Podiatrists can successfully use their expertise in institutions providing primary care by creating and integrating services that expand the capacity of doctors of various specialties and primary care teams to prevent and intervene early.
One of the podiatry fields that has developed and is focused on improving how foot health issues are addressed is that of the integrated approach to people with diabetes.
Affecting the inferior limb structure in people with diabetes (diabetic foot) is the most common, disabling complications that have critical, social and economic consequences. Among these, diabetic neuropathy is considered to be the most frequent chronic complication.
It significantly affects the quality of life of patients, being the most important risk factor for ulceration and amputation of the lower limbs, generating significant direct and indirect costs for the public health system. ”
Therefore, Podiatrist is a health care specialist with medical training, which deals with foot care, especially for people with diabetes. At the end of last year.
The HIGHER EDUCATION FOUNDATION profession was officially recognized in Romania and was introduced in the Romanian Occupation Classification (COR), with the code 226926, the basic group 2269 “Health Specialists Unclassified in Earlier Basic Groups” after as shown in a document issued by the Ministry of Labor.
The result is due to the sustained efforts of the Podiatry Association, its leadership represented by Conf. Dr. Ioan Veresiu, president and dr. Norina Gavan, Honorary President.
This process will be finalized by publishing the joint order signed by the Labor Minister and the President of the National Institute of Statistics (INS) in the Official Gazette.
If we look carefully at some studies by the Diabetic Neuropathy Society, we will realize the social importance of this approach.
The first of these, published in the Journal of Diabetes Complications, conducted on a nationally representative sample of 25,000 people with diabetes, showed a prevalence of neuropathy of 67%, a proportion of 10.0% to 22.3% of patients with history of ulceration , and between 1.9% and 5.5% of patients reported lower limb amputations.
Another, published in Diabetes Research and Clinical Practice, in which the frequency of lower limb amputations was evaluated in diabetic patients nationwide over the period 2006-2010.
Found an average of nearly 5,000 amputations / year, nearly 14 major amputations per day! It is worrying that the multiannual trend is net ascending.
Also in the Memorandum of Understanding submitted by the Podiatry Association it also shown:
“Promoting podiatry as a technique integrated in the diabetes patient care protocol reduces the risk of amputation by 75%. in support of this approach, we bring experiences from the EC, namely from Germany, the Netherlands.
The UK and France, and from America, the United States. The presented work model approved and comes from the UK, France and Germany, countries with a tradition in research, development and implementation of Podiatry and related work techniques.
In England, and not only (we can also mention Germany, Belgium, Denmark, France, the Netherlands, USA. Countries where these methods used) they indispensable in maintaining the health of people with diabetes, but also as a segment prevention and treatment in sports medicine.
International literature and practice cite over 200 foot-and-mouth diseases that are in the skill of footwitnesses. Podiatry has wide applicability, mainly used to maintain, rehabilitate, stimulate. The patient’s capacity with a diabetic foot in functional parameters.
In addition, we bring the general economic argument, which becomes strong justification in the national context, where the National Diabetes Program is part of the Ministry of Health Strategy for the period 2015-2020. ”
This context, the fact that in Romania the National Diabetes Program the largest curative program developed by the National Health Insurance House (CNAS), reaching 823,000 patients this year, according to the data presented by the institution.
November last year, the D-Foot International Organization through the campaign “FOCUS on FEET” reveals a very worrying situation worldwide. More than 425 million people worldwide suffer from diabetes, most of whom have type 2 diabetes.
Here, not only the high number of cases has to worry. But also the fact that one in two people not diagnosed on time. Moreover, the official estimates of the International Diabetes Federation for the year 2045. Show that the number of diabetes cases will reach 629 million.
Loss of sensitivity in the lower limbs is a consequence of diabetic neuropathy, a major complication that can cause diabetes.
Statistics show that 1 out of 4 people diagnosed with diabetes. Who lose their legs sensitivity will develop a leg ulcer at some point. Moreover, 85% of the cases of amputation caused by these ulcers of the foot.
Every 93 seconds, somewhere in the world, one person loses one leg because of diabetes. As a result, these people lose their ability to work and integrate properly in society.
On the other hand, depression caused by the loss of a inferior member is another extremely serious consequence.
Complications caused by diabetes at the foot stage become an important burden for the health system of any modern society. For example, it estimated that 12% of the global health budget goes to patients diagnosed with diabetes.
The figure is, indeed, huge and alarming: over $ 670 billion each year. The prognosis of survival in individuals diagnosed with diabetes with infected ulcers is only 85% in the first year.
17.4% of people diagnosed with diabetes suffer minor or major amputation in the legs. In the first year of the first infected ulcer. ”
In all this avalanche of worrying information there was also good news. “8 out of 10 amputations can avoided, at an early stage of the disease, through a simple. Objective clinical examination of the legs.
For this reason, the prevention of amputations must become the main objective of decision-makers in each country. ”
Here’s what was going to happen in the past, it has come true. All we have to do is hope that the decision-makers will provide the full legislative framework. And the funds needed to develop the PODIATRIEI as a medical discipline.
As well as the PODIATR, as a practitioner of this medical profession, which is extremely important for the entire society.