Dr. Alison D. Croughan, DPM
Chances are you or someone you know is Diabetic; one in three North Americans is Diabetic. November is National Diabetes Month and in our practice we have been discussing our “Got Sugar” campaign all month long. What exactly does “Got Sugar” mean? Most of our patients, including the newly diagnosed Diabetics present to our office talking about sugar problems. The old age saying “too much of anything is not a good thing” fits this situation perfectly. We all need sugar in our lives; not speaking in terms of flavor, but function. Blood sugar equates to blood glucose which helps fuel our bodies and the function of our organs, body regulation and natural processes.
Your blood sugar is regulated by insulin which is a hormone (produced in the pancreas) in our bodies that helps break down the sugar, carbohydrates, fruits, and vegetables that we eat. Diabetes is a disease where the body either does not have enough insulin or is not using it properly. What does blood sugar have to do with your feet….everything.
Too much glucose in your body directly affects your eyes, kidneys, stomach, skin, immune function, bladder, blood vessels and nerves. Thickened, painful, dry skin, numbness, tingling, burning, weakness, and cramping are symptoms that usually walk into our office as complications of blood sugar that is not controlled properly. What should your numbers be? A fasting blood glucose level taken after not eating for at least eight hours should be between 95-115mg/dl. If your blood glucose level is measured after eating your numbers should be less than 200mg/dl. If your bloodwork is performed and there is a suspicion that you may be Diabetic than a Hemoglobin A1c will be ordered by your medical doctor. The Hemoglobin A1c measures your blood glucose over a three month period and gives us the best idea of how your body is regulating its levels. The goal here is less than 6%.
If you are one of the many today (young or old) that is diagnosed it is not the end of the world. It is where the conversation begins. Diabetes can be controlled with nutrition, exercise and sometimes medications. Awareness is the best type of medicine and in this specific case, prevention is the best defense.
Insurance companies allow preventative care for Diabetic patients (whether Type 1 or 2) and this includes an evaluation of your circulation, sensation, and muscle strength. A Diabetic Foot evaluation in your Podiatrist’s chair also will include the treatment of painful nails, callouses, corns and in some cases wounds. Over sixty percent of Diabetics will suffer from nerve damage due to increased blood glucose called Diabetic Peripheral Neuropathy. Most Diabetics are hospitalized due to this type of nerve damage which can result in wounds and amputations of digits or limbs.
What To Do If You are Diagnosed with Diabetes
1. See your Primary Care Physician regularly. And follow their advice. They will get you started on the appropriate regimen after running a few tests.
2. See your Podiatrist as soon as possible and then on a regular basis. If you don’t have one, get one. If you don’t know how to find one, call us, we may know one. We’re like fast food places; you can’t turn around and not run into one.
Why would you need to see a Podiatrist? We keep you moving, literally. No one knows feet better than us. No one. We check everything; your circulation, your nails, skin, foot structure, sensations with various instruments, your gait. We treat any and everything of the feet including corns, callouses, heel spurs, foreign bodies, hammertoes, joint problems, fungal nails, flat feet,
3. Exercise (after approval by your MD). Walking is the best way to begin. Inside or outside, it doesn’t matter. Do not make excuses not to go because of the weather or not liking the treadmill or you’re not a ‘gym’ person. Just Do it.
A number of the gyms in the area are also not expensive. And if you think they are, just think of what your monthly bill is at the pharmacy. Some insurances will offer a break on your premiums if you join a gym. And vice versa.
4. Diet. No, I don’t mean go on one, I mean change it. Eat better. You already know what to and what not to eat. No one has to tell you. If you truly do not know, ask someone in the medical field to direct you to a Nutritionist or a Diabetes Educator. We are all here to help you live a better life from sun up to sundown, every day.
It is also important to note that Medicare has a Diabetic Shoe Program which provides a Diabetic patient with a pair of shoes once a year if they meet the qualifications of the program. These shoes are a bit wider and deeper than those found on the shelf in your local department stores and come with inserts specifically made for Diabetics that mold to your feet to provide cushioning and support where you specifically need it. If you yourself are Diabetic or know someone who is and do not see a Podiatrist on a regular basis please contact our office. Each year the statistics increase in regards to obesity and Diabetes and it is our goal to work with our patients to change these numbers and not let sugar slow them down.