Diabetes and foot problems are strongly connected, with diabetic neuropathy being one of the most common disorders. Diabetic neuropathy also referred to as nerve pain, can lead to shooting pains, numbness, and tingling in the feet and legs. The increased blood glucose levels that diabetics experience can damage the nerves over time....Learn more
Diabetes Mellitus is a medical condition in which your blood glucose, or blood sugar, levels are consistently too high. Glucose is needed to supply the body with energy. Diabetes occurs when the body does not make any insulin or does not use enough of it. It is a life-long, chronic health condition that requires ongoing maintenance and monitoring.
Insulin works by sending glucose to your body’s cells, where it is converted into energy. The body also stores glucose in the muscles, fat cells, and liver, to use as energy later. Without insulin, glucose stays in the body. This can lead to high blood sugar, which could damage important organs.
The pancreas produces insulin. However, in individuals with type 1 diabetes, the immune system attacks the pancreas, prohibiting it from producing insulin. In people with type 2 diabetes, the body produces insulin but does not use it properly. Over time, the body may reduce its production of insulin.
Different Types of Diabetes
There are two major types of diabetes, type 1 and type 2. Type 1 diabetes is a genetic condition that often occurs early in life. Type 2 diabetes is the most common type of diabetes and does not usually happen until later in life.
It is also possible to have prediabetes. Prediabetes is a condition in which your blood sugar levels are higher but not high enough for a diabetes diagnosis. Patients with high blood sugar are at an increased risk of eventually developing diabetes.
Gestational diabetes is another type of diabetes that occurs in pregnant women. Women with gestational diabetes did not have diabetes prior to conception. Gestational diabetes also does not guarantee that you will have diabetes following childbirth. Fortunately, gestational diabetes can be managed by working closely with your doctor.
It is important to note that while type 1 is often referred to as juvenile diabetes, this does not mean that children and teens cannot develop type 2 diabetes. The same risk factors, including being overweight and poor dietary habits, can lead to type 2 diabetes in children.
Symptoms of Diabetes
The symptoms of diabetes will vary, depending on the type and severity of the disease. Because diabetes is caused by increased blood sugar, the amount of excess glucose in the body will dictate the severity of the symptoms.
The symptoms of diabetes often include:
- Increased thirst
- Increased urination
- Increased appetite
- Weight loss
- Chronic fatigue
- Ketones in the urine
- Chronic infections or slow-healing wounds
- Blurred vision
- Tingling or numb toes
- Nausea or vomiting Nausea or vomiting
- Chronic irritability
Men may also have additional symptoms, including erectile dysfunction. Women tend to have symptoms like chronic urinary tract yeast infections.
While type 1 and type 2 diabetes symptoms are similar, they tend to present themselves differently. The symptoms of type 1 diabetes tend to show up quickly, usually in a matter of a few weeks. They are also more likely to occur earlier in life. However, it is still possible to develop type 1 diabetes later in life. The symptoms of type 2 diabetes tend to be slower progressing. They may be harder to notice or attributed to old age.
The symptoms of prediabetes might include:
- Increased hunger
- Increased fatigue
- Increase in urination
- Increased thirst
- Dry mouth
- Itchy skin
- Blurred vision
Prediabetes does not always lead to diabetes, but it does increase your risk. Fortunately, you can still make lifestyle changes to reduce your chances of developing type 2 diabetes.
Understanding a Diabetic low Blood Sugar
A diabetic low blood sugar occurs when the body experiences increased blood pressure, lower than normal blood sugar, and is unable to heal itself. This will often present with anxiety, fatigue, and shock, and the individual may eventually become incoherent and even go into a comatose state.
If you feel these symptoms, it is important to test your levels immediately to correct the problem as soon as possible. If you are with someone you suspect is having a diabetic low blood sugar and they lose consciousness or appear incoherent or confused, it is important to call 911 immediately and or provide the person with carbohydrates.
Causes of Diabetes
Diabetes can occur in anyone and affect any age, gender, race, or nationality. Because Type 1 diabetes most often begins during childhood, it is often referred to as juvenile diabetes. Its cause is unknown. It is a type of autoimmune disease in which the body’s immune system fights off the cells in the pancreas, leading to a lack of insulin production. Once the body destroys those cells, the body is unable to produce insulin. People with type 1 diabetes require daily injections of insulin.
Type 2 diabetes, however, most commonly occurs after age 40. It is likely caused by genetics and environmental determinants, like diet and lack of exercise.
Prediabetes, which will sometimes occur before type 2 diabetes, occurs when the cells develop a resistance to the insulin. As a result, the pancreas works harder to compensate, but cannot provide the body with or effectively use the available insulin.
It is also not known what causes gestational diabetes. However, doctors believe that it is due to hormone changes that come with pregnancy. Additionally, women who are already considered overweight before pregnancy or who gain a lot of extra weight during pregnancy are more likely to develop gestational diabetes.
The Risk Factors of Diabetes
While there is no guaranteed way to prevent diabetes, there are a few factors that can put you at an increased risk.
The risk factors for type 1 diabetes include:
- Genetics:Family history of type 1 diabetes and the presence of damaging autoantibodies can increase your risk.
- Environment:Some researchers have identified a connection. between viral infections and type 1 diabetes.
The risk factors for type 2 diabetes include:
- Genetics:A lack of exercise:A lack of exercise and a sedentary lifestyle can increase the odds of developing type 2 diabetes.
- Being overweight: Having a body mass index (BMI) in the “overweight” category increases the risk of type 2 diabetes diabetes up to three times.
- Family history:Genetics can also contribute to the risk of type 2 diabetes.
- Race:Some studies show that certain races, including black, Hispanic, American Indian, and Asian American, have an increased risk.
- Co-occurring medical conditions:Certain medical conditions also can increase the risk of type 2 diabetes, including Polycystic ovary syndrome and high blood pressure.
- Smoking: Smoking increases the chancesof type 2 diabetes by as much as 30-40%.
- High alcohol consumption: High alcohol consumption can decrease the body’s sensitivity to insulin, leading to diabetes.
It is also crucial to be aware of the risk factors of prediabetes.
The risk factors of prediabetes include:
- Being overweight
- Family history
- High-density lipoprotein cholesterol levels
- Frequent high blood pressure readings
- Previous diagnosis of gestational diabetes
- Being diagnosed with certain medical conditions, like polycystic ovary syndrome
- Being 45 years or older
- Lack of exercise
The risk factors of gestational diabetes include:
- Being overweight before pregnancy
- Gaining a lot of weight during pregnancy
- Over the age of 25
- Previous case of gestational diabetes
- Previously given birth to a baby that weighed over 9-pounds
- Diagnosed with polycystic ovary syndrome (PCOS)
Being aware of the risk factors can help those with an increased risk of developing diabetes make the necessary lifestyle changes. Taking early action can reduce your chances of developing diabetes while also reducing the symptoms' severity.
Diabetes is diagnosed by a medical professional. Your visit will include a discussion of your symptoms, as well as a thorough evaluation of your health history. If you or your doctor believes that you have symptoms that could be diabetes, then they will run a few diagnostic tests.
The tests might include:
- Blood tests:A blood test looks at glucose levels in the blood. The fasting plasma glucose (FPG) is one of the tests used to measure glucose levels. Additionally, an A1C blood test may monitor blood sugar levels after being diagnosed with diabetes.
- Oral glucose tolerance test:During this oral test, you will be given a drink with glucose ingredients. A few hours later, your doctor will measure the glucose level in your blood, determining how well your body is producing insulin.
- Blood sugar test:Random blood sugar tests might be done to measure your blood glucose level at random times throughout the day.
Even if you do not have symptoms, your doctor may want to test you for diabetes. Many medical professionals recommend routine screenings of type 2 diabetes included in heart risk testing between the ages of 40-70. This gives them the opportunity to identify the potential warning signs of prediabetes and develop a treatment plan early. Frequent medical checkups during pregnancy are also important to monitor for the occurrence of gestational diabetes.
While it is not possible to test yourself for diabetes, you can test your own blood sugar levels. In fact, this is an important part of monitoring, and managing, diabetes.
Treatments Available for Diabetes
While there is currently no cure for diabetes, there are treatments available to reduce symptoms and help you lead a normal life. Medication management is a common treatment for diabetes. The specific medications will vary, depending on your symptoms and the type of diabetes that you have. There are also different types of insulin. Discussing your needs with your doctor is important when deciding which medications are right for your needs.
Patients with type 1 diabetes do not make any insulin, meaning they will rely on daily insulin injections. They will need to monitor their blood sugar levels to calculate the right amount of insulin. This is often done using a glucometer.
Patients with type 2 diabetes do not always need insulin. It is possible that they can manage their symptoms through dietary changes and frequent exercise. Some may need medications to manage symptoms and others may eventually need insulin.
It is also important to keep in mind, medications may need to be adjusted over time to better accommodate new symptoms or a worsening of the disease.
Medications available for diabetes include:
- Alpha-glucosidase inhibitors:Alpha-glucosidase inhibitors slow down the pace at which the body breaks down sugars and starches.
- Biguanides:Biguanides decrease the amount of glucose produced by the liver.
- DPP -4 inhibitors: DPP-4 inhibitors control blood sugar levels without leading to low blood sugar.
- Being Glucagon-like peptides: Glucagon-like peptides affect how the body produces insulin.
- Meglitinides: Meglitinides stimulate the pancreas to increase the production of insulin in the body.
- SGLT2 inhibitors:SGLT2 inhibitors prevent glucose reabsorption and encourage the increase of glucose excreted into the urine.
- Sulfonylureas: Sulfonylureas stimulate the pancreas to increase insulin.
- Thiazolidinediones: Thiazolidinediones encourage the existing insulin to work better.
Your doctor will help you determine the best combination of medications needed to manage your diabetes.
It is also important to be aware of the potential complications that come with some diabetes treatments. Just as too little insulin in the body can be harmful, so can too much. Too much insulin in the body can lead to hypoglycemia or low blood sugar. Additionally, medications may have side effects associated with them. If you notice any side effects or your current medications do not work as well as they once did, reach out to your doctor as soon as possible.
Risks of Diabetes
An important part of managing your diabetes is understanding the acute and chronic risks and then taking the necessary actions to prevent a worsening of your symptoms.
The acute complications of diabetes can include:
- Hyperglycemic emergency: Hyperglycemic emergencies can include diabetic ketoacidosis (type 1) or hyperglycemic hyperosmolar syndrome (type 2). Diabetic ketoacidosis occurs when there has been a significant loss of insulin and an increase in glucagon. This occurs when an individual with type 1 diabetes is fighting off an infection, or when the patient goes a long period without insulin injections. Hyperglycemic hyperosmolar syndrome occurs when the plasma osmolarity and the plasma glucose levels are increased in patients with type 2 diabetes. It is most often found in senior patients.
- Hypoglycemic emergency: Hypoglycemia occurs when the plasma glucose levels in the blood significantly decrease. This often occurs in patients who have skipped numerous meals, rapidly increased their exercise routines, or significantly increased their alcohol intake. It can also occur with insulin dosing errors.
Long-term complications can develop with diabetes, especially if your blood sugar levels are not managed effectively.
A few common chronic complications can include:
- Cardiovascular disease: Diabetes damages blood vessels and increases the chances of having heart disease or stroke.
- Neuropathy disease: Neuropathy disease occurs when the increase of blood sugar damages the blood vessels, often in the legs. This can lead to numb feet and toes.
- Eye damage: Diabetes can affect the retina's blood vessels, which can lead to vision loss and even blindness.
- Kidney damage: Diabetes impacts the blood vessels that flow waste from the kidneys, leading to kidney damage. Patients may eventually need kidney dialysis or a transplant.
- Skin conditions: Patients with diabetes often have an increased risk of getting chronic skin infections.
- Hearing problems: Diabetes can increase the chances of hearing problems.
- Alzheimer’s Disease: Diabetes can increase the risk of dementia, including Alzheimer’s disease.
- Foot damage: When nerve damage occurs, there is a decrease in blood flow to certain body parts, including the feet. Cuts and lacerations in the feet often heal poorly.
- Mental health conditions/depression: Diabetes, and its many co-occurring medical conditions, can increase the chances of developing depression
Routine medical care and a customized treatment plan are crucial to avoid acute or chronic conditions that commonly occur with diabetes. Once diagnosed with diabetes, it is important to visit with your medical provider frequently. Your doctor will play an important role in stabilizing and then monitoring your blood sugar levels.
Living with Diabetes and Life-Expectancy
With effective management, patients with diabetes can live a fulfilled and normal life. While there is no cure for type 1 or type 2 diabetes, other types of diabetes can be reversible. Prediabetes is preventable, and gestational diabetes will often go away once the baby is born. With treatment, many patients with diabetes can live a good and long life. However, it is a serious medical disease. Even with management, the disease can lead to further complications. That is why it is so important to schedule routine visits with your medical provider so that they can identify any additional concerns as soon as possible. Diabetes is a life-threatening disease that needs to be taken seriously always.
While type 1 diabetes mellitus cannot be prevented, there are ways to prevent a worsening of symptoms. It is also possible to prevent prediabetes or to delay a type 2 diabetes diagnosis. Living a healthy lifestyle is important in the prevention of diabetes symptoms. Maintain a healthy weight, eat a nutritious, well-balanced diet, and manage all medical conditions. Other types of diabetes, like gestational diabetes, can also be prevented by making dietary and exercise changes.
You can prevent certain diabetes conditions or manage your symptoms with the following tips:
- Eat a healthy, well-balanced diet: Certain foods can assist with weight loss and decrease blood glucose levels.
- Eat smaller portions: Smaller portions are important in maintaining weight and blood sugar levels.
- Exercise for a minimum of 30-minutes per day: Exercise can increase overall health and reduce many of the risk factors of diabetes.
- Lose weight, if overweight: Losing excess weight is also important to avoid diabetes complications.
- Avoid consuming empty calories: Empty calories can lead to an increase in weight and can make it difficult to balance your levels.
Diet is a huge factor in controlling diabetes risk and symptoms. While everyone is likely to have different dietary needs to manage their symptoms, there are a few recommended foods, as well as others that should be avoided. Some experts recommended getting half of your daily calories from carbohydrates. However, too many carbs can be a bad thing. You may need to learn how to balance carb intake with insulin needs.
It is also important to remember that not all carbohydrates are the same. Some are better for the body, while others are worse for those with diabetes. Carbs that are unprocessed and non-starch are recommended. Some starch-based carbs are okay, in moderation. If possible, it is best to avoid carbs that are highly processed and refined.
Diabetes patients should also take care with sugars. Natural sugars are better than added sugars. Added sugars are often referred to as dextrose or fructose and should be avoided. It can also be helpful to be aware of the foods that can quickly reduce your blood sugar levels. If you have diabetes, it is important to monitor your levels regularly. If your levels are too high, there are certain foods that you can consume to lower them quickly.
This includes foods like:
- Whole wheat bread
Natural Remedies for Diabetes
In addition to medications, there are natural methods that you can also use to reduce diabetes symptoms. These include:
- Frequent exercise: Frequent exercise is not only important for preventing diabetes, but also in managing it.
- Controlling your weight: Closely monitor your BMI to avoid many of the complications that come with obesity.
- Avoid high consumption of alcohol: High consumption of alcohol can worsen your diabetes symptoms.
- Recognize signs of low blood sugar: This often includes fatigue, dizziness, pounding heart, sweating, pale skin, feeling anxious, ongoing confusion, headaches, poor coordination, difficulty sleeping, irritability, and numbness of the mouth or tongue. Some people may also pass out.
- Foot care: Reduced levels of insulin lead to poor circulation, often causing swelling and numbness of the feet and legs. This means that good foot care is also important when managing diabetes.
- Stress-relief: High amounts of stress can be problematic for those with diabetes. Find ways to relieve stress to decrease your blood sugar levels and blood pressure.
- Increase water-intake: Avoiding dehydration is important when managing blood sugar levels. More water can also help you flush out sugars. This also means increasing hydration when exercising or when outdoors in hot temperatures.
- Increase electrolytes: Increased thirst and urination means you are pushing water out of your body, including electrolytes. Increase your electrolyte intake. You might try Propel or certain foods, like bananas or sweet potatoes. Your doctor might also recommend supplements.
- Increase glutamine: Many patients with diabetes also have low glutamine levels. Discuss with your doctor and consider a supplement.
- Get a good night of sleep: A lack of sufficient or quality sleep can wreak havoc on the body, especially in those with diabetes. Less sleep has been correlated with higher fatty acid levels in the blood.
Natural remedies, in combination with the treatment recommended by your medical provider, is ideal.
Why Foot Care Is Important With Diabetes
Foot problems are common with diabetes. Peripheral diabetic neuropathy and peripheral vascular disease are a few of the possible side effects of diabetes. Both of these conditions cause nerve damage. Nerve damage can lead to numb feet and toes. Other foot problems common with diabetes include athlete’s foot, calluses, blisters, bunions, dry skin, foot ulcers, hammertoes, and ingrown toenails. In addition to the right shoes, good foot care is important when dealing with these side effects.
Well-fitting, comfortable shoes will not only prevent further damage to your feet and toes but can also increase your comfort levels. With so many potential foot problems associated with diabetes, it can also be helpful to choose a shoe that best manages your pain and individual diabetes symptoms.
Features to look for when choosing the right shoes should include:
- Good level: You don’t want shoes that are entirely flat, but you also don’t want ones that have high heels. Foot pressure ideally should be evenly distributed.
- Soft insoles: Soft insoles will help with comfort while also improving the feet’s circulation.
- Wide toe box: Give your toes more room to avoid developing conditions such as hammer toe, bunions, corns, or calluses. It also allows your toes to spread out, which improves your balance and ensures proper alignment of the ankle, knee, hips, and spine.
- Lightweight: Heavy shoes can lead to discomfort and can make it difficult to spend long periods of time on your feet.
- Well-fitted: The right shoes will also increase circulation in the feet, preventing that feeling of numbness and tingling. This means choosing shoes with adjustable laces.
Those with diabetes should also avoid going barefoot and immediately take care of any cuts or infections of the feet. It can even be helpful to regularly see a good podiatrist, who can monitor the condition and health of your feet.
More Diabetes Resources
Fortunately, there are many resources available that will help you learn to manage your diabetes symptoms. Just a few include:
- American Heart Association
- American Diabetes Association
- International Diabetes Federation
- National Kidney Foundation
- National Institute of Diabetes and Digestive and Kidney Diseases
You can also request additional resources from your medical provider. They may refer you to a specialist, depending on your symptoms and condition.