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What is diabetes?
Diabetes is a condition where the body can no longer metabolise glucose, leading to a build up of sugar in the blood.
Usually, an organ called the pancreas will produce a hormone called insulin to help break down the glucose into energy. In people with diabetes, the pancreas either produces too little insulin, or none at all, which then causes high blood sugar levels.
There are three main types of Diabetes Mellitus:
- Type 1 or early onset diabetes
- Type 2 or late onset diabetes
- Gestational diabetes which occurs during pregnancy
All three types are essentially the same disease with differing times of onset.
- In Type 1 diabetics, the pancreas stops making insulin, which means it has to be injected regularly during the day to keep the sugar in the blood level.
- In Type 2 diabetics, the pancreas produces less and less insulin over time with the patient often beginning treatment with dietary changes and increased physical activity, progressing to oral medication and then sometimes insulin injections.
- Gestational diabetes occurs during pregnancy when the pancreas doesn’t produce enough insulin – of which twice as much as normal is required.
How is it dangerous?
When the sugar levels in the blood fluctuate significantly throughout the day or reach very high levels, serious and long-term damage is done to the nerve cells and blood vessels in specific areas of the body. The eyes, kidneys and periphery (i.e. feet and hands) are commonly affected.
Pins and needles, sharp intermittent pain, decreased sensation or numbness are all neuropathic symptoms and suggest damage to the nerves. Alongside the neuropathy there is usually signs of poor circulation such as cold, pale skin, which heals slowly when wounded.
Both of these things mean that a person with diabetes may reach a point where they might stand on a nail and not be able to feel it. They then develop an infection and ulceration at the wound site due to the poor circulation causing inability of the skin to heal and fight infection. These ulcers often take months to heal. Or if the damage is extensive and infection recurrent, amputation is often required, sometimes of the whole lower leg.
Why is podiatry important?
A podiatrist can help by monitoring the health of the feet by checking the sensation and circulation regularly. They are able to reduce areas of thick skin and corns which, being areas of pressure, are sites of possible ulceration. They can also help by trimming the nails correctly to prevent ingrown toenails and other nail infections.
All people with diabetes should see a podiatrist at least twice a year. Some diabetics that are considered a moderate or high risk of developing complications (such as the elderly, those with poor blood glucose control or those with Type 1) will need to see a podiatrist much more regularly. In fact, it has been shown that those diabetics that seek regular podiatric management can significantly reduce their risk of severe foot complications including long-term ulceration and amputation.
If you would like to know more, the national diabetes website has an amazing amount of information about diabetes prevention and treatment including low fat recipes, exercise programs and new research. The Baker IDI Heart and Diabetes Institute website is also a great source of information, especially for healthy eating.
Don’t forget, foot health is the key to a happy life!
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