Lower limb injuries and foot ulcers affecting 50% of all diabetic patients

Updated 21 May 2012

Lower limb injuries and foot ulcers affecting 50% of all diabetic patients

A five-day symposium was held at Crowne Plaza Hotel in Jeddah to highlight diabetic foot ulcers and all practical aspects of the pre and post surgical treatment of diabetic foot infections. The initiatives were taken by the Health Ministry’s Diabetic Foot Academy (DFA) in Saudi Arabia, the DFA of medical technology company Smith & Nephew, and the University of California, San Diego.
Diabetic foot complications are the most common cause of non-traumatic lower extremity amputations in the industrialized world. The risk of lower extremity amputation is 15 to 46 times higher among diabetics compared to people who do not have the disease.
The Middle East and North African region is among the world’s most affected by the consequences of diabetes. The disease affects between 25 and 35 percent of the adult population. Furthermore, due to cultural, social, educational and climatologic aspects, the incidence and recurrence of lower limb lesions among diabetic patients is high, reaching around 50 percent.
Dr. Khaled Abdulrahman Tayeb, chairman of the diabetes committee at the Health Ministry and director of the diabetes and endocrinology center at Al-Nour Specialist Hospital in Makkah, explained that there is a rise in diabetes throughout the world, but particularly in Saudi Arabia and GCC.
“All diabetic people are prone to develop foot complications, including diabetic foot ulcers. However, this problem can be minimized with better care and prevention strategies. Our aim is to reduce the prevalence of amputations,” said Dr. Tayeb.
According to him, Saudi Arabia has an exceptionally high amputation rate as compared to the other countries in the region. The control of diabetes prior to surgery is particularly significant; complications can be reduced by providing guidance to patients on how to take care of their feet and what to do if complications develop to prevent amputations.
“We don’t have clear-cut statistics on diabetic foot amputations, but in some Saudi major cities there is a rate of one or two amputation cases per day.”
There are several types of foot ulcers. One of them is neuroischemic foot ulceration. These ulcers, caused by the friction between the feet and the shoes, are usually encountered on the margins of one’s feet, but can also be found at the tips of the toes or beneath the toenails, especially the ones that are thick. Their development is characterized by the redness of skin in those areas. This red mark then develops into a blister or ulcer. This type of ulcer is common in Saudi Arabia. It is extremely dangerous: Twenty percent of the patients end up with amputations.
“To effectively decrease the level of amputations, we have to work on three levels. On the primary level, we have to identify the problems and help patients prevent having ulcers. On a secondary level, we have to teach those already affected how to deal with ulcers. The third level is to have a center of excellence to deal with complicated cases.”
The doctor advises patients with diabetic problems to follow up with their physician. “Patients shouldn’t try to treat a wound themselves. As one of the symptoms is loss of sensation, patients can use a mirror to look for skin change, change of color, or redness. They need to take care of the nails, cracks, dry skin and also inspect their shoes, which can harm their feet. Patients are part of the solution,” he said.
Gerit D. Mulder, director of the wound treatment and research center and professor of surgery at the University of California, San Diego, told Arab News that the diabetic population in Saudi Arabia is close to 30 percent, "which is higher than the world average.” It is extremely important to open centers here that can control the problem and prevent amputations. “The control of contaminations is very important among diabetics. When they get wounded, they need to take care of the wound right away to prevent infections that could lead to amputations,” said Dr. Mulder.
According to Dr. Tayeb, the Ministry of Health put a plan to have 20 diabetic centers in the Kingdom. Some of them have been launched and are operating already.

Baby Talk: How to deal with fears of first time parents

Updated 09 December 2019

Baby Talk: How to deal with fears of first time parents

  • Babies are totally dependent on their parents and care-givers for all their needs
  • Learning is on the job, but you can be prepared

DUBAI: It is natural for a first time mom (and dad) to have fears and worries about the responsibility of their brand new little baby. Babies are tiny, they are vulnerable, and they are totally dependent on their parents and care-givers for all their needs. This can seem overwhelming, and as each baby is different, it is not possible to provide a text-book of answers with each new arrival. Learning is on the job, but you can be prepared.

Common worries of first time parents:

  • Recognizing your baby’s cries

At first your baby’s cries may sound similar to you but soon you will learn to recognize the difference between a hungry cry for feed, a cry of discomfort for a diaper change or other discomfort, or a more serious discomfort such as colic or something else. An unusually high pitched cry can mean illness. You will soon not only know what your baby wants but also recognize your baby’s cry among other babies.

  • Going out of the home with your baby

It can be scary leaving the house for the first time with your new baby; the outside world can seem hazardous and contact with other people give risk to sources of infection. It is perfectly natural to feel this way but important to remember that the benefits or getting out and about with your baby will outweigh the risk with planning and preparation. Take sensible precautions with safety when you are out and ensure you have everything with you that you need including a cell phone for emergencies. Strangers may wish to admire your baby but it is reasonable to not allow others outside immediate family and friends handle your baby. Keep your first trips out short until you feel more comfortable and take someone with you if that helps you build confidence.

  • Waking your sleeping baby

New parents are often frightened to make a noise during their baby’s nap times in case they wake. Naturally you have finally got your baby to sleep and will not want to wake them. It is best to carry out general house chores and conversations as usual because babies are used to noise from within the womb. Background noise of TV, vacuum cleaner, chatting or fans should not be avoided and your baby will become accustomed to sleeping through such noise. Loud and sudden noises will wake a sleeping baby but they should not wake because of usual household noise and there is certainly no need to tiptoe around a sleeping baby.

  • Putting baby down to sleep while they are crying

It is emotionally hard to put your baby in their crib whilst they are crying, particularly if they double their efforts as soon as you have laid them down. However it is also not idea to be in a situation where you cannot put your baby down to sleep for hours whilst you rock and sooth them, exhausting yourself and also possibly your baby. Babies can become overtired and if you have taken care of feeding, changing and winding and your baby is still fussing and crying they may need to sleep and will soon settle if you allow them to cry on their own a short while. The more used a baby is to settling themselves the better for baby and parents. Be brave and try to leave them briefly whilst close at hand and see if they settle by themselves. It is not wise to leave a baby to cry for too long and always seek medical advice if you have any concerns.

  • Handing over the baby care

One of the hardest things for a new mom to do is hand her baby over to another to care for in her absence, sometimes even if the person is her husband and she is only gone for a short time. This is natural and does not mean that you do not trust the person it means that you are programmed to be present for your baby at all times! However it is very important in modern society that you are able to leave your baby with your partner, trusted family members and friends. It is important that your baby leans to be soothed by others than yourself. It will become easier with time. Remember it is not important that your baby is wearing the outfit you would have chosen or if things have not been tidied away like you would have done, the important things is that you were able to have time away from your baby and that your baby is safe on your return.

This article was first published on babyarabia.com.