Prevention and screening


Screening for the diabetic foot: how and why

Given the dimensions of the current global diabetes pandemic, the number of people who are at risk of developing a diabetes-related foot complication is enormous – and growing. Everybody with the condition is at risk, irrespective of the type or severity of their diabetes. The aim of screening is to identify the people who are at greatest risk in order to allocate to them limited medical resources. Several simple screening techniques exist that can help to distribute therapeutic and preventive foot care to those in greatest need. Edgar Peters reports.

Counting the costs of the diabetic foot

Diabetes is a chronic condition that requires a life-long commitment of resources to the prevention and treatment of complications. The condition affects an increasing number of people all around the world, putting them at risk for foot ulcers and amputations. In addition to causing acute suffering, foot lesions in people with diabetes have substantial economic consequences: up to 20% of total expenditure on diabetes might be attributable to the diabetic foot. Jan Apelqvist and Gunnel Ragnarson Tennvall report on the economic impact of diabetes foot damage

The diabetic foot: epidemiology, risk factors and the status of care

The development of foot problems is not an inevitable consequence of having diabetes. Indeed, most foot lesions are preventable. However, recent statistics are somewhat depressing: approximately a quarter of all people with diabetes worldwide at some point during their lifetime will develop sores or breaks (ulcers) in the skin of their feet. Moreover, as the number of people with diabetes rises worldwide, there can be little doubt that the burden of diabetes-related foot

Project HOPE Mexico: empowering people to care for themselves and others

If current trends continue, within the next 10 years, a quarter of all people in Mexico will be living with diabetes. Diabetes already affects 12% of the general population and, astonishingly, one in three people over 65 years of age. Diabetes is the leading cause of blindness, kidney failure and lower-limb amputations. Indeed, in 2004, diabetes was declared the leading cause of death in Mexico due to its link

Key aspects of care after a lower-limb amputation

Of all the lower extremity amputations carried out worldwide, 40%-70% are related to diabetes. In people with the condition, ulceration is provoked by diabetesinduced nerve damage, reduced mobility due to alterations in the functioning of joints in the foot, and disorders in the blood vessels that supply the legs and feet (peripheral vascular disease). When a person’s ulcerated foot becomes infected or when the blood supply is severely impaired, amputation of the foot – or even the leg – may not be preventable. People with diabetes who have suffered an amputation

A holistic approach to diabetes care in Bolivia

Bolivia is a land-locked country in central South America. Bordered by five nations, it is one of the so-called developing countries; levels of infant mortality and illiteracy are among the highest in the world. While Bolivia is rich in ethnic and cultural diversity and natural resources, including silver and natural gas, the development of the nation continues to be constrained by economic and societal problems which affect all levels of society. Furthermore, the areas of health and education have

Diabetes after transplantation: revised guidelines target early treatment

People who have a kidney, liver or heart transplant are at high risk of developing diabetes. This can lead to cardiovascular disease and the rejection of the transplant. Factors such as age, weight and family history can increase the risk of new-onset diabetes after transplantation. Importantly, drugs that suppress the immune system and prevent transplant rejection also play a key role. In December 2003, an international panel of experts in transplantation and diabetes met to update the existing guidelines for the management of new-onset diabetes after

Essential diabetes care: the prevention of fracture risk

Assessing the health of people’s bones should be a standard component of diabetes care. People with diabetes are at an increased risk for fractures; this risk increases with the development of diabetes complications. Bone fractures impose a major impact on a person’s quality of life and on healthcare budgets. Inge Van Pottelbergh explains bone loss in people with diabetes and looks at the current treatment options.

The year of the diabetic foot

The human and economic consequences of the diabetic foot are extreme. Due to various complications of diabetes, a person’s foot can become vulnerable. Nerve

The history of diabetes nutrition therapy: from starvation to evidence-based recommendations

“For forty-eight hours after admission to the hospital the patient is kept on an ordinary diet, to determine the severity of his diabetes. Then he is starved, and no food allowed save whiskey and black coffee. The whiskey is given in the coffee: 1 ounce of whiskey every two hours, from 7am until 7pm. The whiskey is not an essential part of treatment; it merely furnishes a few calories and keeps the patient more comfortable while he is being starved.” Starvation (Allen) Treatment of Diabetes (1915).