ISLAMABAD – World Diabetes Day is being marked today (Wednesday).

Diabetes mellitus has reached a pandemic state and diabetic foot disease is the most dreadful complication of diabetes. The prevalence of diabetes is 8.3 per cent and out of this 15 per cent develop diabetic foot disease, and the rate of amputation is almost 19 seconds.

One person becomes disabled after every second globally. According to health experts in Pakistan 150 million people suffer from the disease. Foot complications are multifactorial including nerve damage, poor blood supply, minor trauma, on going infection and last but not the least improper foot wear and lack of knowledge of foot care.

Foot complications lead to loss of limb, which results in physical handicap, social stigma and economic constraints. So the aim should be preventing any foot complication. This can be done by simple measures like avoiding walking barefoot, daily inspection of feet and daily washing and drying the feet especially between the toes.

This should be done especially after ablution and dry cotton or tissue paper should be placed between the toes. ‘The skin should be lubricated to avoid cracking. Always wear clean, soft cotton socks. Toenails should be cut straight. Footwear should be of proper fitting and well cushioned. One should avoid sitting in front of heater and avoid using hot water bottles, which is common during winter seasons’, suggested Jamal Zafar, Head of Medical Department at Pakistan Institute of Medical Sciences (PIMS).

If there are symptoms of nerve damage or poor blood supply like, insensate feet, pain after walking, callous, cracks and redness, early medical advice should be sought. If any ulcer develops urgent medical attention is required. Foot care specialist and podraticians are very few in Pakistan. Foot complications develop very early in Pakistani population, resulting in loss of working days and economic burden on family, so the need of hour is emphasis on preventive education and foot care, he added. A diabetic foot care clinic is established in medical OPD of PIMS, Islamabad in an effort to improve foot care facilities, to educate people about foot care and foot wear, proper control of diabetes and infections. The main objective of this clinic is to “Save a leg, Save a Life”. A trained podratician is deployed at this clinic that is rendering his services in this field for the last 5 years. In the clinic 20 to 25 patients are examined daily and approximately 500 to 600 patients monthly and are provided daily dressing and education about foot care. So, preventing the foot disease is most important in the management of Diabetes mellitus.

Mild stress leads to long-term disability

Online adds: A new study has revealed that even relatively mild stress can lead to long-term disability and an inability to work. It is well known that mental health problems are associated with long-term disability, but the impact of milder forms of psychological stress is likely to have been underestimated, say the authors.

Between 2002 and 2007, the authors tracked the health of more than 17,000 working adults up to the age of 64, who had been randomly selected from the population in the Stockholm area. All participants completed a validated questionnaire (GHQ-12) at the start of the study to measure their mental health and stress levels, as well as other aspects of health and wellbeing.

During the monitoring period, 649 people started receiving disability benefit – 203 for a mental health problem and the remainder for physical ill health.

Higher levels of stress at the start of the study were associated with a significantly greater likelihood of subsequently being awarded long term disability benefits.

But even those with mild stress were up to 70 per cent more likely to receive disability benefits, after taking account of other factors likely to influence the results, such as lifestyle and alcohol intake.

One in four of these benefits awarded for a physical illness, such as high blood pressure, angina, and stroke, and almost two thirds awarded for a mental illness, were attributable to stressThe authors say that it is important to consider their findings in the context of modern working life, which places greater demands on employees, and social factors, such as fewer close personal relationships and supportive networks.

These factors lead them to ask: “Are the strains and demands of modern society commonly exceeding human ability?” And they conclude that while mild stress should not be over-medicalised, their findings suggest that it should be taken more seriously than it is.