THE DIABEE BLOG

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September 15, 2018 Diabetes Care0

 

Rakesh, a 42 years old marketer who has type 2 diabetes, never made it to the diner to till 10 pm, as he worked in Manesar, Haryana and lived with his family in Delhi.

He daily had to commute at least 60 km one side to reach the organization he worked for. Since years he was driving 3-4 hours on a daily basis. One day, as he drove through Gurgaon, he experienced sudden anxiety, restlessness, dizziness and was feeling extremely exhausted to drive home.

He pulled his car to the side near Delhi cantt, where some traffic police were present. Somehow, he asked a pedestrian for help and with his help they contacted the police.

Initially, police were suspecting that he may be drunk, but in faint voice Rakesh muttered that he is diabetic. He told that I have diabetes since last year but I have not experienced such symptoms. The police contacted the ambulance. And then the attendants in the emergency vehicles managed his case.

This may be a case of Rakesh who is living with diabetes in the past 1 years but I am sure there may be a lot of people with diabetes who have to go through all this.

Let’s understand what might have happened:

People with diabetes experience sudden dips in blood sugars, also known as hypoglycemia. This may sometimes have confusions, loss of consciousness, vision disturbances, delayed responses etc. On the contrary, people with diabetes may experience eye problems, neuropathy in feet, that may affect ability to feel the clutch and brake. This may impact driving and may lead to dangerous consequences also.

According to a study, people with diabetes who drive have 12-19% higher risk for motor vehicle accidents. It is generally seen that most accidents related to diabetes complications happen to a small group of people with type 1 diabetes, who need to take insulin and also people with type 2 diabetes who are at high risk.

Most of the people who drive on daily don’t even check their blood sugars before driving. They are totally unaware of the dangers that driving can bring in, if one has diabetes. Sometimes, if one experience symptoms of hypos, he or she can avoid driving on that day, but milder symptoms sometimes get ignored.

The problem here is people don’t know about the relation of driving with diabetes.

The responsibility of a person who is driving is not only his life, he has to ensure that there is no collateral damage also. This means safety of other people on the road should be a priority.

Following are simple tips that people with diabetes should follow while driving:

  • Check blood glucose before going for drive
  • Avoid delaying or missing meals on the day of driving
  • Always keep healthy snacks and sugar sachet or glucose tablet handy
  • Take short breaks on long drives

If you feel any warning signs of hypoglycemia like sweating, diziness or blurred vision then stop the car at an appropriate place. People with diabetes should know how to recognize physical signs of low blood sugar and treat it. If you are not able to manage it then talk to your health care provider immediately, ask for help or call an ambulance.

 


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August 31, 2018 Diabetes Care0

People with diabetes are more prone to develop foot problems due to nerve damage and poor circulation. Diabetic foot problems may arise when the wrong kinds of socks or footwear are worn. Unfortunately, majority of individuals still not aware and don’t realize importance of footwear in effective diabetic foot care. As, the right kind of footwear including shoes and socks can protect feet from injury. And, not attending to diabetic foot care carefully and consistently can lead to amputation of the toes, feet, or even the entire leg below the knee. That is why it is so important for people with diabetes to pay close attention to the kinds of socks they wear.

Although not all people with diabetes are required to wear diabetic socks. But, a good pair of socks can become a great rescue for some diabetes patients who have the risk of friction injuries. And, it can be saviour for people who have sensitivity or circulation issues, prone to swelling in feet and at high risk of getting foot injury. Diabetic socks are specially designed to provide extra cushioning to pressure points of the feet and protect feet from injuries, absorb moisture and keep the feet warm and dry, minimise irritation, improve blood circulation and keeping fungal and bacterial infections at bay.

Important Features to Consider Before Purchasing Socks with Diabetes

Usually people don’t think anything before buying socks except the looks. However, people with diabetes need to consider few things, more important than looks before purchasing their new pair of socks.

Seamless: Socks with seams can rub against the skin and can cause blisters or ulcers, which may be harmful for diabetic feet. That’s why the seamless design is ideal for diabetic feet as they fit snug and close to the skin. There are minimal chances of them wrinkling inside the shoes to cause potential blisters, chafing, or irritation.

Moisture Wicking: It is important to keep feet dry in order to prevent skin infections. Diabetic socks are often made from a combination of materials such as acrylic, merino wool, bamboo, charcoal mixed with spandex for stretch. These materials offer more moisture wicking ability than the traditional cotton socks. In addition, these materials are wrinkle-resistant to minimize the chances of material abrasion on skin.

Non-constricting: The fit of diabetic socks should be non-constricting which is close to the skin but without putting any extra pressure. Tight socks especially if have narrow toe box or elastic at the top should be avoided. As tight socks from toe area allow moisture to build-up between toes and elastic on top can  cause discomfort and inhibit circulation, which might be challenging for those who suffer from circulatory issues. However, in some cases where there is problem of swollen feet light compression socks may help as they allow proper and quicker blood flow into the feet but should be worn only if advised by your doctor.

Extra Padding: Padding provide cushioning for sensitive areas help prevent injury and enhances comfort. Normally the extra padding runs along the bottom of the sock, around the toes, and at the heel of the foot. Depending on your specific requirement or activity you can choose thickness of the padding e.g. while running or playing tennis, you need extra cushion or support at specific areas of feet as compare to normal walking.

Maintain Temperature: High blood sugar over a period of time, can cause blood vessels to restrict, decreasing circulation to the feet. Diabetic socks are made from fabrics that keep feet warm to improve blood circulation.

Light in Colour: A white or lighter colour socks especially sole area is important for people with compromised sensation, as it helps alert people to notice injury that is caused by a draining wound.

Anti-microbial: It is an important feature for diabetic socks to prevent bacterial and fungal growth on humid and moisture prone region of the feet. They are made of breathable fiber which keeps the feet dry. In addition, some higher-end diabetic socks even contain silver or copper threading to actively fight against bacteria and fungi, and prevent foot odour and infection.

When to Wear the Socks?

It is typically recommended that individuals should put on their diabetic socks and footwear from the time they step out of bed in the morning until right before they go back to bed at night. The less time you are barefooted, the less likely you injure your feet by accidentally kicking things or stepping on items. It also reduces the friction on the foot from the floor surface, the socks can also maintain your feet at an optimal temperature for better blood circulation.

Care for your Diabetic Socks

  1. Wash your diabetic socks with warm water and mild detergent after every use and dry them in sunlight. This will prevent bacterial growth.
  2. Do not bleach or use very hot water as it can damage the fabric. As fibers such as wool and spandex to lose their elasticity in hot water. Prefer hand washing and air drying the socks.
  3. You can use a fabric shaver to remove the minor pilling of the socks. However, socks should not be worn again in case of major piling or damage. Ideally, you need to change a regular pair of socks every 6 months.

Wear socks, keep your feet safe!


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August 10, 2018 Diabetes Care0

Decision to replace a pair of shoes depends on how often you wear them. For everyday shoes, a good rule of thumb is to change them at least once a year since the interior cushioning of the shoe wears down over time. If you see any considerable and irreparable damage to your shoes change them instantly e.g. the heel begins to collapse to one side or the bottom of the heel is worn down or the inner lining of the shoe is torn.

The Right Fit – Why it is Important?

We all can relate “bad shoe day” to the blistered heel or painful arch that goes away quickly in a day or two. But for people with diabetes like Mr. Narang, a poor footwear triggered infected blister on his sole which lead to foot bone injury. Though it was cured with antibiotics and foot surgery but recovery took away two important years of his life. Diabetes can affect almost all parts of the body including feet. It can cause nerve damage, or neuropathy, that lessens the foot’s sensitivity. It means a person may not feel heat, cold, or pain in his feet. Apart from nerve damage, people with diabetes are at high risk of developing impaired circulation to the feet. Poor circulation causes wounds on the feet to heal more slowly, raising their risk of becoming infected.

In diabetes even minor foot problems, like calluses or blisters, can lead to serious diabetes-related complications or even result in amputation. That’s why shopping for shoes is more than a matter of style. Before you shop for diabetes footwear, it’s important to have your feet evaluated by a podiatrist or foot specialist to determine your risk for infections or complications. Based on this assessment, the doctor can recommend exactly which types of shoes will be best for your feet. In case if your diabetes is under control and your feet are healthy, there are several factors you should consider when selecting shoes. By looking for certain characteristics and avoiding others, you can protect against irritation, infections, ulcers, and potentially worse foot problems.

Right Shoe – What are the Characteristics?

  1. Correct size: It is important to measure your feet each time you buy shoes to make sure the shoes you select fit your feet. Feet tend to change shape and size over time, and few people can wear the same shoes at age 50 as they did in their teen age. In addition, many people have one foot that’s larger than the other because of factors such as swelling, so it’s always better to have both feet measured.
  2. Comfortable: Comfort should top the priority chart while selecting the shoes. In fact, your first thought when you try on a new pair of shoes should be “How do these feels?” rather than “How do these looks?” You can take a short walk to check its feel.
  3. Wide toe-box: Check that the shoe fits well and provides enough room to wiggle your feet. Avoid narrow or pointed toes that pinch the foot and restrict blood supply. Shoes should have round and wide toe-box which is spacious enough, so that your toes do not rub against the front of the shoe. However, it should not be so wide so your foot slides around inside.
  4. Adjustable Closure: Look for shoes that have laces or velcro like sports shoes. The built-in flexibility allows you to tighten or loosen your shoes depending on swelling in the foot. It will give your feet enough room to breathe and enhance flexibility.
  5. Cushioned Inner Sole: It’s important to choose footwear with a good amount of cushioning inside the shoe. It should be well-padded at the top (where foot slips in), or the rim, and inside so it does not rub, causing friction against your anklebones This added support helps reduce foot pressure and the risk for developing foot ulcers, and other complications.
  6. Hard Outer Sole: Although the inside of your shoe should provide support with cushioning, the outer sole of any shoe you select should be hard. This will help protect your feet from rough or sharp objects and provide shock absorption.
  7. Low Heel: Shoes with heels less than two inches high are a better option than shoes with higher heels. Lower-heeled shoes reduce the amount of pressure applied to the ball of the foot and prevent foot injuries due to friction.
  8. Choose Shoe Material Carefully – Shoes comes in a variety of materials, some more breathable and flexible than others. Choose styles made from soft materials, such as leather, suede, cloth, canvas or mesh. Since feet tend to swell throughout the day, these softer fabrics will provide enough space. Breathable fabrics will also prevent the build-up of moisture within the shoe. Avoid purchasing a shoe that contains plastic or other abrasive material.

Going for Shoe-shopping? TIPS to Remember

  • Avoid going for shopping wearing footwear like sandals, flip-flops, slip-ons, high heels or loafers or anything made of plastic or hard material. This kind of footwear often don’t cover feet properly and support is also limited which increase the risk of injury. They can cause irritation or put extra pressure on feet which may result into callus, blisters and ulcers.
  • Consider shopping later in the day. Since feet tend to swell throughout the day, visiting the shoe store in the afternoon or evening when feet are swollen to their maximum capacity is best way to get a more accurate size.
  • The real test is how shoes feel on your feet. Make sure you are wearing the sock you normally wear, and don’t forget to bring any orthotics or inserts you will be wearing in the shoe.
  • After finalising take the shoe trial. Put on both shoes and attach the laces, buckles, or straps, then stand up. Walk around, and make sure that your arch is fully supported and that the break or bend of the shoe is located at the ball of your foot.
  • Break in slowly into your new shoes. Consider wearing your new shoes for 2 to 3 hours for the first time. This gives you enough time to check your feet for cuts or blisters. After the first day, wear your shoes for a period of 3 to 4 hours to gradually get comfortable in them.

Note: Inspect your feet daily and especially when you break into new shoes. Check feet for problems or signs of irritation redness, cut or bruise. People with diabetes should be evaluated by a podiatrist annually and get sensation, circulation and pressure analysis done. Anyone diagnosed with neuropathy, foot deformity, calluses or foot ulcers — should be prescribed customised footwear or insoles according to the foot condition.

Have a Happy and Healthy Feet….!


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July 19, 2018 Diabetes Care0

Achieving your ideal body weight and body image is not at all easy. In my daily practice, I often hear from my clients that I have tried endless plans to lose weight and I have failed.

Ever wonder why – no matter how much you exercise – it rarely has the desired effect?

Before you start a plan to achieve your ideal body image, it’s imperative to understand your own body. Body fat accumulation can be of two types. One, when the number of fat cells increase in your body and second, when the existing fat cells don’t increase in number but increase only in size.  The later is easier to handle as you can burn down the amount of fat in each cell but you cannot burn the new cells completely.

Fat loss results will also depend on your body shape – if you have apple or pear-shaped obesity.

You’ll be pleasantly surprised to find that with knowledge about Apple and Pear body shapes you can finally understand what you have to do to lose weight more easily from the bothersome areas.

“What do you mean by Apple vs. Pear shape body”, you ask?

Well, it refers to where you store fat – above the waist, on your upper body (Apple shaped body) or below the waist, on your lower body (Pear shaped body). Whether you are Apple-shaped or Pear-shaped makes a lot of a difference – both in your physiology and psychology.

Based on this, it’s easy to understand how your metabolism is dramatically different, you assimilate nutrients differently, store the extra calories as fat differently (either subcutaneously or deep in the body, viscerally) – and even respond differently to supplements and medications – based on whether you have a Pear-shaped body or an Apple shaped body.

In the case of an apple shaped body the normal physiology is greatly affected by a large amount of abdominal fat surrounding the internal organs; this leads to a host of hormonal changes resulting in metabolic issues causing weight gain and difficulty in losing it.

In contrast, in the case of a pear-shaped body the extra fat is deposited directly under the skin, mostly in and around the hips and thighs. As a result, women with a pear-shaped body often struggle with low self-esteem or eating disorders (stemming from conflicts with the “ideal” body image imposed by media/society standards). These issues just make weight loss that much more difficult.

For a better understanding of this try and figure out your waist-to-hip-ratio (WHR): take a measuring tape and measure:

  1. your waist circumference, about one inch (2 fingers) above your navel
  2. your hip circumference, around the widest area of your lower body

(Hold the tape loosely, without applying pressure on your skin and stand up straight, relaxed and without sucking in your tummy.)

Next, divide your waist number by your hip number.

–> If the result is higher than 0.8, you have an Apple shaped body.

–> If the result is 0.8 or lower, you have a Pear shape body.

 

So, forget about that weighing scale when you are beginning a weight loss program.

Instead, sit with your health care team and nutritionist to discover how to lower your waist circumference to reduce the volume of that dangerous visceral fat pressing on your internal organs and creating havoc with your metabolism.

No matter how many weight loss plans have failed you in the past, no matter how many extra pounds/ kilos you have or how long you’ve gone without taking care of yourself, understand your body shape and fat type and set realistic short term goals. Take action to make you as healthy as possible through the right diet and exercise routine for your specific body shape and type. The physical implications of achieving ideal body shape are evident in having more energy, having a healthier heart, lowering the risk of Type II diabetes, and helping to avoid both osteoarthritis and many forms of cancer and not just the numbers on your weighing scale.


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July 5, 2018 Diabetes Care0

Rainy season brings the much-awaited respite from the scorching summer heat. However, you cannot avoid the changes it brings. This humid weather can increase the risk of several health problems including respiratory problems, skin or foot complications, food borne illness and increased risk of infections. While taking care of health is important for everyone but it is crucial for people with diabetes especially during monsoons.

Here are some important care tips for people with diabetes to protect their health and manage diabetes better while enjoying the season to its fullest:

Take Good Care of Your Skin and Feet

Diabetes affects all organs; whether its skin or feet which are particularly vulnerable. Although daily selfcare should be a year-long routine for people with diabetes. But, maintaining skin and foot hygiene is of utmost importance especially in monsoon due to increased risk of infections. Here are some handy tips to remember this rainy season:

  • Wherever you go, keep an extra pair of footwear and clothing with you. As wet and dirty feet or skin from contaminated rain water increase the risk of bacterial and fungal growth.
  • After coming back from rain, bathe and wash the feet with soap and water. You must also dry them well to prevent the growth of any infection.
  • Keep your skin and feet soft by applying some moisturiser as dryness increase the chances of cuts or cracks which can lead to infections.
  • Keep your nails clean and trimmed. Also, place your wet shoes in the open, preferably in the sun, to dry out and eliminate bacterial growth.
  • Use talcum powder on skin folds, on the feet, between toes before you wear clothes, socks and closed footwear in order to keep these areas dry.
  • Wear comfortable slipper or footwear all the time. Avoid walking bare feet even at home as germs and infections are very high this season.
  • Make sure your footwear is made of a comfortable material which doesn’t bite you. Avoid using plastic or non-breathable material footwear.
  • Regularly monitor every nook and corner of your body especially feet. Simple things like boils, corn, rashes or cuts could get infected and lead to serious complications.

Eat Balanced Diet and Keep Yourself Hydrated

Standing in the rain and snacking on your favourite chaat may sound like a fun idea, but it is a big NO for people with diabetes. They should avoid eating out especially street food — to avoid food poisoning and other foodborne illnesses such as cholera and diarrhoea.

  • Have freshly cooked home-made food, so you can be sure of the hygiene, quality and the nutritional value of your food.
  • Eat small and frequent meals which are easy to digest. Avoid the temptations and ditch oily, fried and spicy food preparations.
  • Make sure you wash all the fruits and vegetables thoroughly before eating. During monsoons, these are more likely to be infested by worms.
  • Drink plenty of liquids to prevent dehydration. Avoid aerated and caffeinated beverages, instead opt for boiled or filtered water, home-made soups, ginger or green tea, etc.
  • Always keep some healthy snacks handy when you go out. As rainy season may cause unpredicted delays and long gaps can cause blood sugar fluctuations.

Monsoon Blues – Tips to Prevent

The humid and filthy conditions in monsoon plays a host for many disease-causing germs and bacteria, which further result in diseases like dengue, malaria, viral fever and stomach trouble. Asthma, allergies, respiratory tract or eye infections are also quite common during monsoon.

  • Boost Your Immunity – Eat food that boost immunity to fight against common cold, flu or infections e.g. citrus fruits like lemon or orange, bell peppers, garlic, ginger, nuts and yogurt.
  • Monitor blood sugars regularly – As high blood sugars increase the risk of infections. In case you observe any changes in your results, be sure to inform your doctor immediately.
  • Don’t skip your exercise routine – It may seem easy to skip your exercise routine if it is raining, but lack of physical activity will obviously send blood sugars for a toss and increase risk of illness. If you are unable to go out then go for a gym or do some simple exercises at home e.g. climb stairs, dance with the music or try some skipping, squats, push-ups or stretching.
  • Pay attention to senior citizens – Special care for the elderly diabetics is warranted especially during monsoon. Blood sugar fluctuations, monsoon fall and infections are common among them. Caregivers should keep an eye on their health to avoid untoward incidences.

 

Monsoons bring a refreshing and mostly welcome change to the weather. People with diabetes can enjoy this season to its fullest with a little bit of extra care and precaution. This extra effort can go a long way in keeping you fit and healthy the rest of the year!

Have a Happy and Healthy Monsoon!

 

 


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