CHENNAI: : For most diabetics, changes in their body come as a shock because they are not prepared for it. Doctors say that by educating people when they are well, they can be prepared to handle the problem better.

Besides checking blood sugar levels, people must be taught to take foot care seriously. Foot care must start even before diabetes is detected, diabetologists say.

At Kilpauk Medical College's podiatry ward diabetics are counselled to look at their feet in a mirror at least once a day. ``The nerves die and people lose sensation in their feet. In our podiatry department educators use simple tests,'' says C.R. Anand Moses, in-charge of diabetology department.

Neglect of shoe bites and changes in the contour of bones can lead to irreparable damage and amputation, explained S. Nallapuramal of Swamy Diabetes Centre, at a recent patient education programme.

Doctors feel that training science graduates as diabetes health care givers would fill the gap but that may take some time.

Team care

``It is only the Government that can provide general information to the public. We (private practitioners) can cover only five per cent of the population. Diabetes requires team care," says A. Panneerselvam, Secretary of Diabetics Association of India's southern chapter. ``A diabetic and his relatives must be guided throughout his life.''

A specialised clinic must have a trained dietician, pharmacist and lab technician to prevent people from forgetting to take their medicines and tests. There are only a handful of such clinics in the country and most of them are concentrated in cities. With diabetes affecting the rural population too, doctors are looking to volunteers for help. Non-government organisations could use trained diabetes educators to work at primary health care centres, says Dr. Moses.

Though several non-government organisations have extended their help, there is still not enough awareness among people, according to specialists.

"It is less exciting for a young doctor to tell a chronic diabetic to take care of himself. Every diabetic needs to be told that he must be on intensive treatment,'' says A. Ramachandran, director of Royapuram-based diabetes research centre.

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