Quality of care of patients with diabetic foot problems in Barbados

In Barbados diabetics with foot problems account for 80% of the patients in the female and 50% of those in the male general surgery wards, and many pa tients have major amputations for preventable problems. A six month prospec tive study was undertaken of all cases admitted with foot problems to the g eneral surgical wards of the Queen Elizabeth Hospital (QEH) in order to det ermine the quality of foot care, particularly among diabetics. 67.5% of the 195 patients (55% female) admitted to the study were diabetic, most of who m were diagnosed IO to 19 years previously. Most of the patients were 70 to 80 years old, but significantly more diabetics than non-diabetics were 40 do 70 years old. Foot problems in diabetics were precipitated by events tha t are considered trivial in non-diabetic patients. 87 (58%) of 150 respondi ng patients had their feet inspected by health personnel in the previous ye ar. 47 (63.5%) of the 74 who responded about the care of their nails said t hat they took care of their nails themselves. Nearly 40% of diabetic and no n-diabetic patients had no reported source of care before their admission. 14 patients (10 diabetic) sought care the same day and II (nine diabetics) the day after noticing foot problems. Most patients presented with infectio n as part of their problem; recognition of the early signs of infection sho uld be an integral part of the education of the diabetic patient Educationa l efforts for patients must be continually reinforced because many patients said they had had no education about the care of their feet in the previou s year.