Communities Can Prevent Diabetic Foot Complications

Diabetes is a complex chronic disease. Diabetes affects 2.4 million Canadians and is projected to increase to 3.7 million by 2018/2019; about 20% of diabetes cases remain undiagnosed (PHAC, 2011). The increase in diabetes is found in the working age population aged 25-62 years and the Aboriginal populations. The Public Health Agency of Canada (2011) reports diabetes rates among First Nations population living on reserve as high as 17.2% and 10.3% for First Nations living off reserve. For the Metis population the diabetes rate is reported at 5.8% and for the Inuit population the rate is 4% (age standardized). The Aboriginal Diabetes Intitative (2011) report “First Nations on reserve have a rate of diabetes three to five times higher than that of other Canadians. Rates of diabetes among the Inuit are expected to rise significantly in the future given that risk factors such as obesity, physical inactivity, and unhealthy eating patterns are high”. Persons newly diagnosed with diabetes and persons previously diagnosed with diabetes must be given the opportunity to learn and demonstrate proper foot care practices (Goettl & Keast, 2005). As part of selfmanagement, persons living with diabetes must be empowered to examine their feet daily or have their feet examined daily by a caregiver, the same way one would brush their teeth every day. For all persons with diabetes, a yearly foot assessment must be done in partnership with a foot care specialist (Chiropodist/ Podiatrist), foot care nurse, doctor, or diabetes educator and the comprehensive assessment must be completed more often for persons at greater risk of complications (CAWC, 2012; CIHR, 2009). Health care professionals are responsible to look, feel and ask about individuals‟ feet (CAWC, 2012; NICE, 2004). Health care teams need to partner and commit to examining the feet of persons with diabetes at each appointment. Teams that utilize the Foot Screens build assessment consistency and continuity. Completing a foot screen with an individual or caregiver is a wonderful “teaching moment” to further explore the individuals‟ goals and level of commitment to complete daily foot assessments at home.