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How Do Diabetics Care About Their Feet And Why?

As a diabetic you must have read or heard from your physician that it’s very important to daily check your feet, and that your feet are more prone to trauma, infections and even abcess format than every body else, but why is your feet at danger of these problems, and how can you prevent them early?

Your feet is susceptible to the previously mentioned problems because of the following: 

A. Decrease or loss of sensation:
Diabetes can affect nerves, especially the peripheral nerves meaning the nerves that supply the hands and feet to give them the ability of sensation, once these nerves are affected sensation will gradually decrease in these areas especially the feet so if you had a minor trauma like a pin prick or a small wound you may not feel them, and they may get worse. 
And the best way to prevent your nerves from being damaged by diabetes is to keep your blood sugar levels within the normal range. 

B. High liability for infection :
Excess sugar in blood makes it a very good environment for bacteria to attack and live in there, so again, controlling blood sugar is a vital step for decreasing the degree of infection.

C. Immune system dysfunction
When you have an injury somewhere, for example your foot, some of the first cells that come to act there are the white blood cells, which arrive at the wound area to fight against foreign bodies, and prevent wound infection, but in uncontrolled diabetes mellitus this process is slower and is much inhibited by excess blood sugar.

All these factors contribute to the incidence of wound infections,  which are sometimes highly resistant to antibiotics, and they heal very slowly or even get worst. In the US 50% of foot amputations are due to diabetes.

So, how to care about your feet?

1. Inspect your foot daily for the presence of any redness, punctures or pus,  you can ask someone to help you, or use a mirror.

2. Wear comfortable shoes :
Wear comfortable shoes that are exactly your size, because smaller and lager shoes can cause many troubles due to repeated friction which may cause ulcerations.
Check your shoe before wearing and make sure they are completely empty.
Also you need to make  to wear clean and comfortable socks.

3. Cut your nails with caution : 
Cut your nails carefully, trying not to cut too much, and you may also ask someone to help you.

4. Clean your feet daily  :
Make sure to use warm water, not cold or hot, make sure to test the temperature of the water as it may be hot and cause injury to you without you realizing  that.

5. Let the doctor check your feet for you :
It’s good to go every few months for a feet check which is better to be done by a surgeon.

At the end we must insist on the fact that the best way to prevent feet problems from the start is by controlling your blood sugar by following an appropriate diet, a healthy lifestyle, and taking your medications as prescribed by your doctor.

How To Know If You're Having Diabetic Ketoacidosis? And What To Do Then?

The primary source of energy for the body is the glucose, which is generated from carbohydrates break down, and glucose cannot be used by the cell except in the presence of sufficient amounts of insulin, but in case of Diabetes where insulin is insufficient (type l diabetes), or where cells don’t respond to insulin (type ll diabetes), glucose sometimes cannot be utilized properly, so the body searches for a different fuel to get energy from, and that fuel is fats.
The problem with fat utilization Is that it produces a substance called ketones, these ketones when become in excess they can cause multiple problems , some of them is to make the blood acidic and the patient dehydrated and this may lead to many complications.
So. Diabetic ketoacidosis, or ketosis  a medical emergency, that should be dealt with very wisely. In this article we are going to know how to recognize this condition  and how to act if it happened to us or to someone we know.
Symptoms of diabetic ketosis:
1. Excessive urination.
2. Extreme thirst. 
3. Abdominal pain.
4. Nausea and vomiting.
5. Deep and rapid breathing.
6. fruity or acetone like breath smell.
7. Decreased level of consciousness.

So, what are the causes of Diabetic ketosis?
A. Emotional or physical stress.
B. Illness , especially infections like respiratory or urinary tract infections.
C. Missing medication doses.
D. Drugs or alcohol use 

Complications of diabetic ketoacidosis:
Ketoacidosis can lead to a variety of problems including :
- Brain oedema (brain swelling) and this cam be mainly due to the imbalance in blood composition, as it may become very acidic.
- Kidney failure: severe dehydration due to excessive urination and vomiting may lead to renal failure in few cases if not managed promptly.
- Diabetic coma.
- Pulmonary oedema (excess fluids in the lungs). 

How to deal with Diabetic Ketosis at home :-
1. Measure your blood sugar level: 
If you have any of the above symptoms and you suspect that you may have ketosis while you have your kits at home then measure your blood sugar immediately.
2. If your blood glucose was high and you have the kits for measuring blood ketones then it will really help you to measure the levels of ketones in your urine, if it’s  below 0.6 mmol/L then it’s normal and it is unlikely that you have DKA. 
If the level is between 0.6 to 1.5 mmol/L this may indicate a small degree of ketosis and you should check again 2 hours later.
If it’s more than 2 mmol/L then there’s a high risk that you may enter a state of ketosis, and you should contact your doctor or seek medical help at hospital.
3. Contact your doctor and tell him what you feel, he’ll probably advice you to go to the hospital, if he thought that you should go then go immediately.

At hospital they might admit you for a while, rehydrate your body by giving you intravenous fluids and measure your urine output to monitor the condition of your kidney.
They will also give you insulin doses monitored to decrease blood glucose and ketone levels.

Hypoglycemia and how to deal with it

Hypo glycaemia ( low blood sugar level), is 
one of the most common and serious complications of Diabetes, and this condition can occur due to many causes, like :
1. Delaying your meal, having your meal late is a very common cause of hypoglycemia, and that’s why it’s better to be very restrict about your meal time, and to carry your lunch with you especially when you’re having a long day at work or at university.

2. Having an overdose of your diabetic medications, your medications which are prescribed by your doctor, act in controlling your blood sugar level by lowering it to the normal if you’re taking it within the recommended doses, but if someday you accidentally had a larger dose than what you’re supposed to, this may lower your blood sugar level to the degree of hypoglycemia.

3. Having smaller meals than you should, Eating enough amount of food in your meal is essential to have a constant level of blood sugar, and having a meal rich in fibers will make digestion more slow which will help in keeping that level of sugar more stable

4. Doing extreme exercise that requires an unusually high effort for you, this might actually consume energy by consuming glucose which means decreasing blood sugar level and this may lead to hypoglycemia.

5. Having a disease that consumes body energy like diarrhea or vomiting, leading to a massive increase in blood sugar.

What are the symptoms of low blood sugar?

Symptoms vary from a patient to another, and they are not specific to hypoglycemia, but the most common symptoms of them are hunger, dizziness, anxiousness, Sweating, tremors or shaking, visual disturbances, headache, and palpitations.
These symptoms are considered initial symptoms, and if not treated early the patient can enter a state of fainting and complete loss of consciousness or seizures. 
As we mentioned, symptoms are not constant, and that’s why you should regularly monitor your blood glucose levels and compare the symptoms, to know what kind of symptoms you have during a hypoglycemic state, and it is also preferred to teach these things to your family si they can act quickly and help you in case of an emergency. 

What to do when you have hypoglycemia?
Hypoglycemia is a serious condition, but luckily it can be easily managed by following the following steps:

A. Measure your blood sugar levels as quick as you can hypo glycaemia is considered as having a blood glucose level lower than 70 mg/dL, or 3.9 millimoles per liter (mmol/L).

B. Immediately take a few discs of readily soluble sugar or hard sugar bars , a candy bar, or a sweetened juice or drink as a source of sugar and the amounts should be as following :
Five to six pieces of hard candy. 
Four ounces (120 milliliters) of fruit juice or regular — not diet — soda
One tablespoon (15 milliliters) of sugar, jelly or honey. 
Four glucose tablets (available without a prescription at most pharmacies)
A serving of glucose gel (read the label for amount)
C. Stop doing any physical activity, and take some rest, and if you’re driving your car it’s better to stop immediately.

D. Measure your blood sugar level 20 minutes later, and if it’s still low you may have another source of sugar. 

E. If this case recurred for many times, look for the precepitating factors and  treat them (i.e. Check your meal timing and amount, check if you have any other disease that may cause hypoglycemia, recheck your doses and consult your physician to know id you should change the dose or the type of your diabetic medications.

Seven Things A Diabetic Patient Should Regularly Check

Being a diabetic patient doesn’t mean that you should be worried about your health and what could be happened to your body because of your disease as a complication of it all day long, no, a diabetic patient can actually lead a very normal life, but there are certain things that he should pay attention for.
In this topic we are going to mention some of the most important things that a diabetic patient should regularly check so that he can be able to know his current condition and so he’ll feel more relaxed.

1. Watch what you eat : 
eating can be something that you really care about as a diabetic, and you should, because uncontrolled diabetes which can occur due to uncontrolled eating can be a major cause for diabetes complications, like : heart diseases, kidney diseases, and eye problems.
There are some foods that should be avoided by diabetics to maintain a healthy level of blood sugar, like :
Sugar sweetened beverages, white bread and pasta, honey and maple syrup, and French fries.

2. Check your feet daily :
Diabetes can decrease the sense of feeling in your feet as it affects the peripheral nerves in your limbs, so you may not feel an injury that may have happened to your foot like a wound due to a pin brick for an example, and this isn’t the only problem, another problem is that wounds in diabetics doesn’t heal as in normal people, because high blood sugar delays wound healing, and as a result a small wound will take a very long time to heal, and it may deteriorate and become more big and infected.

3. Check your blood sugar levels :
Checking your blood sugar levels daily will help you to know the situation of your disease, and it will also help you regulate what and when to take your medications, this will help you to avoid complications and it will let you know when to meet your doctor.

4. Exercise Regularly :
Heart diseases are one of the most important complications of Diabetes, and Exercising regularly can prevent these diseases.
Simple regular exercises can be of a great help to your health, even simple daily walking in your street for at least 15 minutes will have a great positive effect on your general health, and on your heart health.

5. Take a small snack with you :
It’s well known that hypoglycemia ( low blood sugar level) is a very common complication of Diabetes that may happen at any time, and if not detected and managed early, it can cause fainting, that’s why taking a small snack, like dried fruits can help you rise blood sugar as soon as you feel the initial symptoms of hypoglycemia.
These initial symptoms include Dizziness, Sweating, Hunger, Irritability or moodiness, Anxiety or nervousness and Headache.

6. Have your medications in time :
As we previously mentioned, uncontrolled diabetes is one of the worst problems about the disease, because it can lead to diabetes complications even in young ages.
Good dietary control, and taking your medications in time and the way that they were prescribed by your doctor can greatly help in controlling blood sugar levels and thus prevent the appearance of complications.

7. Check your vision annually:
Retinal diseases can be a major concern to diabetics, as visual deterioration usually occurs gradually in many years, and checking with your ophthalmologist every year will be very helpful to the earl detection and management of these problems.

Sticking to these habits will help you be more comfortable with your disease and to have a better control on it. It will also be better to decrease stress and relax more often, as stress elevates cortisol hormone level and this will lead to subsequent increase in blood sugar levels.