World Foot Health Awareness Month: May 2009

Did you know that the average person takes about 8,000 to 10,000 steps every single day? If you add that up over the course of an entire lifetime it works out to be the equivalent of walking four times around the world! That is a long way by anyone's standard and it is no wonder that our feet and legs can suffer from many different medical conditions, ailments and disabilities.

The Federation of International Podiatrists (FIP) have launched the World Foot Health Awareness Month in order to promote better footcare. Feet are taken for granted and people simply do not think about looking after their feet. Many people do not know that feet require any attention, nor do they realise that specialist treatment from podiatrists is available.

"Studies show that 75 per cent of people experience foot ailments at some point in their lives, but many don’t seek medical attention until the problem becomes more severe."

By promoting better healthcare for feet and recommending that people receive regular check-ups from a podiatrist, the FIP are hoping to address this problem.

Special Focus Section - Diabetes

This year, in World Foot Health Awareness Month, special attention is being given to footcare and diabetes.

Diabetes is a cause for international concern. The number of people with diabetes is increasing rapidly. The International Diabetes Federation reports that currently there are 246 million diabetic people worldwide. By 2025 that number is expected to be 380 million people. Diabetes is more common in developed countries, but as developing countries become more wealthy and urbanised, the instances of diabetes will increase in those countries too. It is thought that the bulk of the increase in diabetes will affect people in developing countries. Most diabetics with Type I Diabetes are children, whilst Type II affects mainly adults. However, an increasing number of Type II diabetics are children.

Podiatrists as part of Multi-Disciplinary Team

The IDF are promoting the importance of podiatrists as part of multi-disciplinary team which treats diabetic patients.

Since the first signs of diabetes very often reveal themselves on our feet, podiatrists have a special role to play in the diagnosis and treatment of diabetes and its symptoms. Typical indicators of diabetes on the foot that can be observed during a routine foot examination are:

Podiatrists can help diabetics by referring patients who may have diabetes to their G.P., facilitating early diagnosis of the disease through the use of a blood test.

Podiatrists can help prevent the formation of ulcers by recommending appropriate shoes and orthotics. Regular examination and treatment of ulcers on the diabetic foot by podiatrists can also prevent the necessity for amputation of the toes and lower limbs. Every 30 seconds somewhere in the world a leg is lost to diabetes. The importance of diabetic footcare cannot be understated.

The multi-disciplinary team approach is essential for the best possible treatment of diabetes. Other healthcare professionals in the diabetic care multi-disciplinary team include:

The IDF stress that the most important member of the multi-disciplinary team is the patient themselves. Healthcare professionals can treat symptoms and advise on lifestyle changes in order to control diabetes, but it is up to the patient to implement the lifestyle changes. Additionally it is the patient who knows when something feels wrong and of course, it is the patient who must live their life with the disease day in and day out.

International Working Group on the Diabetic Foot

The International Diabetes Federation (IDF) and the World Health Organization (WHO) have set goals to reduce the rate of amputations by up to 50%. Worldwide initiatives will be needed to if this goal is to be achieved.

The International Working Group on Diabetic Foot (IWGDF) has set up the The Step by Step Programme in order to improve diabetic foot care in the developing world. Supported by the International Diabetes Federation, the project provides education for people with diabetes and healthcare professionals. Focusing on prevention and treatment, the programme has been found to be effective in improving diabetes foot care. People in countries such as India and Tanzania have already benefited from the programme.

The IDF and IWGDF have set up proposals for foot care training courses in order to educate certified Diabetic Foot Care Assistants (DFCA) in countries where there is no licensed podiatry education. Out over 200 countries in the world, only 19 provide licensed podiatry education.

"In the absence of podiatry the need for affordable and practical diabetic foot care education below the level of podiatry has to be recognized by designing suitable programmes to improve care."

Karel Bakker MD, PhD, Chair of the International Diabetes Federation Consultative Section/ International Working Group on the Diabetic Foot.

In those countries where there are no licensed podiatrists it is important to train diabetic foot care assistants adequately. It is essential that the diabetic foot care assistants can treat the diabetic foot in a manner that will protect the diabetic foot from ulceration and prevent the need for amputation.The education and training programmes should take into account regional variations in order to ensure the best results.

In order to achieve better foot care for diabetics, the keypoints that IDF and IWGDF are promoting are as follows:

Through the use of worldwide initiatives and management measures it should be possible to reach the UDF/WHO goal in the nearby future.

References:
Sherkin, K. (2008). Diabetes and the Diabetic Health Care Team, http://www.fipnet.org/resources/Guides/SpecialFocus%2709%5BEnglish%5D.pdf. (Accessed 15.05.09).
Bakker, K. (2009). Diabetes on the rise, awareness and better diabetic foot care very much needed!, http://www.fipnet.org/resources/Guides/IWGDF.pdf. (Accessed 15.05.09).