Published reports suggest that foot complications in patients with diabetes in many less-developed countries in Africa, the Caribbean, and South America are generally infective and/or neuropathic in origin rather than due to peripheral arterial disease. However, because communities across the globe are becoming more urbanized, the epidemiology of peripheral arterial disease is changing across the continent with corresponding increases in prevalence rates of peripheral arterial disease in diabetes populations. In addition, the increased marketing strategies of large tobacco companies to target populations in less-developed countries has compounded the problem by causing a recognized public health disaster—increase in tobacco-related complications, including the increasing prevalence of peripheral arterial disease and its attendant outcomes in diabetes populations with existing foot disease. Poverty is associated with foot ulceration; unhygienic conditions lead to infectious sequelae. Other major factors contributing to development of the diabetic foot include walking barefoot or delayed presentation for initial clinical assessment. Barefoot walking, a common practice in many less-developed countries is directly linked to low income but may often harbor cultural undertones. For diabetes patients shrouded in poverty, even a simple purchase of appropriate footwear is often unaffordable or is low down in the priority. For diabetes patients with peripheral neuropathy, inadvertent trauma or injuries to the foot is liable to go unnoticed until the patient finally becomes symptomatic, presenting with an ulcer or injury that has progressed to fulminating foot sepsis.
. Patients who neither take the time to take care of themselves and address foot care nor attend the diabetes outpatient clinic for follow-up care, advice, or education are most at risk developing infected foot ulcers.
Lack of sensation in the anesthetic foot causes ordinarily conscientious, responsible patients to be unaware of inadvertent injuries sustained through inappropriate or ill-fitting footwear, walking barefoot on hot surface under the midday sun, or use of keratolytic agents or razor blades to cut toenails and callosities.
The global burden of the diabetic foot cannot bc ameliorated unless poverty and access to healthcare is addressed by governments and nongovernmental agencies.
Even in the US, there is a sizable proportion (10%) of the population without any form of access to healthcare /
. Patients who neither take the time to take care of themselves and address foot care nor attend the diabetes outpatient clinic for follow-up care, advice, or education are most at risk developing infected foot ulcers.
Lack of sensation in the anesthetic foot causes ordinarily conscientious, responsible patients to be unaware of inadvertent injuries sustained through inappropriate or ill-fitting footwear, walking barefoot on hot surface under the midday sun, or use of keratolytic agents or razor blades to cut toenails and callosities.
The global burden of the diabetic foot cannot bc ameliorated unless poverty and access to healthcare is addressed by governments and nongovernmental agencies.
Even in the US, there is a sizable proportion (10%) of the population without any form of access to healthcare /
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