Never say ‘I ain’t able’
THE service being rolled out to patients at the Canada-funded Inter-Professional Diabetic Foot Centre (DFC) at the Georgetown Public Hospital Corporation  (GPHC) is excellent.
By the end of Phase I of the two-phase Project, major complications and amputations had been reduced by more than 46 percent.
However, while this is so, the number of persons being admitted to the surgical wards with foot ulcers weekly, has increased considerably, prompting Head of the DFC, Dr. Carlos Martin to observe that, not sufficient is being done by the patients themselves to help keep their condition under control.
Even though diabetic foot complications may begin with an ulcer, there is an underlying cause and it all begins with not being able to keep your blood sugar under control.
To this end, the rule of thumb, the physician says, is that: “If you have an ulcer, the first thing you have to do is treat the cause.”
In so doing, the medical team will pay attention to things such as your blood sugar level, blood pressure, diet, cholesterol, circulation, and will prescribe medication and recommend an exercise plan, among other things.  But for the desired results to be achieved, the patient must play his/her part.
Sadly, Dr. Martin has observed that the two major bugbears that the Centre is faced with are:
**   Patients collect medication at the hospital pharmacies, but
store them at home and do not drink them.
**  Too many ‘sit back’ and believe that the doctor must  do everything for them, whilst for others still, the cliché “I ain’t able” seems to predominate their thinking.  Invariably, this term would pop up when a decision pertaining to their health is to be made.
For example,  diabetics could be heard saying:
**    “I need to go get a blood sugar test, but I ain’t able get out of the house right now.”
**      “I’m diabetic and got my toes crushed the other day, but I ain’t able  go and join that long line and sit down for hours at the hospital.”
**       “I have these tablets doctor said I should use, in order to reduce my blood sugar level, but I ain’t able drink so much tablets every  day.”
Concerned over this development, Dr. Martin is admonishing diabetics to demonstrate the will and determination to be actively a part of a process that will guarantee them improved health.  Diabetics are urged to take their medication as prescribed by their doctors.
Albeit, he noted that taking medication is not the ‘be all’  and ‘end all’, and should be taken in conjunction with the recommended diet and exercise plan in order to yield positive results.
The Centre recommends a minimum of 30 minutes of exercise most (if not all) days.  Your blood sugar, blood pressure and cholesterol must be within target range.  At all times, ensure proper foot care and foot wear, and there should be absolutely no smoking! One cigarette will decrease your local circulation 30-50%  for one hour.
“Unless we have that paradigm shift, diabetes is going to be out of control,” Dr. Martin concluded.

Symptoms of Diabetes
Are you experiencing discomforts and wondering if you’re diabetic?   Well, here are some of the symptoms to look out for:
•    Frequent urination
•    Increased hunger and thirst
•    tingling in hands or feet
•    weight loss or gain
•    frequent infection
•    slow healing of sores or  ulcers
•    itching about your body
•    flu-like symptoms, including fatigue, weakness and loss of appetite and blurry vision
•    burning pain in arms, hands, legs or feet
If any of those symptoms are common to you, then contact your doctor soonest, since diabetes is a chronic disease  known to act silently, slowly, but with the potential to cause serious damage to limbs, organs and eventually loss of life.
Diabetes has come to be known as ‘a silent killer’ and is wreaking havoc in Guyana.

Type I Diabetes
Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes.  In type 1 diabetes, the body does not produce insulin, a protein that is needed to convert sugar, starches and other food into energy necessary for daily life.
This deficiency is created as a result of the immune system attacking and destroying the cells of the pancreas that produce insulin.   In Guyana, Type I Diabetes is not very common, and certainly not as widespread as Type 2 Diabetes.

Diabetes Mellitus Type 2
Type 2 Diabetes is a condition which develops when there is too much glucose (sugar) in a person’s blood, and because of  insufficient  insulin, that glucose cannot be converted into energy required  by cells and tissues.
The problem is created when the pancreas makes insulin, but  the body cannot use it efficiently or in the right way, or if, on the other hand, insufficient insulin is produced by the pancreas.
A person is likely to develop diabetes where it is hereditary (runs through the family); if they are overweight, or if he/she leads a sedentary lifestyle, meaning that they do not get regular exercise.

Other factors contributing to high blood sugar levels:
•      A diet too rich in starches or sugars
•      Stress
•      Alcohol use
•      Certain medications such as cough syrups
•      Illnesses that cause your body to produce hormones that raise blood sugar
level.

Preventing Complications
If you are a chronic diabetic, managing your diabetes can help prevent the following serious long-term complications associated with diabetes, namely:
•      Heart and blood vessel diseases. Research has shown that two out of three
people with diabetes die from these conditions.
•       Kidney damage and renal  failure
•       Gum disease
•        Reproductive and social problems.  For example:  In men: Inability to get
an  erection and in women:  yeast infections or pregnancy complications.
•       Nerve damage – to the eyes, stomach or feet.
Nerve damage to the eyes results in blurry vision of blindness; to the stomach it causes nausea or bloating; to  the feet – it causes numbness or burning, poor circulation and at worst – amputation.   Do not let any of these things happen to you.  Remember, prevention is better than cure.