The global prevalence of Diabetes Mellitus (DM) has been estimated to increase by 7.7% affecting 439 million by 2030 and 642 million by 2040; with the current burden of affecting more than 400 million adults in 2014 with a predilection for old people (>65 years). The multifaceted disease has been attributed to sedentary lifestyles, urbanization and aging. (AlOwais et al., 2020)
With a prevalence rate of 9% and a death rate of 13.8% among the adult population in the Caribbean, diabetes is one of the main health issues in this region. (Adeyemi et al., 2021)
A common and deadly complication of diabetes is diabetic foot ulcer, which results from simultaneous physiological activities of ischemia, neuropathy, and infection, with neuropathy accounting for more than 60% of foot ulcers. Around 15-25 % of persons with diabetes worldwide develop foot ulcers at some point in their lives. Adults with diabetes have a higher risk of getting foot ulcers due to inadequate footwear and toenail care. The frequency and incidence of DFU in the Caribbean are 3.7-4.4 % and 17.28 %, respectively. Patients with DFU are more likely to contract infections regularly, which can cause morbidity and eventually result in amputation. (Adeyemi et al., 2021)
In Guyana, diabetes was estimated to be the fourth leading cause of mortality in 2008, and by 2011, the incidence among adults had increased to 15.5%. Up until 2008, complications of diabetic foot issues were the most prevalent cause for admission to the surgical ward at Georgetown Public Hospital Corporation (GPHC), the country’s leading referral and teaching hospital. Of these patients, 42% required lower extremity amputation. Local health care authorities were eager to alter this and teamed up with Canadian surgeons and wound and foot care specialists, who during exploratory trips validated these results. (Lowe et al., 2015)
Additionally, they found narrow spectrum and missed antimicrobial dosages as variables that may be changed, along with a lack of care coordination and a systems approach (practice in silos, no foot ulcer prophylaxis, and no plantar pressure redistribution). They also discovered that staff morale was low due to the high disease burden (30% of inpatient population), lengthy stays, and frequent readmissions with subpar patient outcomes. Surgery debridement frequently took place in filthy, dimly lighted operating rooms with improper amputation. (Lowe et al., 2015)
Therefore, evaluating the knowledge, attitude, and practices among patients with diabetes mellitus is very essential since it allows for assessing how much patients are aware of how well they should care for themselves as well as the need for educating patients. If patients have the right knowledge, attitude, and practices about their diabetes and foot care, they can play a significant role in prevention and further care.
AUTHORS: Chananda Leelkanty, Shanaza Simon, Tashana Blair, Christine Persaud, Sarai Magalee
DATE OF PUBLICATIONS: Not Published
STATUS: Completed
KEYWORDS: health status, diet, and non-pharmacological practices and knowledge, attitude and practice regarding diabetic foot ulcers and healthcare system