate that the prevalence of diabetes in the UAE is rising at a faster rate than both the MENA region and the rest of the world. This becomes a burden in terms of costs of treatment and affects the management of the impending complications as well.2 Among the complications of diabetes, the most common is diabetic foot disease. It results in deteriorating conditions such as diabetic neuropathy and foot ulcers causing a potentially devastating sequelae of mortality and morbidity. Fortunately, diabetic foot complications are also the most preventable if appropriate measures are taken.3 Patient education is the most effective way to reduce the complications of diabetes. Since the patient is the primary foot care taker, good awareness and practice of foot self-care is essential to reduce the incidence of diabetic foot disease.4 People with diabetes often receive the same generalized foot-care education, irrespective of their risk status, which is inappropriate. All diabetics require a foot assessment in order to be graded according to their level of risk. Regular foot assessment needs to be emphasized in the low-risk group. Sensory neuropathy and/or decreased blood flow in the lower limbs (peripheral vascular disease), but with no 'active' foot problems, should be regarded as being at high risk. They require intensive foot-care education including self-care skills and routine podiatry care. High risk patients such as those with an active infection require multidisciplinary care and should receive intensive education to modify behaviour and lifestyle.5