Looking After Your Feet
You should check your feet every day. Diabetes can reduce the blood supply to your feet and cause a loss of feeling.
This means foot injuries do not heal well and you may not notice if your foot is sore or injured. These problems can lead to ulcers and infections.
Simple things are important, like:
- keeping feet clean and dry to avoid infection
- trying not to go barefoot outside to avoid nicks and cuts
- wearing shoes that fit well
Speak to your GP or diabetes nurse if you notice any changes in your feet, including:
- cuts, cracks or blisters
Diabetes UK has advice on how to check your feet.
Your feet should also be checked every year by your GP, diabetes nurse or podiatrist.
Sores or infections that are not treated early can lead to gangrene. Around 175 amputations resulting from diabetes are carried out every week in England.
Infectious Problems In Diabetes
People with diabetes often develop bacterial and fungal infections typically of the skin and mouth. When the levels of glucose in the blood are high, white blood cells cannot effectively fight infections. Any infection that develops tends to be more severe and takes longer to resolve in people with diabetes. Sometimes, an infection is the first sign of diabetes.
People with diabetes are also particularly likely to have ulcers and infections of the feet and legs because of poor circulation to the skin. Too often, these wounds heal slowly or not at all. When wounds do not heal, they typically become infected and this can result in gangrene Gas Gangrene Gas gangrene is a life-threatening infection of muscle tissue caused mainly by the anaerobic bacteria Clostridium perfringens and several other species of clostridia. Gas gangrene can develop… read more and bone infection . Amputation of the foot or part of the leg may be needed.
The Effects Of Diabetes On Your Body
When you hear the word diabetes, your first thought is likely about high blood sugar.
Blood sugar is an often-underestimated component of your health. When its out of balance over a long period of time, it could develop into diabetes.
Diabetes your bodys ability to produce or use insulin, a hormone that allows your body to turn glucose into energy.
Here are what symptoms may occur to your body when diabetes develops.
Normally after you eat or drink, your body will break down sugars from your food and use them for energy in your cells.
To accomplish this, your pancreas needs to produce a hormone called insulin. Insulin is what facilitates the process of pulling sugar from the blood and putting it in the cells for use, or energy.
If you have diabetes, your pancreas either produces too little insulin or none at all. The insulin cant be used effectively.
This allows blood glucose levels to rise while the rest of your cells are deprived of much-needed energy. This can lead to a wide variety of problems affecting nearly every major body system.
Type 1, also called juvenile diabetes or insulin-dependent diabetes, is an immune system disorder. Your own immune system attacks the insulin-producing cells in the pancreas, destroying your bodys ability to make insulin. With type 1 diabetes, you must take insulin to live. Most people receive their type 1 diagnosis as a child or young adult.
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Diabetes And Healthy Weight
If you are overweight, even losing a small amount of weight, especially around the abdomen, helps to lower your blood pressure, blood glucose and cholesterol levels.
It can be difficult trying to lose weight, so to get started set yourself a short-term, achievable goal. Try thinking about the food you are eating, whether you really need it, if it’s a healthy choice, and consider the portion size. An accredited practicing dietitian can help you set a realistic meal plan and answer any food related questions you may have.
What Are The Acute Complications Of Diabetes
Acute complications of type 2 diabetes
In patients with type 2 diabetes, stress, infection, and medications can also lead to severely elevated blood sugar levels. Accompanied by dehydration, severe blood sugar elevation in patients with type 2 diabetes can lead to an increase in blood osmolality . This condition can worsen and lead to coma . A hyperosmolar coma usually occurs in elderly patients with type 2 diabetes. Like diabetic ketoacidosis, a hyperosmolar coma is a medical emergency. Immediate treatment with intravenous fluid and insulin is important in reversing the hyperosmolar state. Unlike patients with type 1 diabetes, patients with type 2 diabetes do not generally develop ketoacidosis solely on the basis of their diabetes. Since in general, type 2 diabetes occurs in an older population, concomitant medical conditions are more likely to be present, and these patients may actually be sicker overall. The complication and death rates from hyperosmolar coma is thus higher than in diabetic ketoacidosis.
Blood glucose is essential for the proper functioning of brain cells. Therefore, low blood sugar can lead to central nervous system symptoms such as:
What Foot Problems Can Happen
Someone who has had diabetes for many years can develop foot problems because of poor blood flow in the feet and nerve damage.
Your doctor will check your feet for any signs of problems. Tell your doctor about any foot problems, such as ingrown toenails, calluses, and dry skin. Even if your feet just feel irritated because you’ve been wearing certain shoes or because you’ve had a minor sports injury, tell your doctor.
To prevent foot problems, wear comfortable shoes that fit well and keep your toenails trimmed to the shape of the toe. Exercise, which increases blood flow to the feet, can also help keep feet healthy.
What Are The Risk Factors For Diabetes
Risk factors for type 1 diabetes are not as well understood as those for type 2 diabetes. Family history is a known risk factor for type 1 diabetes. Other risk factors can include having certain infections or diseases of the pancreas.
Risk factors for type 2 diabetes and prediabetes are many. The following can raise your risk of developing type 2 diabetes:
- Being obese or overweight
- Ethnic background: Hispanic/Latino Americans, African-Americans, Native Americans, Asian-Americans, Pacific Islanders, and Alaska natives are at greater risk.
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How Does Diabetes Affect Your Heart Eyes Feet Nerves And Kidneys
Blood vessels are located throughout our bodys tissues and organs. They surround our bodys cells, providing a transfer of oxygen, nutrients and other substances, using blood as the exchange vehicle. In simple terms, diabetes doesnt allow glucose to get into cells and it damages blood vessels in/near these organs and those that nourish nerves. If organs, nerves and tissues cant get the essentials they need to properly function, they can begin to fail.Proper function means that your hearts blood vessels, including arteries, are not damaged . In your kidneys, this means that waste products can be filtered out of your blood. In your eyes, this means that the blood vessels in your retina remain intact. In your feet and nerves, this means that nerves are nourished and that theres blood flow to your feet. Diabetes causes damage that prevents proper function.
How Does Diabetes Lead To Amputation
Uncontrolled diabetes can lead to poor blood flow . Without oxygen and nutrients , you are more prone to the development of cuts and sores that can lead to infections that cant fully heal. Areas of your body that are farthest away from your heart are more likely to experience the effects of poor blood flow. So areas of your body like your toes, feet, legs and fingers are more likely to be amputated if infection develops and healing is poor.
Nerve Damage In Diabetes
Damage to nerves can manifest in several ways. If a single nerve malfunctions, an arm or leg may suddenly become weak. If the nerves to the hands, legs, and feet become damaged , sensation may become abnormal, and tingling or burning pain and weakness in the arms and legs may develop. Damage to the nerves of the skin makes repeated injuries more likely because people cannot sense changes in pressure or temperature.
Causes Of Type 2 Diabetes
Type 2 diabetes occurs when the body doesn’t produce enough insulin to function properly, or the body’s cells don’t react to insulin. This means glucose stays in the blood and isn’t used as fuel for energy.
Type 2 diabetes is often associated with obesity and tends to be diagnosed in older people. Due to increased obesity, type 2 diabetes is now being seen in young people and all ages. It’s far more common than type 1 diabetes.
Read about the causes and risk factors for type 2 diabetes
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When To See A Dermatologist
Diabetes can cause many other skin problems. Most skin problems are harmless, but even a minor one can become serious in people who have diabetes. A board-certified dermatologist can recognize skin problems due to diabetes and help you manage them.
Are all dermatologists board certified?
No. See what it takes to become board certified.
ImagesImage 1: Image Courtesy of Clark C. Otley, MD. All Rights Reserved
Images 3, 7, 8, 9: Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.
Image 2 from DermNetNZ
Some images used with permission of Journal of the American Academy of Dermatology
ReferencesCohen Sabban, EN. Cutaneous manifestations of diabetes mellitus from A to Z. Focus session presented at: 74th Annual Meeting of the American Academy of Dermatology March 4-8, 2016 Washington D.C.
Duff M, Demidova O, et al. Cutaneous manifestations of diabetes mellitus. Clinical Diabetes. 2015 33:40-8.
Kalus AA, Chien AJ, et al. Diabetes mellitus and other endocrine disorders. In: Wolff K, Goldsmith LA, et al. Fitzpatricks Dermatology in General Medicine . McGraw Hill Medical, New York, 2008:1461-70.
McKinley-Grant L, Warnick M, et al. Cutaneous manifestations of systemic disease. In: Kelly AP and Taylor S. Dermatology for Skin of Color. . The McGraw-Hill Companies, Inc. China, 2009:481-4.
Morgan AJ and Schwartz RA. Diabetic dermopathy: A subtle sign with grave implications. J Am Acad Dermatol. 2008 58:447-51.
Keep The Blood Flowing To Your Feet
Try the following tips to improve blood flow to your feet:
- Put your feet up when you are sitting.
- Wiggle your toes for a few minutes throughout the day. Move your ankles up and down and in and out to help blood flow in your feet and legs.
- Do not wear tight socks or elastic stockings. Do not try to hold up loose socks with rubber bands.
- Be more physically active. Choose activities that are easy on your feet, such as walking, dancing, yoga or stretching, swimming, or bike riding.
- Stop smoking.
Smoking can lower the amount of blood flow to your feet. If you smoke, ask for help to stop. You can get help by calling the national quitline at 1-800-QUITNOW or 1-800-784-8669. For tips on quitting, go to SmokeFree.gov.
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What Is Type 2 Diabetes
Type 2 diabetes was also previously referred to as non-insulin dependent diabetes mellitus , or adult-onset diabetes mellitus . In type 2 diabetes, patients can still produce insulin, but do so relatively inadequately for their body’s needs, particularly in the face of insulin resistance as discussed above. In many cases this actually means the pancreas produces larger than normal quantities of insulin. A major feature of type 2 diabetes is a lack of sensitivity to insulin by the cells of the body .
In addition to the problems with an increase in insulin resistance, the release of insulin by the pancreas may also be defective and suboptimal. In fact, there is a known steady decline in beta cell production of insulin in type 2 diabetes that contributes to worsening glucose control. Finally, the liver in these patients continues to produce glucose through a process called gluconeogenesis despite elevated glucose levels. The control of gluconeogenesis becomes compromised.
While it is said that type 2 diabetes occurs mostly in individuals over 30 years old and the incidence increases with age, an alarming number of patients with type 2 diabetes are barely in their teen years. Most of these cases are a direct result of poor eating habits, higher body weight, and lack of exercise.
What Other Problems Can People With Diabetes Have
If you have diabetes, you need to watch out for blood sugar levels that are very high or very low . These can happen quickly and can become dangerous. Some of the causes include having another illness or infection and certain medicines. They can also happen if you don’t get the right amount of diabetes medicines. To try to prevent these problems, make sure to take your diabetes medicines correctly, follow your diabetic diet, and check your blood sugar regularly.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
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Can Diabetes Be Cured Or Reversed
Although these seem like simple questions, the answers are not so simple. Depending on the type of your diabetes and its specific cause, it may or may not be possible to reverse your diabetes. Successfully reversing diabetes is more commonly called achieving remission.
Type 1 diabetes is an immune system disease with some genetic component. This type of diabetes cant be reversed with traditional treatments. You need lifelong insulin to survive. Providing insulin through an artificial pancreas is the most advanced way of keeping glucose within a tight range at all times most closely mimicking the body. The closest thing toward a cure for Type 1 is a pancreas transplant or a pancreas islet transplant. Transplant candidates must meet strict criteria to be eligible. Its not an option for everyone and it requires taking immunosuppressant medications for life and dealing with the side effects of these drugs.
Its possible to reverse prediabetes and Type 2 diabetes with a lot of effort and motivation. Youd have to reverse all your risk factors for disease. To do this means a combination of losing weight, exercising regularly and eating healthy . These efforts should also lower your cholesterol numbers and blood pressure to within their normal range. Bariatric surgery has been shown to achieve remission in some people with Type 2 diabetes. This is a significant surgery that has its own risks and complications.
Diabetes And Healthy Eating
If you have diabetes its important to include a wide variety of nutritious and healthy foods in your diet, and to avoid snacking on sugary foods.
Enjoy a variety of foods from each food group be sure to include foods high in fibre and low in fat and reduce your salt intake. Its helpful to consult with a dietitian to review your current eating plan and provide a guide about food choices and food quantities.
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The Usc Healthier Vessels Healthier Brain Study: Research To Understand How Early Diabetes Affects Capillaries Brain Cells And Memory Function
Dr. Helena Chui and the research team at the USC ADRCare conducting a study to determine how early diabetes affects capillaries, brain cells and cognitive abilities. USC is the home to the Stevens Institute of Neuroimaging and Informatics. We perform state of the art, high resolution MRI images of the brain and blood vessels. We have developed a new method of assessing capillary integrity using contrast MRI. We can measure hundreds of proteins, including insulin, insulin growth factor, beta-amyloid, tau proteins, omega-3-fatty acids from samples of cerebrospinal fluid. If you are interested in more information, please click here: or call the Research Center for more information and to set up a confidential screening phone interview: Lina DOrazio, Ph.D. 442-7680 or Maria Hernandez 442-6845.
Can Diabetes Cause Tendon Problems
Diabetes is a metabolic disease that causes high blood glucose or blood sugar. Under normal circumstances, the hormone insulin is responsible for transporting sugar from the bloodstream into the cells to be used for energy or stored for later use. In people with diabetes, though the body fails to either make sufficient insulin or it is unable to effectively use the insulin that it is producing.1
If left untreated, high blood sugar due to diabetes can, over time, cause damage to the eyes, nerves, kidneys, and other organs of the body. Diabetes also increases the risk of developing various bone and joint disorders, including tendonitis. This happens because of factors like nerve damage, obesity, and arterial disease.2
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Ways To Manage Type 2 Diabetes And Heart Health
This condition is harmless, and the skin patches dont usually hurt or itch. Treatment isnt necessary, and spots may disappear on their own.
How To Prevent And Treat Tendon Damage With Diabetes
The best way to prevent tendon problems is to keep your diabetes under control. Keep your blood sugar under control with the help of a healthy diet, regular exercise, and the medications your doctor has prescribed. If you are overweight, losing some weight can help you better manage your condition. It will also improve your overall health and take some of the strain off your tendons.
In people with diabetes who already have tendon damage, here are some standard solutions to alleviate the pain and other symptoms:
- Apply heat or ice to the affected area
- Take muscle relaxants or pain relievers like ibuprofen or aspirin, but only after consulting your doctor.
- Physical therapy and regular exercise
- A splint for keeping the joint steady while allowing the tendons to heal
In severe cases, your doctor may suggest a steroid injection into the joint to relieve the tendon problems. However, it is essential to keep in mind that steroids can lead to a short-term spike in blood sugar levels.
Regular exercise is essential in managing tendon problems, and it can also help keep your diabetes under control. Talk to your doctor about different ways of keeping your blood sugar levels under control as you recover from tendon problems. Remember, managing your diabetes properly can prevent several complications of diabetes.
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