Diabetes Management

Diabetes is a disorder of metabolism, in which your body is unable to appropriately regulate its blood glucose levels. Glucose, a simple sugar, comes from the carbohydrates you eat. Your body creates and stores glucose to use as energy. For glucose to enter cells and be transformed into energy, insulin (a hormone produced in the pancreas) must be present. If you have diabetes, your pancreas either produces little or no insulin, or your body cells don’t respond to the insulin it produces. Whatever the cause, glucose isn’t getting into your body’s cells and glucose levels in your blood become elevated. Uncontrolled high blood sugar levels will damage many organs of your body.

At Risk for Diabetes

Certain factors can increase the risk of developing diabetes. People who have close family members with diabetes and people who are overweight have greater chances of developing diabetes. Also, the risk of diabetes is increased in some ethnic groups including people who are African-American, Latino American or Native American. High blood pressure and hyperlipidemia (elevated cholesterol) can also affect the risk of diabetes.

Symptoms

Symptoms of diabetes include increased thirst and urination, blurred vision, fatigue, and weight loss. In some individuals, elevated blood sugar may lead to recurrent infections such as urinary tract infection, vaginal yeast infection, or skin infections. However, many individuals with diabetes may go for many years without symptoms. For that reason, it’s recommended that all adults age 45 and older should be tested for diabetes every three years.

Treatment

Treatment for diabetes is specific based on your age, health and tolerance to specific medications, among other factors. There are two types of diabetes. Daily injections of insulin are used for people with Type 1 diabetes to keep their blood sugar level within normal ranges. Treatment may also include managing a proper diet to maintain blood sugar levels and exercise. It may also require regular testing of hemoglobin A1c levels, which shows the average amount of sugar in the blood over the last three months.

For people with Type 2 diabetes, losing weight, improving nutrition and exercising can control the disorder. In some cases, medication or insulin must also be used. If diabetes remains untreated, it can cause problems for the kidneys, legs, feet, eyes, heart, nerves and blood flow.

Complications

If you have diabetes, you may be at risk for complications affecting your eyes, kidneys, nerves or circulatory system. Managing your diabetes requires that you establish goals of therapy to include establishing a target blood sugar range and monitoring your glucose levels, weight management and dietary and lifestyle changes. Comprehensive treatment of diabetes requires a team approach involving you and your healthcare providers. Include, on your team, an endocrinologist, a diabetes educator, a nutritionist, an ophthalmologist and a podiatrist.

Take Special Care of Your Feet

Because diabetes can cause poor circulation and nerve damage to your feet, you are more likely to develop infections, even from a minor foot injury. If you have diabetes, treat your feet with special care. By following a simple foot care regimen, you can dramatically reduce your risk of amputation and lead a healthy, active life. Foot ulcers, a common and costly complication of diabetes, can easily be prevented through self-examination and proper foot care. When left untreated, however, foot ulcers can lead to infection, gangrene and lower limb amputation. Most often, the cause is minor foot trauma and wound-healing failure. Diabetes related amputation accounts for 51 percent of all amputations in the United States. 

If you have diabetes, follow these steps to help prevent foot ulcers.

Every day:

• Check your feet for cuts, sores, blisters, or areas of irritation. If you have any concerns, see your podiatrist or internist.
• Wash and dry your feet, particularly between your toes.
• Always protect your feet from extreme hot and cold temperatures.
• Avoid walking barefoot.
• When your toenails need trimming:
  • Trim your nails straight across, and only if you can see well.
  • If you cannot see well or if your toenails are thick or yellowed, have a podiatrist trim them.
  • Do not cut into the corners of your toes.

When you visit your doctor:

• Ask your doctor to examine your bare feet at each visit. As a reminder, remove your shoes and socks when you enter the examining room.
• Make sure your doctor checks your feet for sense of feeling and your pulse.
• Have your doctor show you how to take care of your feet.