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‘NON‐COMPLIANCE, NOT AMOUNTING TO BE CALLED DEPRESSION’, IN LONG‐TERM DIABETICS AND DIABETIC LIMB LOSSES
Author(s) -
De los santos R. C.,
Ashrafi M. W.,
Lamont P. M.,
Pawape G.,
Ashrafy M.,
Maharaj M.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04929_2.x
Subject(s) - medicine , diabetes mellitus , neglect , overeating , depression (economics) , diabetic foot , intensive care medicine , physical therapy , psychiatry , obesity , economics , macroeconomics , endocrinology
Purpose: To emphasize the point that chronic diabetics at some point gives up their vigilance in the sugar control and end up with intractable diabetic feet with limb losses incurring enormous pressure on health budget, enormous morbidity and mortality. Self neglect is very obvious in many who have controlled diabetes for years. Methodology: 300 patients who presented with diabetic feet been interviewed and noticed that few weeks or months prior to their start of symptoms a major change in the treatment mechanism happens which lead to catastrophic complications of Diabetes. They do not qualify according to DSM IV classification to be called MDE but can be called dysthymia. Result: Diabetic patients over time develop Dysthymia when they feel hopeless about control of their illness. Often they are overwhelmed by thoughts of long‐term complications of Diabetes. A dysthymic person either has poor appetite or overeating, which leads to poor sugar control. Primary health carers and diabetic educators should take preemptive measures to identify the dysthymics and help them stick to the routine treatment. Prevention is the best method of treatment of complications of diabetes. In many part of world overuse of sugar and fine carbohydrates is a part of cultural transformation. Conclusion:• Diabetic feet are preventable. • Early psychiatric assessment is helpful. • Preventive steps are cost effective. • Diabetic educators are very few in contrast to their need.