Few important Guidelines -compiled by my patient.-By a diabetic (Dr Abraham Joseph)..For the diabetics

 I.GUIDANCE TO DIABETIC PATIENTS WHILE PURCHASING A NEW PAIR OFSHOES

1. Purchase the shoes only on doctor’s advice.
2. Always wear cotton socks along with the shoes.
3. Those who are buying the shoes for first time should not start walking with the shoes immediately.
4. First two days after wearing the shoes sit down for 10 to 20 minutes.
5. Next two days wear shoes and stand for some time intermittently.
6. Next two days walk for ten minutes wearing the shoes.
7. Next day walk intermittently for 20 to 30 minutes
8. By this way, slowly and steadily, within next two weeks only, you should start using the shoes permanently.
9. If it is noticed that there is little  formation of red colour  or slight swelling on the foot, give some rest to the foot, If it is not coming down consult the doctor.

II.GUIDANCE FOR INJECTING INSULIN

       1. Wash your hands properly.

      2. Please note the units of insulin you are going to use in the syringe

      3. If insulin is appearing as kanji water, two or three times the bottle should be be rolled in the palm.

      4. The required measure of insulin as prescribed by the doctor must be withdrawn into the syringe.

      5. Bottle   should be kept upside down and the cap cleaned with spirit.

     6. Air inside the Syringe should be pushed into the bottle.  

     7. Keep the bottle with top down and insulin got placed in the syringe. Any air bubble should be 

      removed by gently tapping the syringe.   

     8. Any surplus insulin should be taken back into the bottle and needle taken out.

     9 Clean the skin and inject insulin keeping the syringe at 90 degrees. No need to clean the  skin again

     10. Inject the insulin slowly and keep the finger at the place of injection and take needle back.

     11.The portion below the skin should be protected and hence the place of injection must  be changed  

           every time.                     

     12. The used syringe should be disposed  off.

Care of Wound:

For wounds, small  eruptions, swelling that does not go down when the leg is kept up, follow the instructions below.

1. Clean the wound with dettol or betadine.

2. Clean the wound with gausse dipped in Savlon or iodine.

3. Check the blood sugar.

4. The wounded leg should not be allowed to get wet. Cover the wound   with a plastic  bag.

III.     Instructions to a diabetic patient after the operation on the leg.

1. Wounded leg should not be given pressure.
2. Please cover the leg wounded with a plastic bag. It should be protected from insects.
3. Don’t allow the wounded leg to become wet.
4. As per doctors instructions clean the wound with uninfected materials.
5. Don’t place cotton over the wound.
6. Control the sugar content in the blood and food items.
7. Until wound is cured use walker.
8. Without doctors instructions no stress should be placed on the leg.
9. After the wound is healed   only start using the shoes.

IV. What are the rules and regulations a diabetic patient  should know after operation.

1. The wound of a diabetic patient is like an iceberg  with only a small portion alone shown out side. The wound will be much bigger than what is shown outside.

2. After the first operation keep the wound clean. In all probability more operations will be required.

3. This may necessitate stay in the hospital for many days. Cooperation from the patient is very important.

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