Around two thirds of diabetic patients attending a clinic in Northern India are at risk for foot ulceration, only 19% of who follow correct foot care practices, study results show.

The researchers note that such a level of foot care compares unfavorably with Western rates and may be indicative of the challenges facing developing nations in general.

“This may be due to lack of awareness and/or failure of our health care system to educate the patients regarding preventive foot care,” say corresponding author Anil Bhansali and colleagues from the Postgraduate Institute of Medical Education & Research in Chandigarh.

India has more patients with diabetes than any other country. Foot disease there is exacerbated by sociocultural factors such as the prevalence of walking barefoot, lack of knowledge regarding diabetes foot care, and the socioeconomic status of patients.

Noting a paucity of data on diabetic foot syndrome in India and the developing world, the researchers assessed 1044 patients with diabetes who attended a diabetes clinic of a tertiary care centre in north India from January 2007 to May 2008.

They assessed patients for peripheral neuropathy using vibration perception threshold (VPT) and peripheral vascular disease (PVD) using Ankle Brachial Pressure Index (ABI) in addition to anthropometric measurements and foot examination. Based on this information patients were categorized as having an ulcer, having foot at risk for ulcer, or no risk factors.

Patients also completed a questionnaire to gauge adherence and knowledge of foot care practices.

As reported in the journal Diabetic Medicine, the prevalence of peripheral neuropathy was 34.9% and PVD 12.6%. Two thirds of the patients were considered at risk for foot ulceration; 9% had an ulcer and 20.2% required amputation.

The strongest predictors for presentation with ulceration were nephropathy, PVD, and neuropathy with odds ratios of 1.61, 1.52, and 1.40, respectively.

“The high prevalence of neuropathy and PVD, coexisting with poor adherence to foot care practices predisposes to foot problems in people with diabetes in our study population,” the researchers conclude.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

Free abstract

Diabetic meters are vital for people with diabetes. Blood sugar monitoring is a major aspect of managing your condition and although it is not a task that people really like doing, it is so important if you want to take care of yourself properly.

Here are 4 things to look at and to learn about before you buy or obtain a diabetic meter.

1. Size of the Diabetes Meter

You can choose between small meters or larger ones. Work out if you will be regularly carrying it in your purse, handbag or backpack (you will want a smaller meter to fit) or if it will be only used at home (in which case a larger meter is ok). Also consider your eyesight: people with bad sight may struggle with a small meter, however if it has a clear display screen then this is not an issue.

2. Built in Memory

it is handy to have the memory built in and importantly, able to store a good amount of data. Ideally you will want to store over 200 test records in memory, but aim for 400 or more if you can.

3. Sample Size

This is a major considering but one that is easily overlooked. The best and latest meters will not require a large sample. Many now only require the equivalent of a pin head of blood! This is just 0.3 microliters. There are even some that only require 1.0 microliters.

4. Alternate Site Testing

If you don’t want to be restricted to the finger as a testing location then look for a meter that is approved for alternate testing sites like the leg and forearm. Most meters are now multi-site compatible.

Make sure you find the right blood glucose diabetic meters that suit your lifestyle and budget.

If you have been paying attention to the news at all, you know that diabetes is quickly becoming one of the most common ailments in the United States and many parts of Europe. Some have even said that the prevalence is reaching epidemic proportions. Why? What causes diabetes?

First of all, it is important to realize that there are two types of diabetes: Type 1 is congenital and cannot be prevented. Type 2 is not congenital, although there may be a tendency for it to run in families, and it can be prevented. Neither type of diabetes can be cured, but they can both be managed well in most people through medication and lifestyle.

With so many people now being diagnosed with diabetes, you may be wondering if you are at risk. In order to know that, it is important to know what causes diabetes. The two most significant reasons for developing type 2 are inactivity and obesity, but there are other risk factors as well, which include:

A family history of the disease. If a parent or brother or sister has type 2, you have that as a risk factor Hypertension. If you or a close family member such as a parent or sibling has high blood pressure, you are at greater risk for developing diabetes.

Being over age 45. The older you get, the more chance you have of getting diabetes.

Irregular cholesterol levels. Having too much “bad” cholesterol or too little “good” cholesterol increases your risk of diabetes.

Insulin resistance. If your doctor has determined that you are insulin-resistant, that is often seen as a precursor to diabetes. Some doctors even call this “pre-diabetes.”

Developing gestational diabetes. It is by definition temporary; that is, it occurs only during pregnancy and goes away after delivery of the baby. But, having gestational diabetes increases the risk of getting type 2 diabetes later on.