Sunday, January 3, 2016

Some Detailed Facts About Diebetics In Nigeria You Should Know

Are you a diabetic patient, how well do you take care of your feet?

Your doctor is likely to tell you that a diabetic foot ulcer is a pivotal event in the life of a person with diabetes and a marker of serious disease and co-morbidity.  
On the right is Project Coordinator Diabetes Podiatry Initiative Nigeria/Medical Director, Rainbow Specialist Centre, Lagos, Dr. Afoke Isiavwe.

It is a fact that poorly managed diabetes could lead to amputation and without early and optimal intervention; the wound can rapidly deteriorate, leading to amputation of the affected limb.

 It has been estimated that every 20 seconds a lower limb is amputated due to complications of diabetes. 
Studies done in the US have shown that 50 percent of people who undergo amputations do not live beyond five years, while foot ulcer is a leading cause of hospital admission in diabetic patients in Nigeria.

Medically, it has been ascertained that good sugar control and proper care of the feet is key in preventing foot ulcer. Are you a diabetic patient in Nigeria? 
Diabetologists warn against injury in the feet, unfortunately, Nigeria lacks experts in Podiatry, the aspect of medicine that takes care of people with foot sores.

No medical school in the country currently offers the course, creating a huge gap in management of diabetes, and this gap has led to a high number of cases of diabetic foot ulcers that end up in amputations and even deaths, says a Diabetologist and Medical Director, Rainbow Specialist Medical Centre, Lekki Phase1, Lagos, Dr. Afokoghene Isiavwe.
Early presentation: Isiavwe advised that early presentation and compliance to treatment are key to successful treatment and for the diabetes foot problem, prevention is better than treating it.

As one of the major complications of diabetes, diabetic foot affects a significant number of people living with the disease.

 Findings from a Lagos- based study showed that diabetes mellitus foot is the second leading cause of diabetes-related deaths in Nigeria accounting for 19.5 to 24 percent of all diabetes mortality.
 A study on diabetes mellitus foot ulcer in Midwestern Nigeria showed an amputation rate of 52.2 percent and mortality rate of 14.3 percent in a cohort of diabetes patients with foot ulcers. Isiavwe said good sugar control is key in preventing foot ulcer. 
Foot sores: “A sore in the leg is like a smoking engine. By the time a person comes down with a diabetes foot ulcer, the person has already has blood vessel problem, the blood flows to the heart, brain, kidney, to the leg, there is already circulation problem, many times that circulation problem has already affected the kidney,” Isiavwe noted.

To prevent foot sores, she says you should take your drugs and follow doctor’s advice, check your blood pressure and cholesterol levels. 
Footwear: “Choosing footwear is a project for diabetic patients because there is an ideal time for it. And this is because the type of footwear must be the correct one. The appropriate time for this is usually in the afternoon when fluid accumulates in the legs causing swelling.

 This period gives an accurate size of comfortable shoe for a diabetic. “As a diabetic, you need shoes with enough space. Avoid putting your feet in hot water.

Use your elbow , not your foot to guage the hotness of your bath water.In diabetics, nerve problems are not restricted to the legs.” 
A typical case of diabetic foot. Fungal infections Isiavwe who recommended exercise for the legs also warned against neglecting fungal infections which are a major cause of foot sores in diabetics.

She also advised diabetics to avoid crossing their legs for too long in order not to restrict blood flow.

Data show that cost of successfully treating diabetic foot ulcer in the country averages N220, 000, whereas average monthly wage is about N10, 120.

While the prevalence of diabetes in Nigeria varies, in Lagos it is about 6 percent. Currently, there is no national or localised foot care training institute in Nigeria.

However, to help bridge the gap and raise awareness on the subspecialty of Podiatry, Isiavwe urges government to pay more attention to diabetic foot care.

 As part of strategies to increase awareness, the Podiatry Initiative, Rainbow Specialist Medical Centre, Lagos, World Diabetes Foundation, and Podiatry Institute, USA, are organising an international workshop on foot care with the theme: “Building Local Capacity in Diabetes Foot Care” The conference holds August 17-21, 2015, to build local capacity in foot care in Nigeria and improve management and prevention of diabetic foot complications by raising awareness on proper foot care.

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