Almost one quarter of a million people have diabetes in Norway. They have a lot to do to prevent heart attacks, strokes, damage to the eyes and kidneys. Many take up to eight medications every day to prevent injuries.
Should we bother them with further investigations? Yes, because one in four with diabetes has injuries in the legs.
They have a reduced feeling in their legs. They feel bad when they put their feet and become uncertain. This increases the risk of falls, breaks and other injuries. And this increases the risk of diabetic foot ulceration, which grows for a long time.
Diabetic foot ulcers are an indicator of a more complex picture of the disease and an average increased risk of death.
Double the high risk of death
We examined the population in Nord-Trøndelag and it seems that diabetic patients who have had foot ulcers have twice the risk of death compared to the rest of the population, and about 40 percent more risk compared to diabetes without foot ulcers.
The challenge is that you can not predict which of your diabetic patients have foot ulcers. Therefore, it is important to examine everyone, including three-quarters, who have no nerve damage and therefore do not have the same risk of foot problems.
When the nerves in the feet are damaged, people with diabetes do not notice that they get a stone in the shoe or that the wound is under the foot or the bath is hot.
As a result, in Norway there are about a thousand people suffering from diabetes at any time, and diabetic foot ulcer takes a long time. About three percent of people with diabetes have experienced this. These wounds are most often infected with resistant bacteria that require long-term antibiotic treatment for many weeks. During the growing resistance to antibiotics, also in Norway, this is a situation that we will avoid.
Every year, approximately five hundred amputations are performed with the toes and toes and placed in this group of patients because wounds do not grow. Emotional and physical costs are high for patients and their families.
Similarly, in isolation, amputations and many years of pedestrians are expensive for society. Foot problems caused by diabetes are an important cause of a disease that does not attract the attention it deserves.
It should be tested at least once a year
To prevent this, people with diabetes must be able to check their feet at least once a year. There are reasons to ask why it is no longer a practice in Norway.
National guidelines of the National Diabetes Directorate state that people with diabetes should be examined every year. But it did not become routine. Our research shows that especially men and people with cardiovascular diseases go beyond foot prophylactic examinations.
Who can do anything to prevent foot ulcers, the number of amputations and mortality?
In addition to the annual survey of health professionals, it is important that the person also studies their rates. Use a mirror on the bathroom floor. Check if there is a stone in the shoe. In addition, it is important to cooperate with home nurses, phototherapists and orthopedic engineers (who adjust shoes and soles).
Sweaty feet, strong feet, swollen feet may not be a sexy subject – but after a long while, our items deserve attention. So – on the occasion of World Diabetes Day on November 14: Raise your feet on the table! Ask your medical carer to check rates on the annual diabetes control!