If diabetic, do not miss your appointments with health professionals

Angela Davis

Sunday, November 19, 2017

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WORLD Diabetes Day was observed on November 14. Every year, around this time, I like to write an article on this issue, as it is so prevalent in our society.

At the last count, approximately 425 million people around the world were living with diabetes. This year World Diabetes Day focused on women, and the facts for us here in Jamaica are quite disturbing.

Fact 1: Women show higher morbidity than men who are diabetic.

Fact 2: Approximately 22 per cent of women in Jamaica who are diabetic are unaware that they have the condition.

As a podiatrist, I see many diabetic patients whose feet are suffering as a consequence of ignorance and fear. Today, I will share a case study with you that highlights this dilemma.

A colleague asked me to assess a diabetic female patient who had a trauma injury to her heel. Due to neuropathy (poor sensation), a thorn had punctured her skin and caused an infection.

The doctor had prescribed a course of antibiotics and booked an appointment for her to see me. The patient didn't turn up for the appointment, so we called her daughter and scheduled another one. Again, she didn't show up.

Two months after the initial trauma, the daughter managed to convince her mother to come in, who said she didn't know what all the fuss was about and that her heel felt fine. She said her only concern was some boils that had been breaking out all over her body.

On examination, the patient had a blood glucose reading of 22, which was an abnormal level. The trauma site on her heel had a thick covering of hard skin, which on removal revealed a huge ulcer with copious amounts of pus.

The boils breaking out on her body were signs of spreading sepsis and infection. She had to be admitted to hospital immediately, to gain control of her blood sugar level, blood pressure, and the infection.

This happened more than a week ago and she is still in hospital fighting to get control of her health.

The moral of this story is to keep your appointments as directed by your medical practitioner. If this lady had kept her initial appointment with me, it is highly likely that she would be fine now. Instead, two months of neglect led to her whole body being poisoned, which is life-threatening.

There are many reasons why patients don't keep health check appointments. The main ones are being too busy, cost, fear of what the consultation will reveal, and hoping that the problem will get better by itself. This is a high-risk attitude that can often lead to disaster.

So as the world recognises diabetes day, remember foot care and the cardinal rules that all diabetic patients must observe:

1.Never walk barefoot.

2.Do not smoke.

3.Control your blood sugar levels within the normal range.

4.Wash and examine your feet daily, making sure that you dry between the toes carefully.

5.Moisturise your feet, including the sole, but avoid between the toes.

6.Choose supportive, well-fitting shoes that don't rub and have a lace or velcro strap. Ensure that feet have enough space so that you can wriggle your toes around comfortably. Always check that your shoe is clear of foreign objects before you put them on.

7.Never use pharmacy corn remedies.

8.Cut your toenails by following the curve of the nail. Do not cut deeply down the sides.

9.If you discover a problem, no matter how insignificant it may seem, seek help from your podiatrist or doctor immediately.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293- 7119), Mandeville (962-2100), Ocho Rios (974-6339), Kingston (978-8392), and Savanna-la-Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.




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