Dr. K. Srinivasan

Our body cells are responsible for the essential breakdown of food into energy, as it is vital for our body functioning. Cells break down food into glucose and then convert glucose into energy through insulin, which is an important hormone in the body. Diabetes is associated with the inappropriate functioning of insulin and can be classified into two types: Type I and Type 2 Diabetes. In type I Diabetes, the body does not make enough insulin. In type 2 diabetes, the cell do not use insulin properly.

Both conditions cause blood glucose levels to rise in the body. Diabetes is more than one disease as it poses serious health risks. People with diabetes are at risk of developing a host of problems such as stroke, hypertension, nerve damage, skin, eyes and kidney problems. High amount of blood sugar level can cause damage to the blood vessels leading to blocked arteries restricting blood flow to the heart. Poor blood glucose control can lead to high blood pressure and other blood lipid abnormalities including high levels of HDL (good cholesterol) and triglycerides.

The link between cardiovascular disease and diabetes is well established by medical science. It is estimated that 65% of people with diabetes die of heart disease, which makes it a leading cause of all deaths among diabetic patients. Doctors refer to this connection as DHD- Diabetic Heart Disease. The term Diabetic Heart Disease covers coronary heart disease; narrowing of the arteries, heart failure; minimising heart’s capacity to pump enough blood and diabetic cardiomyopathy; alteration in the structure and function of the heart.

A sedentary lifestyle with little or no physical activity, smoking, stressful life and unhealthy eating habits all contribute to weight gain, high cholesterol, high blood pressure, heart diseases and diabetes. Thus, weight and lifestyle issues management is the best way to prevent and control such health risks.

Let’s look at some simple but effective ways towards a healthy lifestyle:

1. Physical exercise: Adopt a 30 minute exercise rule to remain healthy and fit. For diabetic patients, a morning and evening walk is highly recommended. You could walk, run, gym, climb stairs, do yoga, aerobics or other physical activity that interests you.
2. Eat healthy: Avoid fried and packaged foods as they are full of fats, salt and sugar. Include seasonal vegetables and fruits in your diet and drink plenty of water. Dieticians recommend eating a heart-healthy diet including superfoods like broccoli, spinach, berries and fibre rich meal.
3. Weight management: Keeping weight under check is an effective way to prevent the risk of heart diseases. Consult a dietician for a customised diet plan as per your medical condition.
4. Be positive: Stress is a silent killer and a major contributor to all lifestyle diseases. Remain calm and manage your negative thoughts to overcome stress.

Health is the ultimate treasure you have! Preserve it. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

Diabetes alters the metabolism and functioning of almost entire body system. The most important targets are the circulatory and nervous system, leading to peripheral vascular disease and neuropathy. Diabetic foot is the result of a combination of these two factors in the feet – altered/reduced blood flow to the feet combined with reduced sensation.

1. Neuropathy: When the sugar levels are poorly controlled, then the nerves in the legs are damaged, leading to reduced or absence of sensation. The patient cannot feel pain/heat/cold. Sensory neuropathy causes loss of protective sennsation leaving the foot at risk to repetative unnoticed trauma.
2. Peripheral vascular disease: The blood vessels which are away from the heart are affected, leading to poor blood flow from the legs to the heart. Proper blood flow is essential for overall health, and when this is affected, the peripheral foot health is affected.

Some of the common foot problems encountered in diabetics are listed below:

1. Fungal infections: Whether a person wears shoes regularly or not, they become more prone to fungal infections. The nails become discoloured, brittle, and break off. They are difficult to treat and may require oral medications.
2. Ulcers: Diabetic ulcers are very common. The combined effect of reduced sensation and reduced blood flow leads to ulcers, which are not painful (due to lack of sensation) and therefore are ignored and not treated promptly. They can progress and become severe, even sometimes leading to amputation. Fungal ulcer are most common in between toes and in creases of a diabetic patients
3. Corns: Diabetics are more prone to develop corns which are thick masses of skin near the bony area of a toe. This could be in areas where the shoes rub against the toes or between the toes where there is a lot of friction. Home care includes smoothing it with a pumice stone. The person should not try to remove them on their own.  Warts, bunions, ingrown toenails, hammertoes, etc., are also very common in diabetics.

Prevention/Treatment:

1. The first and most important step is to monitor and regulate the blood sugar levels within ranges ideal for you.
2. Warm water to be used for washing feet, and then to be dried well, to not leave a moist area between toes
3. Regular feet care to check for blisters, ulcers, wounds, etc.
4. Check toenails for overall health
5. Preferably wear closed toe shoes
6. Wear stockings or socks and shoes that fit well
7. Moisturise the skin well to avoid drying
8. Avoid exposing feet to extreme weather
9. Quit smoking
10. Ensure blood flow is maintained by not standing or sitting for prolonged periods and with regular exercise

If you wish to discuss about any specific problem, you can consult a doctor.