Rising number of diabetic foot ulcer patients

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A TOTAL of 85 initial patients out of 400 visitors to the Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital’s Podiatry Unit from June to November 2015 were treated for diabetic foot ulcers.

Initial patients refer to new cases or cases that have been treated and cured in the past but symptoms have returned.

Dr Norafizah Hj Zaine, a podiatrist specialising in diabetic foot, said that this number will increase as the prevalence of diabetes increases in Brunei.

Citing the International Diabetes Federation: Diabetes Atlas Fourth Edition 2009, Dr Norafizah said the national diabetes prevalence estimate in Brunei was 10.7 per cent of the population in 2010 and is expected to rise to 13.4 per cent by 2030.

In 2012, approximately 40 to 70 per cent of lower limb amputations are diabetes-related and 85 per cent are preceded by a foot ulcer according to the International Working Group on the Diabetic Foot, Epidemiology of the diabetic foot.

“We see (amputations) quite often, a lot of the cases we see (are for) amputated toe or up to the knee,” said Lim Kai Woon, a podiatrist from the RIPAS Hospital.

Lim said that the main causes of diabetic foot ulcers are usually due to Type 1 and Type 2 diabetes which causes two complicatons: blood circulation and neuropathy, where there is either a loss or heightened sensation of the nerves.

“We had cases where there were something stuck in the wound and they cant feel anything, or they have ulcers and they dont feel anything due to neuropathy,” said Lim.

“(Another issue) is blood sugar level, if blood sugar level is not controlled, it’s very prone to infection and that is what we are worried about.” he added.

He advises the general public, particualrly those who are diabetic, to wear proper footwear and to make sure that there are no sharp object or debris in their footwear as a means to avoid getting foot ulcers.

He also advised diabetic patients to refrain from soaking their feet in hot water as they may scald themselves and cause blisters which may develop into an ulcer.

“(Some) people like to soak their feet in hot water, they think it’s good for them. Most of the time due to neuropathy, they may not be able to tell that the water is too hot,” said Lim.

He reminded patients to be wary of their sugar level and to maintain a balanced diet and to take the prescribed medication.

The Brunei Times