- May 6, 2016
- Posted by: Active Foot Care Podiatry
Diabetes is a condition where there is too much glucose (sugar) in the blood. This may occur if the body is unable to produce enough insulin or the insulin is not working properly. Glucose is the main source of energy for our bodies and comes from carbohydrates. Some foods which contain carbohydrates include breads, cereals, potato, milk and fruit.
Insulin is a hormone that is produced by the pancreas. This hormone is responsible for opening up the muscle, fat and liver cells in the body so they can store glucose and use it for energy. Without insulin, the cells in the body would not be able to use glucose for energy, which means the body would not have any energy.
There are four different types of diabetes, these include Type 1, Type 2, Gestational Diabetes and Impaired fasting glucose (pre diabetes). Type 1 Diabetes occurs when the pancreas is not able to produce enough insulin. Unfortunately Type 1 Diabetes cannot be prevented or cured. Type 2 Diabetes occurs when the body either does not produce enough insulin, or the insulin produced does not work effectively. Gestational Diabetes is diagnosed when the blood glucose levels are higher than normal during pregnancy. Pre Diabetes is diagnosed when the blood glucose levels of an individual is higher than normal, but not high enough to be diagnosed with Diabetes.
Diabetes is the fastest growing chronic condition in Australia. According to the Australian Diabetes Council, 3.1 million Australians have diabetes, or pre-diabetes. This means that 1 in 4 adults in Australia are living with diabetes. Approximately, 280 Australians develop Diabetes every day.
There are two main components to managing Diabetes and these include Healthy eating and regular physical activity.
- Eat plenty of vegetable and legumes
- Eat a moderate amount of fruits and cereals
- Monitor your carbohydrate intake as it directly affects your blood glucose levels. To determine the right amount of carbohydrates you need to consume, you may refer to an Accredited Practising Dietician.
- Include dietary fibre, to help keep you full for longer, keep your bowels healthy and may help to lower your cholesterol levels. (Note that is is important to increase your water intake when increasing the amount of fibre in your diet).
- Limit Saturated fat and lower total fat intake
- Use foods lower in salt, or swap the use of salt in cooking with herbs, spices,garlic, vinegar or lemon juice.
- Don’t smoke or drink alcohol
- Aim to limit your sugar consumption from natural sources such as milk, fruit or yoghurt.
There is a wide range of benefits associated with being physically active especially for people living with Diabetes.
- Physical activity can improve the body’s response to insulin, which in turn will lower blood glucose levels
- Physical activity can lower blood pressure and cholesterol, which will reduce the risk of cardiovascular disease )
- Weight control
- Stronger bones
- Improved mood
- Increased energy levels
- Reduced stress and tension
- Improved sleep
Blood Glucose Monitoring
Regular testing of your blood glucose levels can reinforce your healthy lifestyle choices and let you know how your body responds to other factors. Blood glucose levels respond to food, particularly carbohydrates but other influences like physical activity, travel, changes in routine, stress and illness will also cause blood glucose levels to go up or down. The frequency and timing of your blood glucose monitoring is different for each individual and should be determined by your Diabetes team.
Podiatry in Diabetes:
The role of your Podiatrist. Diabetes is a systemic disease affecting many different parts of the body so its management requires a team approach. The podiatrist , as an integral part of the treatment team, has documented success in the prevention of amputations, one of the most serious conditions that they treat. For diabetic patients to avoid amputations, it is important to attend regular foot screenings (atleast annually). for early recognition. Along with these check ups, there are some warning signs patients should be aware of, and brought to the attention of your GP or Podiatrist. These include:
- Skin colour changes
- Elevation in skin temperature
- Swelling of the foot or ankle
- Pain in the legs
- Open sores on the feet that are slow to heal
- Ingrown and fungal toenails
- Bleeding corns and calluses
- Dry cracks in the skin, especially around the heel
- Wound Healing
If you have Diabetes, it is important to:
Wash your feet daily. Using mild soap and lukewarm water, wash your feet in the mornings or before bed each evening. Dry carefully with a soft towel, especially between the toes, and dust your feet with talcum powder to wick away moisture. If the skin is dry, use a good moisturizing cream daily, but avoid getting it between the toes.
Inspect your feet and toes daily.
It is important to check your feet every day for cuts, bruises, sores or other changes that may be less obvious. If age or other factors hamper self-inspection, ask someone to help you or use a mirror.
People with diabetes are commonly overweight, which nearly doubles the risk of complications.
Give up smoking.
Tobacco can contribute to circulatory problems, which can be especially troublesome in patients with diabetes.
Cut toenails straight across.
Never cut into the corners, or taper, which could trigger an ingrown toenail. Use an emery board to gently file away sharp corners or snags.
As a means to keep weight down and improve circulation, walking is one of the best all-around exercises for the diabetic patient. Walking is also an excellent conditioner for your feet. Be sure to wear the appropriate athletic shoe when exercising. Ask your podiatrist.
Wear thick, soft socks.
Socks made of an acrylic blend are well suited, but avoid mended socks or those with seams, which could rub to cause blisters or other skin injuries. There are currently Diabetes friendly socks available at your local pharmacy.
See your podiatrist:
Regular check-ups by your podiatric physician-at least twice annually-is the best way to ensure that your feet remain healthy.
Wear the right shoes
Be properly measured and fitted every time you buy new shoes. Shoes are of supreme importance to diabetes sufferers because poorly fitted shoes are involved in as many as half of the problems that lead to amputations. Because foot size and shape may change over time, everyone should have their feet measured by an experienced shoe fitter whenever they buy a new pair of shoes. New shoes should be comfortable at the time of purchased and should not require a “break-in” period, though it is a good idea to wear them for short periods of time at first. Shoes should have leather or canvas uppers, fit both the length and width of the foot, leave room for toes to wiggle freely, and be cushioned and sturdy.
If you have Diabetes it is important to avoid:
Barefoot walking outside is particularly dangerous because of the possibility of cuts, falls, and other foot injuries on unfamiliar terrain. When at home, wear slippers. Never go barefoot. Avoid wearing high heels, sandals, and shoes with pointed toes. These types of footwear can put undue pressure on parts of the foot and contribute to bone and joint disorders, as well as diabetic ulcers. In addition, open toed shoes and sandals with straps between the first two toes should also be avoided.
Drinking in excess.
Alcohol can contribute to neuropathy (nerve damage) which is one of the consequences of diabetes. Drinking can speed up the damage associated with the disease, deaden more nerves, and increase the possibility of overlooking a seemingly minor cut or injury.
Wearing anything that is too tight around the legs.
Panty hose, panty girdles, thigh-highs or knee-highs can constrict circulation to your legs and feet. So can men’s dress socks if the elastic is too tight.
Removing calluses, corns or warts by yourself.
Commercial, over-the-counter preparations that remove warts or corns should be avoided because they can burn the skin and cause irreplaceable damage to the foot of a diabetic sufferer. Never try to cut calluses with a razor blade or any other instrument because the risk of cutting yourself is too high, and such wounds can often lead to more serious ulcers and lacerations. See your podiatric physician for assistance in these cases.
Another serious condition of the foot is Ulceration. Ulceration is a common occurrence with the diabetic foot, and should be carefully treated and monitored by a podiatrist to avoid amputations. A wound can develop due to poorly fitted shoes, that may not be felt by a patient with low levels of skin sensations. These ulcers may become infected and lead to more serious consequences if left untreated. Your podiatric physician knows how to treat and prevent these wounds and can be an important factor in keeping your feet healthy and strong. There are currently new healing techniques to help heal wounds. These products have the appearance and characteristics of human skin and are applied to wounds that are properly prepared by podiatrists.