Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Sep 2:8:1173-7.
doi: 10.2147/PPA.S68680. eCollection 2014.

Self-directed treatment for lower limb wounds in persons with diabetes: a short report

Patrick Harnarayan  1 , Shamir O Cawich  1 , Shariful Islam  1 , Shivaa Ramsewak  1 , Vijay Naraynsingh  1
Affiliations

Self-directed treatment for lower limb wounds in persons with diabetes: a short report

Patrick Harnarayan et al. Patient Prefer Adherence. .

Abstract

Aim: There has been little focus on self-directed treatment for lower limb wounds, although it a common practice among persons with diabetes across the Caribbean. We sought to document this practice in a Caribbean nation.

Methods: We prospectively interviewed all consecutive patients with diabetes who were admitted with lower limb wounds at the San Fernando General Hospital in Trinidad and Tobago over a period of 18 months. A questionnaire was used to collect data on patient demographics, use of self-directed treatment, and details of these treatments.

Results: Of 839 persons with diabetes who were admitted with infected lower limb wounds, 344 (41%) admitted to self-directed treatment before seeking medical attention. These patients were predominantly male (59.9%) at a mean age of 56.4±12.4 years. The practice was most common in persons of Afro-Caribbean descent (45.9%) and those with type 2 diabetes (93.9%). In this group, 255 (74.4%) patients were previously admitted to hospital for lower limb infections. And of those, 32 (12.6%) had a prior amputation and 108 (42.4%) had at least one operative debridement specifically for foot infections.

Conclusion: Caribbean cultural practices may be an important contributor to negative outcomes when treating lower limb wounds in persons with diabetes. Despite being acutely aware of the potentially devastating consequences of inadequate treatment, 41% of our patients with diabetes still opted to use self-directed treatment for lower limb wounds. This deserves further study in order to give a more tailored approach in care delivery.

Keywords: alternative; amputation; diabetes; foot infection; home; remedy.

PubMed Disclaimer

References

    1. Cawich SO, Islam S, Hariharan S, et al. The Economic Impact of Hospitalization for Diabetic Foot infections in a Caribbean Nation. Perm J. 2014;18(1):101–104. - PMC - PubMed
    1. Samuels TA, Hospedales CJ. From Port-of-Spain Summit to United Nations High Level Meeting CARICOM and the Global Non-communicable Disease Agenda. West Ind Med J. 2011;60(4):387–391. - PubMed
    1. Boyne MS. Diabetes in the Caribbean: Trouble in paradise. Insulin. 2009;4(2):94–105.
    1. Ferguson RS, Tulloch-Reid MK, Wilks RJ. Epidemiology of Diabetes Mellitus in Jamaica and the Caribbean: A Historical Review. West Ind Med J. 2010;59(3):259–264. - PubMed
    1. Hennis A, Wu SY, Nemesure B, Li X, Leske MC. Diabetes in a Caribbean Population: Epidemiological Profile and Implications. Int J Epidemiol. 2002;31:234–239. - PubMed

LinkOut - more resources