People with diabetes need their own care: Dr Ram

Diabetic patients need to be supported by their health care system to learn how to self manage effectively and the timely access to proper treatment and medical advice is also vital, said Medicine Professor Bekha Ram on Tuesday.

He expressed these views to this scribe on the World Diabetic Day, at District Medical Research Centre.

Professor Ram said that diabetes is a growing pandemic of this century and it has crippled many. He said each year more than 3 million people die from diabetes-related causes and the burden is particularly harsh in countries like Pakistan where diabetes is rising by 180 percent every year.

He said that diabetes mellitus is a chronic disease caused by the body’s inability to produce sufficient insulin, or by the ineffective use of the insulin produced. Such a deficiency results in increased concentrations of glucose in the blood, which in turn damage many of the body’s systems, he added.

He maintained that the diabetic foot problems are caused by changes in blood vessels and nerves that can lead to ulceration and subsequent limb amputation.

He said that the daily life of the diabetic patients is disrupted by the need to monitor blood glucose levels, take medication, and balance the effect of activity and food.

Professor Ram said that amputations due to diabetes cause unnecessary loss of life and disability. In high-income countries, treatment of diabetic foot complication accounts for 15-25 percent of total health care resources for diabetes, he added.

The leg and foot amputations in people with diabetes can be prevented by using low cost, low technology solutions and simple behaviors should be encouraged such as regular foot examination and examining the inside of shoes before putting them on, not walking barefoot, wearing comfortable shoes, keeping feet clean, and maintaining good care of the skin and nails, he added.

About the diet and nutrition Professor Ram said that the patients are usually dependent on soup kitchens or shelters for meals, and it may be difficult to plan meals to coincide with insulin administration.

He explained that the coincidence should work with shelters and soup kitchens to promote healthy food choices and to provide supplemental snacks to those with diabetes.

About exercise he said that for patients who are homeless, walking is their typical exercise and they usually carry their belongings which increase the exercise effort. He said that patients with foot problems should take precautionary measures such as proper footwear.

Professor Ram said foot problems often result from prolonged standing and walking. When combined with diabetes, the patient is at high-risk for foot ulcers.