What Can I Do To Keep My Feet Healthy
Work with your health care team to make a diabetes self-care plan, which is an action plan for how you will manage your diabetes. Your plan should include foot care. A foot doctor, also called a podiatrist, and other specialists may be part of your health care team.
Include these steps in your foot care plan:
Blood Sugar And Diabetes
Many diabetes symptoms area related to blood-sugar levels being out of your target range, so monitoring your blood-sugar levels to make sure they are within your range is the name of the game with diabetes. Your doctor will let you know whether you should be monitoring your blood glucose regularlythis is usually the case for people who are taking insulin or who are having trouble controlling their blood-glucose levels. They will likely want you to keep a strict log of your blood-sugar readings so they can review it with you during appointments.
Typical targets are 80-130 mg/dL before a meal and under 180 mg/dL one to two hours after you start eating a meal. That said, these targets can vary depending on things like your age, so your doctor can let you know what your target blood-sugar range should be.
What Are Risk Factors For Hyperglycemia
Major risk factors for hyperglycemia are:
- You have a family history of type 2 diabetes.
- You are African American, Native American, Hispanic or Asian American.
- You are overweight.
- You have high blood pressure or cholesterol.
- You have polycystic ovarian syndrome .
- You have a history of gestational diabetes.
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Table : Causes Of Hypoglycemia Re
Hypoglycemia most often occurs in Type 1 diabetics on insulin. It can be due to an increase in the patients insulin dose, skipping meals or heavy exercise.1
Hypoglycemia can also occur in Type 2 diabetics who take oral hypoglycemic medications, particularly the sulfonylureas.
The sulfonylureas, including glipizide, glimepiride and glyburide, act by increasing insulin release from the pancreas. Non-sulfonylurea oral diabetic medications, such as metformin, dont usually cause hypoglycemia.2
It should be noted that infection in both Type 1 and Type 2 diabetics can present as hypoglycemia, and that hypoglycemia can also occur in non-diabetic patients.
Signs and symptoms: Hypoglycemia should always be considered and immediately excluded in the diabetic patient presenting with altered mental status, weakness or stroke symptoms.
Signs and symptoms can be divided into neuroglycopenic and autonomic manifestations.2
Neuroglycopenic manifestations are those that result from low levels of glucose in the brain. This includes confusion, agitation, focal neurological deficits, seizures and coma. Focal neurologic deficits may mimic stroke and are the reason all potential stroke patients must have their glucose checked as soon as possible.
The autonomic manifestations occur due to counter-regulatory hormones, such as epinephrine, which are released during a hypoglycemic state. These signs and symptoms include palpitations, tachycardia, anxiety and sweating.
Does Diabetes Make A Heart Attack Feel Different
By Lisa Rapaport, Reuters Health
5 Min Read
– People with diabetes may not always feel classic symptoms like acute chest pain when they have a heart attack, according to a small study that offers a potential explanation for why these episodes are more deadly for diabetics.
Researchers examined data from detailed interviews with 39 adults in the UK who had been diagnosed with diabetes and had also experienced a heart attack. Most of the participants reported feeling some chest pain, but they often said it didnt feel like they expected or that they didnt think it was really a heart attack.
Long term diabetes damages your heart in many ways , but it also damages your nerves, said study co-author Dr. Melvyn Jones of University College London.
So a bit like a diabetic might not feel the stubbing of their toe, they also feel less pain from damaged heart muscle when the blood supply gets cut off, so they dont get the classical crushing chest pain of a heart attack, Jones said by email.
People with diabetes are three times more likely to die from heart disease than the general population and possibly six times more likely to have a heart attack, Jones added.
All patients in the study received care at one of three hospitals in London, and they ranged in age from 40 to 90. Most were male, and roughly half were white.
Many of the participants described heart attack symptoms such as chest pain and discomfort.
SOURCE: bit.ly/2yEDdTr BMJ Open, online September 15, 2017.
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Insulin Questions For Your Doctor
If your doctor prescribes you insulin for your diabetes, it can feel overwhelming. Its important to ask questions so you understand the ins and outs of your treatment. Some questions you may want to ask your doctor include:
What are the details of my prescription?
How do I safely store my insulin?
How does insulin work?
When should I first start taking it?
How do I take my insulin? Do I need any other supplies?
How long does it take to feel the effects?
At what times should I take my insulin? How do I need to plan my meals/snacks around it?
Are there any foods or drinks I cant have while on this medication?
What happens if I forget to take it?
What should I do if my blood sugar levels are too high or too low?
What side effects might I experience?
Hyperglycemia Without Obvious Acidosis
Patients with either Type 1 or Type 2 diabetes can present with hyperglycemia without ketosis or signs of HHS. These patients may be encountered early in the course of their DKA or HHS, and thus havent yet developed acidosis or hyperosmolarity, or they may just be chronically hyperglycemic.
Its also possible for patients to be hyperglycemic for a long period of time yet be unaware. For example, an undiagnosed Type 2 diabetic may develop hyperglycemia, polydipsia and polyuria over several weeks; although their blood glucose level may be well over 200 mg/dL, they may have no other symptoms or laboratory abnormalities.
Once diagnosed, its very important for diabetics to maintain euglycemia , since long-term hyperglycemia can lead to multiple complications including heart attack, stroke, blindness, neuropathy and extremity infections leading to amputations.
Causes: The causes of hyperglycemia without acidosis are the same as the causes with acidosisnamely the five Is.
Signs and symptoms: Whats important to note in hyperglycemia without acidosis is the lack of symptoms. Patients wont have Kussmaul breathing and their breath wont take on a fruity odor. Unless theres a CVA, there should be no neurologic abnormality and patients are generally well-appearing. The only clue may be polydipsia and polyuria, or just nonspecific complaints like weakness and fatigue.
Its important to consider whether the patient has signs or symptoms of an infection.
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What Should My Blood Sugar Level Be
When you’re first diagnosed with diabetes, your diabetes care team;will usually tell you what your blood;sugar level is and what you should aim to get it down to.
You may be advised to use a testing device to monitor your blood sugar level regularly at home.
Or you may have an appointment with a nurse or doctor every few months to see what your average blood sugar level is. This is known as your;HbA1c level.
Target blood;sugar levels differ for everyone, but generally speaking:
- if you monitor yourself at home with a self-testing kit; a normal target is 4 to 7mmol/l before eating and under 8.5 to 9mmol/l 2 hours after a meal
- if your;HbA1c level is;tested every few months; a normal HbA1c target is below 48mmol/mol
The Diabetes UK website has more about;blood sugar levels and testing.
How Can Diabetes Affect My Feet
Over time, diabetes may cause nerve damage, also called diabetic neuropathy, that can cause tingling and pain, and can make you lose feeling in your feet. When you lose feeling in your feet, you may not feel a pebble inside your sock or a blister on your foot, which can lead to cuts and sores. Cuts and sores can become infected.
Diabetes also can lower the amount of blood flow in your feet. Not having enough blood flowing to your legs and feet can make it hard for a sore or an infection to heal. Sometimes, a bad infection never heals. The infection might lead to gangrene.
Gangrene and foot ulcers that do not get better with treatment can lead to an amputation of your toe, foot, or part of your leg.A surgeon may perform an amputation to prevent a bad infection from spreading to the rest of your body, and to save your life. Good foot care is very important to prevent serious infections and gangrene.
Although rare, nerve damage from diabetes can lead to changes in the shape of your feet, such as Charcots foot. Charcots foot may start with redness, warmth, and swelling. Later, bones in your feet and toes can shift or break, which can cause your feet to have an odd shape, such as a rocker bottom.
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What Causes Hypoglycemia
Several things can cause hypoglycemia. Your blood sugar level could be low if you:
- Become more physically active than usual
- Miss a meal
- Change when or how much you normally eat
- Take your insulin or medication in a different amount or at a different time than usual
- Drink alcohol excessively without eating
Obesity And Belly Fat
Being overweight or having obesity;can make it harder to manage your diabetes and raise your risk for many health problems, including heart disease and high blood pressure. If you are overweight, a healthy eating plan;with fewer calories and more physical activity often will lower your blood glucose levels and reduce your need for medicines.
Excess belly fat around your waist, even if you are not overweight, can raise your chances of developing heart disease.
You have excess belly fat if your waist measures
- more than 40 inches and you are a man
- more than 35 inches and you are a woman
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Are There Symptoms Of Hypoglycemia Or Warning Signs Of Insulin Shock
The symptoms of hypoglycemia can be classified as mild or early, moderate, and severe. Mild symptoms include:
Hypoglycemia can also occur overnight while you sleep. Symptoms may include:
- Crying out in your sleep
- Damp pajamas or sheets resulting from perspiration
- Waking tired, irritable, or confused
If you experience any possible signs of mild hypoglycemia, it’s important to check your blood sugar if you can to make sure it isn’t low. If it is, you should treat it quickly or seek emergency care. If you can’t check your blood sugar level for some reason, you should go ahead and treat yourself for low blood sugar if you notice symptoms or seek emergency care. If symptoms are severe or you are unable to help yourself, seek emergency medical attention.
Type 1 & Type 2 Diabetes
The pathophysiology of Type 1 and Type 2 diabetes are actually quite different, although their names suggest two subtypes of the same disease.
Type 1 diabetes, previously called juvenile-onset diabetes, usually begins in childhood and is often familial. In Type 1 diabetes, the body has an absolute lack of insulin.
Type 2 diabetes, previously referred to as adult-onset diabetes, is distinct from Type 1 in that cells in the body become resistant to insulin, but there are still some cells that still produce insulin. Most patients with Type 2 diabetes are older and have comorbid conditions such as obesity and hypertension.1,2 Unfortunately, there are a growing number of obese adolescents who are developing this adult-onset disease relatively early in their lives.
Patients with Type 2 diabetes usually take oral medications vs. insulin for treatment, whereas patients with Type 1 diabetes require insulin replacement therapy. In both types of diabetes, uncontrolled hyperglycemia is damaging to virtually all body tissue.
Severe hypoglycemia usually occurs when glucose is < 50 mg/dL and can lead to rapid deterioration and death if not corrected promptly.
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What Causes Diabetes In The First Place
The causes of diabetes differ depending on what type you have. No matter what type it is, though, issues with insulin are the core of the disease. With type 1 diabetes, its believed that a combination of environmental factors and your genes trigger the body to start attacking insulin-producing cells. With type 2, lifestyle factors and genes contribute to insulin problems. Typically, this starts with insulin resistance, in which your body simply doesnt use insulin as well as it should.
What Causes High Blood Sugar
A variety of things can trigger an increase in blood sugar level in people with diabetes, including:
- missing a dose of your diabetes medicine or taking;an incorrect dose
- overtreating an episode of;low blood sugar
- taking certain medicines, such as;steroids
Occasional episodes of hyperglycaemia can also occur in children and young adults;during growth spurts.
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Diabetes Symptoms In Women
Diabetes may affect you differently based on your sex. Risks tend to be greater and complications more severe in women. For example, women with diabetes have double the increased heart disease risk of men, according to the CDC. Women also have a greater risk of complications from diabetes like blindness, kidney disease, and even depression.
Women with diabetes also are at an increased risk of vaginal yeast infections and urinary tract infections. Keeping your blood sugar levels under control can help reduce this risk.
On top of all that, those who menstruate may find their blood sugar levels are trickier to predict before and after your period thanks to changing hormones. Those hormone changes can cause difficulties in your sex life, tootalk with your doctor if youre concerned about painful sex or low libido.
Finally, diabetes can make it harder to get pregnant and raises your risk of pregnancy complications. Getting your diabetes under control before getting pregnant is ideal, along with regular checkups throughout pregnancy.
Type 1 Diabetes Treatments
The main treatment for type 1 diabetes is insulin. Heres what you need to know.
All people with type 1 diabetes need to take insulin daily. There are a couple of different ways insulin can be delivered to the body:
Injection: This is the most common way to take insulin. To inject the drug, you will use a syringe or pen, usually in your belly, upper arm, thigh, or butt.
Insulin pump: People who need multiple injections per day or are at high risk of ketoacidosis may prefer an insulin pump, which automatically delivers insulin throughout the day through a tiny catheter thats worn on your body.
Insulin inhaler: Some adults with type 1 or 2 diabetes can also use inhaled insulin, a powder you breathe into your lungs through an inhaler.
The Dangers of Too Much Insulin
Accidentally getting too much insulin is dangerousit can cause your blood sugar to plummet and lead to hypoglycemia. This can happen if you accidentally inject the wrong dose at the wrong time, or inject your insulin but then skip your scheduled meal afterward. If youve overdosed on insulin, its important to seek medical care right away. In the most severe cases, an insulin overdose can lead to seizures or coma.
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Causes Of Anxiety For People With Diabetes
People with diabetes may become anxious over a variety of things. These can include monitoring their glucose levels, weight, and diet.
They may also worry about short-term health complications, such as hypoglycemia, as well as long-term effects. People with diabetes are at higher risk for certain health complications, such as heart disease, kidney disease, and stroke. Knowing this can lead to further anxiety.
But keep in mind that the information can also be empowering if it leads to preventative measures and treatments. Learn about other ways one woman with anxiety feels empowered.
There is also some evidence that anxiety may play a role in causing diabetes. One study found that symptoms of anxiety and depression are significant risk factors for developing type 2 diabetes.
Trim Your Toenails Straight Across
Trim your toenails, when needed, after you wash and dry your feet. Using toenail clippers, trim your toenails straight across. Do not cut into the corners of your toenail. Gently smooth each nail with an emery board or nonsharp nail file. Trimming this way helps prevent cutting your skin and keeps the nails from growing into your skin.
Have a foot doctor trim your toenails if
- you cannot see, feel, or reach your feet
- your toenails are thick or yellowed
- your nails curve and grow into the skin
If you want to get a pedicure at a salon, you should bring your own nail tools to prevent getting an infection. You can ask your health care provider what other steps you can take at the salon to prevent infection.
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Learn First Aid For Someone Who Is Having A Diabetic Emergency
1. Give them something sweet to eat or a non-diet drink.
If someone has a diabetic emergency, their blood sugar levels can become too low. This can make them collapse.Giving them something sugary will help raise their blood sugar levels and improve their bodily function. Avoid giving them a diet drink, as it wont have any sugar in it and will not help them.
2. Reassure the person. Most people will gradually improve, but if in doubt, call 999.
If you cant call 999, get someone else to do it.
If A Person Is Unconscious
If a person loses consciousness;because of;severe hypoglycaemia, they need to be put into the;recovery position and given an injection of the hormone glucagon;. The injection will raise their blood glucose level.
The injection should be carried out by a friend or family member who knows what they’re doing, or by a trained healthcare professional.
You should dial 999 to request an ambulance if:
- a glucagon injection kit isn’t available
- there’s nobody available who’s trained to give the injection
- the injection is ineffective after 10 minutes
Never try to put food or drink into the mouth of someone who’s unconscious as;they could choke.
If you’re able to give a glucagon injection and the person regains consciousness, they should;eat some longer-acting carbohydrate food, such as a few biscuits, a cereal bar or a sandwich.
You should continue to monitor the person for signs of recurring symptoms;in case they need to be treated again.
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