Diabetic foot common in Namibia

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Alvine Kapitako

Windhoek-In patients with diabetes, nerve damage, circulation problems and infections can lead to foot problems, which in some instances may prove to be serious.

Experts in diabetes health spoke to New Era on diabetic foot, an infection that can develop in the skin, muscles or bones of the foot as a result of damaged nerves and poor blood circulation associated with diabetes.

According to Manga Libita of the Ministry of Health and Social Services, diabetic foot is a complication seen in patients with diabetes mellitus. Diabetic foot ulcers are caused by neuropathic (nerve) and vascular (blood vessel) complications of the disease.

Nerve damage due to diabetes causes altered or complete loss of feeling in the foot or leg, or even both in some instances.

“Diabetic foot is a common complication seen in Namibia and unfortunately most present to health facilities late. If not treated early the infection will spread and thus result in cellulitis or infection of the bone,” said Libita, a nurse by profession.

She explained that common symptoms of diabetic foot include changes in skin colour, swelling in affected toe or foot, fungal infection, as well as ulceration. “It can be avoided by a healthy diet, wearing well-fitting shoes, control of infection by antibiotics and local treatment of ulcers,” added Libita.

Contacted for comment on diabetic foot, Hileni Samuel, a nurse who specialises in diabetes care, explained that diabetic foot is symptomatic of cases when complications arise in patients with diabetes.

“Diabetic foot ulcers are a major cause of disease and death in people with diabetes. It accounts for much of the cost of diabetes to health budgets and contributes to the majority of diabetes-related hospitalisation,” Samuel said.

Lesions of the feet and lower extremities affect approximately 15 percent of diabetics in their lifetime, with an amputation rate 15-fold higher than non-diabetics, according to the World Health Organisation.

Samuel added that persons with diabetes are at risk of developing an ulcer and that such ulcers in the foot can be the presenting feature of late diagnosis of Type 2 diabetes. “Therefore, screening for diabetes is important.”

Preventing diabetic foot infections

Patients with diabetes can develop sores or wounds on your feet. These sores are called ulcers. If a foot ulcer does not heal, it could get infected. However, if you watch your diabetes carefully and take good care of your feet, you can usually prevent infection. Here are some tips to help you avoid an infection.

DO:
Do inspect your feet daily. Look for redness, pain, blisters, cuts, scratches, or other sores. If you can’t see your feet, use a mirror or ask a family member or caretaker for help.
Do wear comfortable shoes. Make sure to check the inside of your shoes and feel around for anything that could rub against your feet.
Do wash your feet regularly. Dry them carefully, especially between the toes.
Do use lubricants or moisturizers to keep your skin from getting dry or cracking. These also prevent calluses from forming.
Do cut your nails straight across, and avoid cutting into the corners of the nails. If the edge of your nail is sharp, file it down to make it smooth. If you can’t feel your toes, don’t cut your own nails. A special foot doctor called a podiatrist should check your nails regularly.
Do avoid extremely hot or cold temperatures. Always test the temperature of the water before you take a bath or shower.
Do visit your doctor immediately if you find anything wrong with your feet.

DON’T:
Don’t walk barefoot indoors or outdoors, or use adhesive tape on your feet.
Don’t treat calluses or corns by yourself, and don’t treat them with a sharp instrument or chemicals.
Don’t use hot water bottles or other devices that warm your feet.
Don’t wear tight stockings. Avoid wearing socks with elastic tops, because they can reduce blood flow to your feet. Change your stockings daily. – apma.org

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