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World Diabetes Day: beware diabetic foot and how not to get there

World Diabetes Day: beware diabetic foot and how not to get there

Durban – As people around the globe observe World Diabetes Day (November 14), the condition continues to be one of the leading causes of death among South Africans.

With more than four million people living with the condition in South Africa and another five million more who are unaware that they have it, one of South Africa’s leading vascular surgeons, Dr Vinesh Padayachy, is urging South Africans to go for a medical check-up to see if they have the condition.

For those who have been diagnosed, the surgeon is pleading with them to follow a healthy diet and to exercise to keep their glucose levels in check.

Padayachy, who is based at the Lenmed eThekwini Hospital and Heart Centre in Durban, treats many patients with diabetic foot disease, which if not cared for properly can lead to amputation.

World Diabetes Day: beware diabetic foot and how not to get there
Leading South African vascular surgeon Dr Vinesh Padayachy. Picture: Supplied

According to a study in the “African Journal of Primary Health Care and Family Medicine”, diabetic foot disease accounts for 20% of all hospitalisations of Type 2 diabetes patients in sub-Saharan Africa and frequently leads to chronic disabilities, loss of income, lower limb amputation or death.

It is estimated that one in every five persons with diabetes has a 15% probability of developing a foot infection in a year, and 5% of diabetic patients with diabetic foot will eventually undergo amputation.

“I would rather not have patients reaching this point, but we cannot ignore the stats. About 80% of all non-traumatic amputations are performed on diabetic patients and highlights the seriousness of the disease,” Padayachy said.

Diabetic foot comprises a constellation of vascular and neurological pathologic changes that are the direct result of diabetes, causing local tissue destruction by sensory neuropathy and compromise of the vascular system of the affected lower extremities in diabetic sufferers.

South Africa ranks among the most obese nations in the world according to several studies, which is one of the main reason for Type 2 diabetes.

Diabetes affects the way the body processes blood sugar or glucose which if it spikes can seriously damage your body.

This eventually leads to diabetic foot disease.

Padayachy said the people who are pre-diabetic have a chance to reverse the situation.

“Pre-diabetes is the stage before diabetes, so in a pre-diabetic you are not a diabetic, but if you continue with your current lifestyle, current eating habits, current weight then most likely down the line you will end up being diabetic. So, what we do for a pre-diabetic is treat this patient as a diabetic, we get them to do lifestyle changes, we get them to start exercising with the hope of preventing and slowing down their progression of diabetes,” he said.

Asked why diabetics were worst affected by Covid-19, Padayachy said there were a multitude of reasons, but mainly because diabetic patients are immunosuppressed.

“This means they are are more prone to getting infections and when they do get these infections it is more significant. What I have also seen in patients that were infected with Covid-19 is that it did affect the pancreas and patients that were pre-diabetic became diabetic and patients that were not diabetic often became pre-diabetic,” he said.

The surgeon added that in order to manage diabetes, one needs to control their diet, which means avoiding excessive starches or sugars.

“However, patients often tell me that they don’t eat sweet things but remember starches are in almost everything we consume, and it does not necessarily have to taste sweet to contain starches and carbohydrates. Processed carbohydrates and starches are bad foods for pre-diabetic and diabetic patients. White bread and rice should be avoided. The better choice would be your brown bread and rice and whole-grain foods. Lifestyle is important, exercising, losing weight and maintaining a healthy weight. Often patient’s that are overweight and obese and are diabetic can reverse their diabetes by losing weight and maintaining a healthier lifestyle,” he said.


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