Diabetes Self-Management

The high blood sugar levels common in diabetes can lead to two types of damage that spell trouble for the feet:

• blood vessel damage: Blood vessel damage can reduce blood flow to the feet, which can make the feet more vulnerable to ulcers and infection and make wounds slower to heal.
• nerve damage (peripheral neuropathy): The nerves that carry messages from the feet to the brain and vice versa can be compromised by too much sugar in the blood. When that circuit is interrupted by nerve damage, your feet might have a painful burning or tingling sensation, or they might be numb, making you unable to sense pain from a cut or blister. That may sound like a good thing until you realize that feeling pain is what tells you that problems are afoot.

So say you wear new shoes, and they rub a blister onto your heel. With nerve damage, you can’t feel the blister so you might never know that the blister is there at all. A simple blister that goes undetected can grow into a deep sore, known as an ulcer. An ulcer that becomes infected is a serious condition. Add reduced blood circulation to the mix, and the healing process slows down. Ulcers and other foot injuries can affect mobility, changing a person's weight distribution on their feet, boosting their risk of additional blisters and calluses. Infections can even advance to the point of gangrene, which is tissue death. Amputation may be needed to prevent gangrene from spreading to other parts of the body. This is why people with diabetes have a higher risk of foot or leg amputation.

What can you do to care for your feet?

Foot care actually starts far from your feet. Undoubtedly, the first and best strategy is to manage your blood glucose levels. Keep your levels on target as often as possible, and you will minimize and even prevent damage to your nerves and blood vessels. And smokers with diabetes, be advised: smoking also decreases blood flow to your feet and can increase your risk of requiring an amputation.

Beyond blood sugar management and stopping smoking, there are several things you can do directly to manage your feet:

• Check all sides of your feet daily – tops, bottoms, toes, in between the toes, on the heels. You're searching for any sign of potential trouble: ingrown toenails, cuts, cracking or dry skin, calluses, blisters, sores, corns, or warts. Use a mirror to get a better view of the bottoms of your feet.
• If you notice any changes or troubling marks, consult your physician, primary health care provider, or foot specialist. Do not attempt to self-treat injuries or infections – even something as seemingly minor as an ingrown toenail.
• Wash your feet daily in warm water using a mild soap. This means wash, not soak. Soaking can actually dry the skin, increasing your risk of foot infection. And use warm water, not hot or cold. Nerve damage may make it hard to tell how hot or cold the water is, so test the temperature with your hand or your elbow.
• Dry your feet well. Be gentle. Use a soft towel to pat them dry and don't forget between your toes. Avoid scrubbing or rubbing the skin.
• Moisturize your feet – your heels and soles – in the morning and at bedtime. Dry skin can crack and leave you susceptible to infection. Excess moisture also welcomes germs, so don't use too much lotion, and never apply it between the toes.
• Before slipping your feet into your well-fitting, supportive shoes, look into each shoe and use your hand to feel around inside. You never know when a stray pebble, thumbtack, or paperclip could be awaiting your foot.
• Put your feet up when sitting. Don't cross your legs for long periods of time. Wiggling your toes and moving your ankles when sitting can help to maintain a good blood flow.
• Your health care team knows that foot care is a priority for people with diabetes. Beyond your daily foot check, you should have your feet looked at by your health care team at least once a year. Don't be foot-shy. If you have a question or concern, speak up.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Diabetes-Self-Management

People with diabetes are more at risk of diseases of the mouth than people without diabetes. If you have diabetes, it's important to keep your blood sugar levels within target and to maintain good oral care to reduce your risk of mouth problems such as gingivitis. Common oral health problems in people with diabetes include cavities, gum disease, fungal infections, and taste impairment.

How does diabetes affect oral health?

High blood sugar levels can cause you to produce less saliva and have more salivary sugar, which can cause dry mouth (xerostomia). Diabetes also increases your chance of getting cavities, ulcers, and fungal infections. Additionally, people with diabetes have a lower resistance to infection and slower wound healing. Put together, people with poorly managed diabetes are more at risk of oral diseases (e.g., oral infection, gum disease).

What can you do to maintain good oral health?

People with diabetes who maintain good oral health and have good blood sugar control generally have the same risk for severe gum disease as people without diabetes. Take these steps to help maintain good oral health:

• Keep your blood sugar levels under control. Take your medications as prescribed by your doctor and monitor your blood sugar levels regularly. Other ways to keep your blood sugar levels under control include eating a healthy diet, exercising regularly, and maintaining a healthy weight. Maintaining good blood sugar levels may help to reduce your risk of oral health problems.
• Help prevent plaque formation and acid (from foods and drink) from attacking your teeth: Brush your teeth at least twice a day with a fluoride toothpaste and a soft toothbrush. If you can, also brush after each meal and snack. Don’t forget to floss daily.
• Get regular check-ups from your dentist (and let your dentist know you have diabetes!). For people with diabetes and gum disease, dentists may recommended dental visits every 3 months. Follow the schedule your dentist suggests. At the appointment, let your dentist know of any changes in your health status and any symptoms you may have (e.g., sores, mouth pain, swelling, bleeding, or areas of redness in the mouth).
• Get treatment for oral infections immediately.
• Don’t smoke. When you have diabetes, you are already at a higher risk for oral problems. Smoking and other ways of using tobacco can further contribute to gum disease. Tobacco products damage the gum tissues by cutting off their oxygen supply and making them more prone to gum infection.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Diabetes-Self-Management

At some point in their lives, about 1 in 3 people with diabetes will develop a skin disorder related to their diabetes. Just a few factors take the blame for most diabetes-related skin problems, including high blood glucose levels causing dry skin, nerve damage, poor circulation due to damaged blood vessels, and reactions to the pokes and jabs from insulin injections or home blood glucose testing.

How does diabetes affect skin health?

Nerve damage interrupts the messages your skin sends when it's in danger from infection, injury, or excessive dryness. It also decreases your body's sweat output, which can leave skin overly dry. Damaged blood vessels cause poor circulation, which deprives the skin of oxygen and can lead to itching, ulcers, infections, and wounds that heal slowly.

When blood glucose levels are high, the body tries to flush out some of the glucose through the urine, causing your body to lose water. This causes your skin to lose precious fluids that it needs to keep the skin healthy and moisturized. Skin that becomes very dry can crack and peel and leave a person vulnerable to bacterial and fungal infections that may be severe and slow to heal.

Regular blood glucose tests require tiny pin-pricks to the skin, and the skin can become irritated and painful. Remember to switch which finger you use regularly.

Sometimes fatty deposits (lipohypertrophy) can develop beneath the skin in the spots where insulin is repeatedly injected, making the skin appear lumpy or indented. To avoid these deposits, switch up where you are injecting with each injection – this is called rotating injection sites.

What can you do to maintain healthy skin?

• Control your blood glucose level. It's not always easy, but maintaining a healthy blood glucose level could work wonders for your skin.

• Wash and dry. Keep your skin clean by washing in warm water and using mild, unscented soap. Gently pat-dry your skin, paying extra attention to places where water can hide – under arms, under breasts, between legs, or between toes. Make a part of your shower routine quick "skin scans" looking for irritation, redness, cuts, and sores. Avoid using hot water (use warm instead) and limit shower or bath time to 10 to 15 minutes, as hot water and long exposure can strip the skin of oils and make skin even drier.

• Moisturize. Massage lotion or moisturizer into your skin after bathing. Don't skimp on dry-patch-prone spots like elbows, knees, and heels. However, avoid applying in areas between the toes or in skin folds, where extra moisture can cause a skin breakdown.

• Stay hydrated. This is good skin care advice for everyone! Drink lots of fluids to keep your skin supple.

• Dress the part. Wear breathable materials, especially on areas prone to moisture.

• Humidify your home. During the winter months, use a humidifier to moisten the air dried out by radiators and forced heating.

• Protect your skin from the sun. While this is true for everyone, wearing sunscreen with at least an SPF of 15 every day will protect your skin from the burning and blistering that can lead to dangerous infections.
• Talk to your doctor. Let your health care team know if your skin problem does not resolve. Also, see the doctor immediately if you have any skin infection, cuts, or burns.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Diabetes-Self-Management

As with any medical diagnosis, receiving a diagnosis of diabetes can trigger a wide-ranging torrent of emotions: nearly-numb denial, frustration, anger and resentment, fear and confusion, depression and grief.

Diabetes requires a great deal of day-to-day commitment. Diabetes demands lifestyle modifications and steady, consistent discipline. And for people with the condition, so much of the required care and treatment falls into their own hands. Managing diabetes takes up time in your day, but it shouldn't take up that much space in your mind. So how does one stay positive in the face of such an ongoing challenge to one's physical and mental well-being?

• Accept diabetes as a part of your life. Denial is common. It's normal – at first. But ignoring diabetes will only make it worse. While it may sound impossible, make it a part of your life that you have to accept unconditionally. When you accept that you have to live with diabetes, you can get on with the business of living well with it.
• Know diabetes well. Part of learning to accept your diagnosis is learning about the disease itself. Ask your health care providers why you developed diabetes so you can understand the factors that brought it on. Get to know the potential complications and the actual risks of developing them. By arming yourself with knowledge, you can disarm the feelings of panic and confusion you might feel.
• Make a realistic plan. You will need to have a solid plan for managing your condition – but you will also have to be flexible enough to know when some part of the plan is not working well. Work with a diabetes educator to create a realistic plan that matches your lifestyle, your personality, and your body's specific needs.
• Create a contingency plan. Just like you need an everyday plan for managing diabetes, you need a plan in place in case something goes awry. Do you know what to do if your blood sugar dips too low or soars too high? What will you do if a medication causes unpleasant side effects? Where will you turn if you feel overwhelmed by the responsibility of it all? Think ahead to anticipate potential situations and work with your health care team to set up a backup plan.
• Have a support network in place. Reach out to friends and family when you need support. Forge friendships with other people living with diabetes. Clue in your boss and co-workers on your condition so they can lend a hand or simply understand when you need a moment or a day off.
• Master the numbers game. The lives of some people with diabetes can become a numbers game: blood glucose readings, A1C, carb counting, weigh-ins, blood pressure, and cholesterol checks. Keep in mind that the numbers will shift and change over time, and that you will have good and bad days (or weeks, or months!). Look at the numbers as measures of health factors – not as measures of your self-esteem.
• Know the signs of depression. About 15% of people with diabetes experience depressive symptoms. Depression can lead to poor self-management and ultimately a higher risk of complications. Watch for signs of depression, including sadness, changes in appetite and sleep patterns, nervousness, and loss of energy and concentration.
• Catch yourself being good. It's easy to get into a negative spiral and only notice the mistakes you make. Guilt over a skipped workout, remorse for an overindulgence, letting your numbers slip into the danger zone – seeing only the negatives can sabotage your better efforts. Turn guilt on its head and catch yourself being good! Reward yourself for small victories: establishing a good habit, keeping your blood sugar in range, getting out to exercise, or making a healthier food choice. Give yourself a gold star – and maybe buy yourself new clothes or electronics when you get enough stars.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Diabetes-Self-Management