PATIENTS' AWARENESS

Awareness Regarding Foot Ulcer in Patients of Diabetes

Name of the Writer

Name of the Institution

Awareness Regarding Foot Ulcer in Patients of Diabetes

Introduction

One of the major resultant of diabetes mellitus is diabetic foot ulcer, and perhaps the main element of the diabetic foot. The sores on the feet are basically diabetic foot ulcers, which occur in approximately 15 percent of all patients with diabetes some time during their lifetime, and led to about 84 percent amputation of lower leg. The possibility of amputation of lower-extremity is increased 8-fold in diabetic patients with the development of ulcer.

The rational for choosing this specific aspect of diabetes care is that the writer is a district nurse, caring for housebound patients and has high percentage of diabetes patient on the caseload (Appendix 1), also some patients with leg ulceration has background of diabetes. Roughly 50 percent of diabetes patients who attended committed clinics of foot have neuro-ischaemic feet; while rest of the 50 percent patients suffered from neuropathic feet. Merely ischaemic feet, where these arise, are managed in a manner identical to neuro-ischaemic feet. The local population statistics shows that there are about 1077 diabetic patients, 7.4 percent were once have foot ulceration, either in present or past, out of that 24.2 percent were vascular and 39.4 percent were neuropathic, and 36.4 percent have both. In a broader sense, the factors that are linked with increase complications risk are cardiovascular factors, duration of disease, ethnic background, and glycaemic control.

This assignment aims to discuss the aspect of diabetes patients that are at risk of developing foot ulcer. The main focus will be on the role of the District Nursing (DN) in prevention of foot ulcer for housebound patients. Finally the proposal of change to prevent diabetic foot ulcer at writer's work place will be discussed.

Discussion

Diabetes mellitus is defined by National Institute for Clinical Excellence (NICE, 2003) as a chronic metabolic disorder mainly caused by defects in insulin action and secretion. Diabetes is of two types, namely type 1 and type 2 diabetes. When the pancreas makes no or little insulin, as the Islet B cell have been destroyed, which produce insulin by means of an autoimmune mechanism, is known as type 1 diabetes. Hence, in order to survive patients become dependent on insulin. Type 2 diabetes is due to the insulin production failure to cope up with the reduction of tissue sensitive to insulin, and called insulin resistance. In this type of diabetes, disease progresses with the decline in insulin production. The diabetic foot is a group of diseases where infection, ischaemia and neuropathy direct to breakdown of tissue, which will results in possible amputation and morbidity (Baker & Fowler, 2007).

The above listed statistics apparently demonstrated that there is an increasing rate of foot ulcer in diabetic patients. (McInnes, 2006) reported that patient awareness is poor, with one third of people with diabetes unaware that they are at increased risk of a lower limb amputation. Diabetes if controlled can allow patients to live full active life; if ...