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Diabetes is a chronic disease that occurs either when
the pancreas does not produce enough insulin or when the body cannot
effectively use the insulin it produces. Globally the number of people with diabetes has risen from
108 million in 1980 to 422 million in 2014. Prevalence of diabetes among adults over 18 years
of age has risen from 4.7% in 1980 to 8.5% in 2014. WHO projects that diabetes
will be the seventh leading cause of death in 2030.1 over 1 million lower limb are
lost due to diabetes annually globally. In
2008, an estimated 347 million people in the world had diabetes and the
prevalence is growing, particularly in low- and middle-income countries. India
had 69.2 million people living with diabetes as per the 2015 data. India
is known as the “Diabetes capital”
of the world.2

 

            It has become major health and socio
economic burden to family and health care system. Interventions that are both
cost-saving and feasible in developing countries include life style
measures- Exercise, low sugar and low saturated fat diet, avoidance of tobacco 1-3.
 In 2015, an estimated 1.6
million deaths were directly caused by diabetes. Another 2.2 million deaths
were attributable to high blood glucose in 2012 3.
Mechanical stresses, poorly fitted shoes causes corns, callus. Wet foot
predispose to fungal infection. Poor educational status
was associated with poor knowledge about foot care.4 The current financing burden for NCD treatment falls
disproportionately on the poor. In 2008, India spent 4.2 percent of its GDP on
health care.5 The incidence of foot ulcers among
diabetics – 8% to 17%. Foot ulcers can cause severe disability and
hospitalization to patients and considerable economic burden to families and health
systems.6 Infection, occurring in about half of the diabetic foot
ulcers, is a further complication.7,8 foot problems account for 25
to 50 % of all hospitalization in diabetic patients. About 85% of
diabetes?related amputations are preceded by foot ulcers, and it accounts for
more than half of non?traumatic lower limb amputations.7,9
Individuals who develop foot ulcers have a decreased health?related quality of
life.10,11

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Lack
of knowledge about foot care practices make the complication worse. It has been shown that
49-85% of all diabetic foot related problems are preventable if appropriate
measures are taken. This can be achieved through a combination of good foot
care — provided by a multidisciplinary diabetes care team and appropriate
education for both people with diabetes and health care professionals.12
All patients with diabetes are potentially at risk from diabetic foot which can
only be avoided by creating awareness about the importance of appropriate self-care. Approximately 15% of
subjects with diabetes develop chronic non-healing foot ulcer in their
lifetime. Realizing
the importance of diabetic foot problems, IDF also chose the theme of World
Diabetes Day in 2005 “Put Feet First, Prevent Amputations”.13

The
objective of the current study was to assess the practices regarding foot care
and to estimate the proportion of people with peripheral neuropathy among
people with diabetes residing in the field practice area of B.J. Medical
College, Ahmedabad. By this study, patients’ knowledge regarding foot care
practices was assessed and this information gained can aid health care
providers and policy makers to develop targeted self?management education
programs for people with diabetes.

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