Ongoing Management of Diabetes

What happens to a person if they stop managing diabetes? If a person were to leave their diabetes untreated, many problems would occur in the body. Diabetic neuropathy or nerve damage will most likely occur over time. This condition is very dangerous as it lessens a diabetic’s sensitivity in their legs, feet, and hands putting them in serious danger. They become less sensitive to temperature and pain. If diabetes is left untreated a person would develop diabetic retinotherapy where the retina of their eye becomes damaged. This is a result of having too much blood glucose in the body and can lead to blindness. Kidney, heart disease and stroke are also very real possibilities if a diabetic receives no treatment for diabetes. These are obviously very serious conditions and can be life threatening.

People who have been diagnosed with diabetes know they would never chance these health conditions happening to them. However, when some folks get their diabetes under control they become complacent with their health. There is no room for complacency with managing diabetes. Yes, you can live a long healthy life, but there are many things you have to do each and every day to stay on top of your health and keep from ever falling ill.

Footcare for Diabetics

Diabetics run a greater than average risk of developing foot problems, making proper care an important part of managing the condition. Some of the effects of the disease mean that complications are more likely unless appropriate precautions are taken.

However, with a little regular attention many foot problems can be addressed if not completely eliminated.

Diabetes can cause nerve damage leading to a reduction of feeling in the feet, this is known as peripheral neuropathy and it is possible to have this without being aware. The condition means that otherwise minor ailments, such as cuts and sores can develop into serious problems and even lead to amputation. For this reason, a regular regime of foot care is advised, especially for older sufferers, who can cut their risk of complication by more than half.

Problems are most likely to occur in sufferers with kidney and eye complications, although all diabetics run a higher than average risk, making it vitally important to check for the warning signs. Healthcare in this area has improved greatly in recent years and clinics have established preventative care programs reducing the rate of amputation by more than 80%.

Follow the simple checklist below to minimize your chances of any trouble:

1. Look out for any unusual redness, changes in skin color or swelling on the feet and lower legs.
2. Have calluses, bunions and fungal infections promptly treated by professionals.
3. Wash your feet thoroughly on a daily basis.
4. Dry carefully, paying particular attention between the toes and use medicated talcum powder.
5. Monitor and control your glucose levels.
6. Buy comfortable, well fitting shoes with cushioned soles and always wear socks.
7. Keep toenails in good order and file regularly.
8. Have your feet examined by your doctor at every visit.
9. Monitor the sensation in your feet regularly.

Diabetes – Effects on nervous system. (diabetic neuropathy)

Diabetes affects both brain and nerves in the all parts of the body.

BRAIN:

It is generally manifested as mental confusion, stupor, restlessness and coma. Usually presented as ketoacidosis or hyperosmolar nonketotic coma. Patient is dehydrated and fluid should be replaced slowly, otherwise cerebral edema develops.

Treatment mainly focuses on correcting high glucose levels, electrolytes, blood chemistry correction and fluid therapy.

PERIPHERAL NEUROPATHY:

Once caused it is not reversible. Atleast 50% of diabetics after 25 years of history are having peripheral neuropathy. Manifested in different clinical settings.

1. Distal symmetric polyneuropathy
2. Autonomic neuropathy
3. Focal or multifocal asymmetric neuropathy

What causes neuropathy?

* Hyperglycemia in nerves shunted through different polyol pathway. This leads to production of sorbitol and fructose in the nerves. These substances cause impaired axonal transport and nerve conduction. Also there will be damage to nerve fibers.

* The small capillaries in the nerves are damaged with thickening of basement membrane, formation of AGEs leading to thickening of the vessel wall. This leads to ischemia of nerves and damage.

1. Distal symmetric polyneuropathy:

Most common form affects both legs and hands like ‘Glove and stocking’ pattern of functional loss. Sensory involvement causes loss of sensations like touch, pain and temperature. Motor involvement causes loss of nerve supply to small muscles and causes clawing of toes and hands. Loss of pain sensations and altered pressures on foot because of muscle atrophy leads to callus formation and ulcers. Ulcers take long time to heal because of impaired wound healing in diabetes and immune mechanism.

2. Autonomic neuropathy:

Presentations may include orthostatic hypotension, resting tachycardia, loss of sweating, inability to empty the bladder, altered bowel habits, small pupils sluggishly reactive to light and impotence. There is no effective cure for these, but only symptomatic treatment towards the cause.

3. Focal or multifocal asymmetric neuropathy:

Sometimes single or multiple nerves are affected giving asymmetric distribution of peripheral neuropathy. These usually develop suddenly and recovery will be complete in most of the cases. These are attributed to vascular ischemia and trauma to nerve. Examples for this type of neuropathy are cranial and femoral nerve involvement. If third cranial nerve is involved, ptosis, diplopia may occur. Treatment is directed to diabetic control and analgesia.

How to take care of your feet and hands?

* Check your hands and feet for any cuts, ulcers. If you see any, clean them properly and put some antibiotic.

* Use well fitted shoes. Tight ones may damage your skin giving blisters and ulcers.

* Regular exercise and physiotherapy to keep the muscles in action. This way you can also improve your muscle function.

* Good nutritious diet with well controlled blood glucose levels.

* Quit smoking. Smoking damages the blood vessels and leads to ischemia of the hands and feet. This further aggravate the pain of diabetic neuropathy and delays the healing.