Sunday November 13, 2005
It’s diabetes day
Medicine Cabinet
By DIONG SWEE HOON
EVERY year, World Diabetes Day falls on November 14. World Diabetes Day was established by the International Diabetes Federation (IDF) and World Health Organization (WHO) in 1991, with the aim of coordinating diabetes advocacy worldwide. It has become the primary awareness campaign of the global diabetes community.
 |
In people with diabetes, lower extremity amputations are usually preceded by a foot ulcer. |
Somewhere in the world, a leg is lost to diabetes every 30 seconds. Given the high incidence of diabetic foot ulcers and the frequency with which, though often treatable, they lead to amputation, the choice of theme is highly appropriate.
It is also fitting that 2005 marks the shift towards year-long campaigning. This will enable IDF to promote forcefully the message that, with relatively low investment, governments can advance education and prevention messages that will result in lower rates of amputation than the unacceptable figures we see today. It is possible to reduce amputation rates by between 49% and 85%.
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 foot lesions varies in different regions of the world due to differences in socio-economic conditions, standards of foot care and quality of footwear.
Diabetes facts
Diabetes is a serious chronic disease. In 2003, the global prevalence of diabetes was estimated at 194 million. This figure is predicted to reach 333 million by 2025 as a consequence of longer life expectancy, sedentary lifestyle and changing dietary patterns.
Although many serious complications, such as kidney failure or blindness, can affect individuals with diabetes, it is the complications of the foot that take the greatest toll. Of all lower extremity amputations, 40-70% are related to diabetes. In most studies, the incidence of lower leg amputation is estimated to be 5-25/100,000 inhabitants/year: among people with diabetes, the figure is 6-8/1,000.
The signs of diabetes include being very thirsty, urinating often, feeling very hungry or tired, losing weight without trying, having slowly healing sores, dry itchy skin, losing feeling or tingling sensations in limbs and having blurry eyesight.
There are two common forms of diabetes:
Type 1 diabetes, or insulin-dependent diabetes, is usually first diagnosed in children, teenagers or young adults. In this form of diabetes, the beta cells of the pancreas no longer make insulin because the body’s immune system has attacked and destroyed them.
Type 2 diabetes, or non-insulin-dependent diabetes, is the most common form. People can develop type 2 at any age and this is where the pancreas does not make enough insulin and the body does not use it properly due to insulin resistance.
Pre-diabetics (people with higher than normal blood glucose levels but who are yet to be diagnosed as a diabetic) are also seen worldwide to be on the rise at an alarming rate.
Chronic hyperglycaemia (raised blood glucose levels) is usually associated with long-term damage to the body and the failure of various organs and tissues. People with diabetes are at risk of nerve damage (neuropathy) and problems with the blood supply to their feet (ischaemia).
Nerve damage results in a reduced ability to feel pain, and injuries often go unnoticed. Ischaemia can slow down any wound healing.
Both neuropathy and ischaemia can lead to foot ulcers. Infections in these wounds may ultimately result in amputation.
Foot 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 5% 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 take up 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 (RM111,000 and RM222,000).
· Most amputations begin with a foot ulcer.
· One in every six people with diabetes will have a foot ulcer during their lifetime.
· Each year, four 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-organised diabetic foot care teams, good diabetes control and well-informed self care.
Warning signs of a diabetic foot at risk
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 discoloration)
· Pain in legs at rest or while walking
· Open sores
· Non healing wounds
· In-growing toe nails
· Corns and calluses
· Lack of hair growth on the foot.
Treatment for diabetes includes medications, supplements, wise food choices and exercise.
References:
1. Diabetes Atlas second version, International Diabetes Federation, 2003 - More information on diabetes and foot care can be found in the World Diabetes Day 2005 leaflet “Diabetes and Foot Care – Put Feet First Prevent Amputations”.
2. International Diabetes Federation
RSS
