How Diabetics Can Protect Their Feet

How People With Diabetes Can Protect Their Feet

Being alert to signs of an infection can prevent far worse

People living with diabetes often suffer nerve damage that numbs their extremities—a dangerous condition that can lead to sores and infection.

Here's how to avoid a serious problem:

Do a regular visual check: Check feet nightly before bed, advises Stephen Kominsky, a podiatric surgeon and diabetic foot expert at Washington Hospital Center in D.C.

Daily exams allow patients to get help before a minor situation becomes catastrophic.

Look for areas of redness, cracks in the skin, corns, ingrown toenails, and other abnormalities.

Since neuropathy can cause numbness in fingertips, run the back of the hand along the tops and bottoms of feet to feel for areas of warmth. If a spot on one foot is hotter than the corresponding spot on the other foot, it may indicate an infection.

Anything suspect warrants a conversation with a doctor, who is likely to examine the affected area and advise immobilization, antibiotics, or surgery depending on the problem's severity.

Change shoes frequently: David Armstrong, a podiatric surgeon and diabetic foot specialist at Rosalind Franklin University Medical Center in North Chicago, recommends changing shoes multiple times daily to limit the damage from rubbing and pinching that one pair can inflict. Patients without pain may not notice blisters caused by their favorite shoes.

See a specialist: If you're at risk for foot complications, ask to be referred to a podiatric medicine specialist. Since general physicians are responsible for treating all of a diabetic patient's ailments, Armstrong says, they're likely to put matters of the feet on the back burner as they focus on managing high blood sugar. Specialists, he says, will ensure that a diabetic's feet aren't neglected, and can educate patients on how to prevent and minimize infections.

Try Tai Chi to prevent diabetes

Summary

Tai Chi and Qigong exercises can relax and de-stress body and mind. According to a small study, doing these ancient Chinese routines can lead to significant alterations in blood chemistry that signal protection against type 2 diabetes.

Introduction

Type 2 diabetes is a growing problem, with the number of cases expected to double by the year 2030, compared to levels in 2000. But there is plenty that can be done to prevent its development. Type 2 diabetes comes on very gradually, over a period of years, and is often preceded by a cluster of risk factors know as metabolic syndrome. Therefore, there is increasing interest in preventing and managing metabolic syndrome - something that can be done by adopting lifestyle changes.

We already know that increasing physical activity is one important chance that can ward off metabolic syndrome and diabetes. But some people are not keen on conventional exercise programs, such as walking or gym visits. Tai Chi and Qigong are traditional forms of Chinese exercise which are likely to have the same health benefits as other forms of moderate physical activity. Previous research has suggested that Tai Chi and Qigong improve indicators of glycemic control, which is important in warding off, or controlling, diabetes. Researchers at the University of Queensland, Australia, have carried out a study to see how these exercises affect indicators of metabolic syndrome in those at risk of diabetes through raised blood glucose.

What was done

A group of eleven participants, three of them male, aged 42 to 65 years, with raised blood glucose, carried out Kai Mai-style Tai Chi and Qigong for a period of 12 weeks. The program consisted of three classes a week with a qualified instructor and practice with a video or DVD for the intervening days. Each session lasted one to one and a half hours.

The researchers measured the main components of metabolic syndrome and found significant improvements in: blood pressure, body mass index and waist circumference. There were also smaller improvements in glycated hemoglobin, a measure of blood glucose control, fasting insulin and insulin resistance. Fasting blood glucose, triglycerides and cholesterol, the three remaining components of metabolic syndrome, did not change. Furthermore, adherence to the program was very good, with participants saying they felt better for it, both physically and psychologically.

What this study means

The researchers note that the participants had previously met Australian physical activity guidelines but this had not controlled their tendency toward metabolic syndrome. Therefore, Tai Chi and Qigong might be able to achieve something that conventional exercise cannot. Particularly noteworthy was the reduction in abdominal obesity and the fall in blood pressure which was more than would normally be noted for the corresponding weight loss. This should be regarded as a pilot study, laying the ground for a larger, controlled, investigation on whether Tai Chi and Qigong provide effective protection against metabolic syndrome and diabetes.

Source

• Liu S Miller YD et al Preliminary study of the effects of Tai Chi and Qigong medical exercise on indicators of metabolic syndrome and glycaemic control in adults with raised blood glucose levels British Journal of Sports Medicine online 2008 doi10.1136.bjsm.2007.043562