Watch Your Feet

A person with diabetes (especially uncontrolled diabetes) needs to inspect his feet frequently (daily).  As the high blood sugar does damage to blood vessels and nerves, the decreased blood flow and nerve damage can cause feet to lose feeling.  That person may step on something and not realize there is an injury until the foot becomes swollen, reddened and infected. 

 WebMD “Diabetes and Foot Problems” webpage says this: 

·       Work with your doctor to control your blood sugar/diabetes and protect your feet. 

·       Wash (not soak) your feet DAILY in warm water (check the water temperature with your elbow to avoid a burn.  Your hands may have decreased feeling also.

·       Dry your feet well, including between toes

·       Inspect your feet daily for sores, blisters, redness, calluses. 

·       Weekly check your toenails.  Trim straight across with a nail clipper.  Don’t round corners or cut down besides the nails.  Smooth freshly cut toenails with a file. 

·       Wear well-fitting shoes that protect your feet.  Closed-toe shoes will protect your feet much more than sandals or going barefoot. Going barefoot isn’t a good idea for people who want to protect their feet from injuries.  Check your shoes before you put them on to make sure Fido or the kids did not leave something inside which could injure your foot. 

·       Wear socks or stockings that fit well and have soft elastic.

·       See your doctor for any foot problems that get worse, including sores which do not heal

·       They give additional suggestions on how to care for your feet at http://www.webmd.com/diabetes/foot-problems?page=3  Do you know whether your insurance/Medicare will pay for podiatrist care of your feet?   Check as they might include that as a covered service. 

 

Diabetes ABC

Did you know you have a diabetes ABC? 
·       A:  A1C (a blood glucose test which shows your blood sugar average for the last 2-3 months. 
·       B:  blood pressure  Your blood pressure shows the pressure inside your blood vessels when your heart is pumping (the systolic or top number) and when your heart is resting (diastolic or bottom number).  When your blood pressure is high, your heart is having to work too hard and damage can occur.  What is your blood pressure?  The ADA recommends below 140/90.  Your doctor may have a lower number as the American Heart Association has lowered their recommended blood pressure goal to 120/80. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/Understanding-Blood-Pressure-Readings_UCM_301764_Article.jsp
·       C:  Cholesterol levels affect your blood supply to all parts of your body.  A recommended total cholesterol level is below 200, LDL cholesterol (bad cholesterol) should be under 100 mg/dL. HDL (healthy or good) cholesterol should be above 40 mg/dL for men (50 mg/dL for women) and triglycerides should be below 150 mg/dL.  High triglycerides mean you are eating more than your body can process. 

Other recommendations for caring for your type 2 diabetes involve healthy eating, losing weight if needed, and physical activity.  Do you know that many hospitals/medical centers/clinics provide diabetes teaching classes?  If you are newly diagnosed, ask if diabetes classes are available and whether your insurance/Medicare will pay for these classes.  If you get some new recipes which fit your new diabetic lifestyle, you may find it easier to eat healthy and keep your blood sugar under control.  Also regular physical activity helps lower blood sugar as well as blood pressure and cholesterol. 

I have seen people who upon learning they were diabetic, worked with their doctors and controlled their blood sugar by losing weight and eating healthy.  If diet and losing weight aren’t enough to control the blood sugar level, medications may be needed to control a person’s blood sugar.  Diabetes pills and insulin medications are available by prescription to help keep blood sugar within normal range.  People dealing with diabetes must work with their doctor to get the best management of this condition. 

 

Next week --Watch your Feet

 

Type 2 diabetes

Normal metabolism means our bodies break down foods (especially carbohydrates) into sugars which are carried throughout our body to the cells which need the sugar to operate properly. These sugars provide important energy to most cells in our bodies.  For example, without simple sugars, our brains don’t think well.  We would become confused and unable to focus. When our blood sugar levels rise, our pancreas releases insulin.  Insulin helps sugars enter the body cells and keeps our blood sugar level under control. 

In type 2 diabetes, also called insulin resistance, this balance of sugar and insulin regulation is impaired or lost.  Blood sugar levels can become low early as the pancreas makes extra insulin, but as the pancreas fails to make enough insulin, the blood sugar levels become high and stay high, bathing the body in sugary blood.  The body quietly begins to suffer damage. 

But notice I said quietly.  Many people do not know they have diabetes.  

In 2012, 29.1 million Americans have diabetes, but 8.1 million do not know they have diabetes.
Do you wonder if you have developed type 2 diabetes?  The American Diabetes Association gives a risk test which tells you if you are at risk.  Check it out at http://www.diabetes.org/assets/pdfs/at-risk/risk-test-paper-version.pdf

What puts us at risk for developing type 2 diabetes?

When doctors talk about risk factors, these are health and lifestyle issues which can affect whether we develop a certain disease.  Usually there are two categories of risk factors:  those we cannot change and those we can change. 

Risk factors we cannot change include our genetics (our inherited genes which may be good or bad).  If your blood relatives (parents, siblings) suffer from diabetes, you face an increased risk.  Age and gender (which we cannot change) may increase our risk of developing diabetes. 

Risk factors we can change involve being overweight, having high blood pressure, high cholesterol, smoking, having unhealthy eating patterns, high blood sugar results on blood tests, and being physically inactive.  These behaviors may be contributing to type 2 diabetes and they can be changed with lifestyle changes. 

What are symptoms? The classic symptoms of diabetes are poly dipsia (abnormal thirst), poly phagia (hungry even when you have eaten) and polyuria (have to urinate more than normal).  Other symptoms are extreme fatigue, slow healing cuts/bruises/injuries, and tingling/numbness in hands and feet.  With the gradual onset of these symptoms, many people do not recognize they have developed type 2 diabetes. 

The high sugar content in our blood causes damage to our blood vessels .  That means every blood vessel from our coronary (heart) circulation to our tiny blood vessels which bring circulation to our eyes and nerve endings.  That explains why type 2 diabetes can cause heart disease, stroke, kidney damage, nerve damage, and vision problems.  But there is much we can do to keep our blood sugar levels under control and prevent/delay the damage type 2 diabetes can cause. 

The American Diabetes Association gives this good news:  “keeping blood glucose, blood pressure and cholesterol on target can help prevent or delay problems.”  American Diabetes Association, Taking Care of Type 2 Diabetes.  Find this patient education booklet under Facts About Type 2 diabetes at http://www.diabetes.org/diabetes-basics/type-2/facts-about-type-2.html?loc=db-slabnav  

 

Next week I will talk about what we can do to protect our health after being diagnosed with type 2 diabetes. 

In the News--New comedy Black-ish star Anthony Anderson deals with diabetes

I haven’t watched this new show yet but I plan to check it out.  Star Anthony Anderson deals with diabetes in his personal life and in his character.  According to the news article I read, Mr. Anderson takes his diabetes seriously and has made healthy life changes:  he has lost weight (almost 50# over the past several years), he has began eating healthy and exercising.  He is adding bike riding, running on a treadmill to his lifestyle and adds basketball and golf into his busy schedule when he can. 

I applaude Anthony Anderson’s efforts to care for his health.  http://abcnews.go.com/blogs/entertainment/2014/09/check-out-blac-kish-star-anthony-andersons-47-pound-weight-loss/

March 24^th is American Diabetes Association Alert Day. Many people who have diabetes do not recognize it.  Do you know the symptoms of diabetes?  Do you know how to protect your health when you have diabetes?  I will be talking about type 2 diabetes for the next few weeks. 

Danger of flying: dehydration

We recently made a vacation trip to Huatulco, Mexico (Western Mexico south of Puerto Vallarta). As we were preparing for our trip, I read an interesting article on Yahoo news about scary health effects of flying.   According to the Yahoo Travel article, a serious result of flying in an airplane is dehydration.  The air inside an airplane can be as low as 10 %.  Our bodies are comfortable at 50%.   This low humidity level can cause all kinds of dehydration side effects:  headache, thirst, reduced urination, constipation.  Dry sinuses, noses and throats can result and make a person more susceptible to infections.  

What can we do to avoid dehydration during flights?  Drink plenty of water.  Begin before the flight and continue to drink water during the flight.  Drinks which contain caffeine such as sodas, coffee, and tea can contribute to dehydration.  Alcohol drinks can contribute to dehydration also. 

After I got home from our trip, I really noticed that my body was dehydrated.  I’ve been drinking extra water, using saline nose spray and artificial tears to add fluids to my head.  I think I am making progress on recovery.