Diabetics can help control health complications

Diabetics can help control health complications

Many diabetic amputations could have been prevented with patient education and professional care. Here are some ways to prevent complications and amputations.

Proper blood glucose control. People with diabetes in good control of their blood glucose have fewer problems then people with diabetes in poor control. High glucose damages the nervous system, delays wound healing and makes it harder for the immune system to fight off infections. Normal range for blood glucose levels is 80 to 120 mg/dl, although if below 140 mg/dl is considered acceptable. The best way to have good control is through regular exercise and proper nutrition. People with diabetes should eat three well-balanced meals daily with possible vitamin supplementation. An internist may prescribe oral hypoglycemic medication, or insulin therapy, to help maintain proper control.

Stop Smoking. Tobacco products cause vasoconstriction of the blood vessels along with other medical complications such as peripheral vascular disease, cardiovascular disease, high blood pressure, atherosclerosis and lung disease. In my opinion, smoking and infection are the number one causes of amputations in people with diabetes.

Daily inspection of legs and feet. Prevention of minor and major problems can be avoided through daily inspection of the lower extremities. Look for abnormalities and signs of infection which are: fever, swollen lymph nodes, increased warmth, increased pain, red streaking up the foot and leg. Look for drainage, pus, odor, openings of the skin, ulcers, and any sign of discoloration of the toes, feet or legs. Corns, calluses, ingrown toenails, and blisters should be cared for by a professional on a routine basis. Look for black, red, blue, or purple areas, or any other abnormal discoloration of the lower extremities. See a doctor immediately if any abnormalities are observed.

Proper shoe gear. People with diabetes need proper-fitting shoes to avoid excessive pressure areas and complications. Improper shoe gear causes multiple problems like ulcers, blisters, and corns. Do not wear shoes that are too tight, too loose, or too narrow. Break new shoes in slowly and check to see if there are any areas of pressure. Change into different shoes during the day this helps alleviate constant pressure that develops from only wearing one pair of shoes. Shoe gear includes custom insoles, extra depth shoes, and custom molded shoes.

See a Podiatrist. People with diabetes should have routine foot care every six to eight weeks. It is easier to prevent a problem from occurring than to treat a problem that has been neglected.

See an internist. Blood glucose control can be regulated by a Physician. People with diabetes should see an internist every six months. More frequent visits may be necessary.

Good Nutrition. Poor nutrition delays wound healing. Avoid fatty foods, sweets, and decrease salt intake. By eating three good nutritious meals a day and exercising regularly, people with diabetes can control blood glucose levels and live a healthier life. Vitamin supplementation is usually beneficial.

Regular eye examinations. Ophthalmologists help prevent vision problems and blindness. Blurry vision, cataracts, and glaucoma can be treated with regular eye examinations.

Other Specialists needed. Urologists, vascular surgeons, nutritionists, infection disease specialists, cardiologists, and family practitioners are often necessary.

Control obesity. Excess weight requires more demand for insulin and cause increase blood glucose levels. Obesity also puts more stress on the cardiovascular system.

A healthier lifestyle. Decrease high blood pressure, heart disease, and high cholesterol through proper diet, cessation of smoking, proper medication, and exercise. Walking two to three miles a day will strengthen the cardiovascular system and develop muscular strength.

Healing wounds. Pressure, infection, vascular problems, nutritional factors, medically compromised patient, hyperglycemia, improper treatment, edema or swelling, smoking, noncompliance, age, tired tissue, malignancy degeneration, location of the wound, and ineffective white blood cells are reasons why wounds delay in healing or will not heal.

Peripheral neuropathy. Most people with diabetes have some form of decreased sensation or neuropathy in there lower extremities. A loss of feeling makes people with diabetes more susceptible to pressure ulcers and other complications. Treatment for puncture wounds is often delayed, causing severe problems. Proper shoe gear helps people with diabetes and peripheral neuropathy avoid unforeseen complications.

American Diabetes Association. To find out how to help fight against diabetes, contact the American Diabetes Association Utah Affiliate, 250 East 300 South Suite 110, Salt Lake City, Utah 84111 or call 801-363-3024 or the American Diabetes Association at 1-800-676-4065. Visit the American Diabetes Association website at www.diabetes.org

Dr. Brian Richman wrote this newspaper article for the Ogden Standard ( Lakeside Review ) on July 25, 1995 for preventing diabetic complications. Dr. Richman specializes in diabetic foot care, foot and ankle surgery, biomechanics, sports medicine, pediatric and elderly foot care, and general podiatric conditions. He practices at Layton and Logan, Utah. Dr. Richman's Layton office phone # 1-801-825-4709. His Logan office phone # 1-435-752-1038.