SELECTION OF FOOTWEAR IN PREVENTING FOOTCARE PROBLEMS

People with uncontrolled sugar levels or foot ulcers need medical footwear and diabetic socks
Diabetes patients develop swelling,flattened arch sometimes.So,the shoe size varies accordingly
Better to use cotton,cushiony socks and well fitting shoes

HOW TO SELECT THE FIT SHOE?
Always shop in the afternoon
The toe area of the shoe should be spacious.Narrow toe areas leads to foot wounds and blood circulation decreases
Hard rubber sole protects the feet from sharp objects
Insoles made from Micro Cellular Polymer are used for cushioning effect
The shoe inner area should be wide to face the swelling problems or to insert insoles
Adjustable straps are required to adjust during swelling
Select shoes with low arch incase of flat foot
The shoe should be completly covered to avoid  from hard objects
Wear low heel shoes

HOW TO PREVENT FOOT PROBLEMS BEFORE THEY OCCUR

What is diabetic neuropathy?
Nerve damage a long term complication in diabetes is called neuropathy
Symptoms:numbness or tingling in toes initially and gradually passes to ankle & leg
No sensation or too sensitive feet
Prevention of diabetic foot problems is very important although treatment has improved

HOW TO PREVENT FOOT PROBLEMS BEFORE THEY OCCUR?

More care for feet is important than face
Examine the foot everyday by using a hand mirror.Check toes,sides carefully
Wash the feet with mild soap or soak the feet in refreshing foot soak.Dry them completely and moisture them
Cut the nails with a clipper straightly and file smoothly
Don't walk with bare feet.Wear shoes at beach.Cover with socks in cold season
Always wear comfortable shoes.Use cotton or wool socks
Quit smoking as it damages small blood vessels due to which circulation shows and leads to foot infections
Keeping blood sugar levels under control by taking medicines regularly,exercising regularly,taking balanced diet,visiting doctor on time.It reduces long term complications like nerves,kidneys,eyes,blood vessels damage
Managing blood pressure also plays a vital role in proper foot care
Regular exercise makes bones & joints strong increases blood circulation
Light the pathways at night remove the obstacles on the way you walk

TYPE 1 DIABETES - JUVENILE DIABETES MELLITUS

Type 1 Diabetes :
This type of diabetes begins in childhood and develops rapidly
It is an autoimmune disease(i.e the body attacks and destroys insulin producing cells in the pancreas)
Thus insulin is not produced which is a hormone necessary to convert food into energy.
In Type 1 diabetes children may also develop rheumatoid arthritis,thyroid disorders,insufficient adrenal
5-10% of total diabetes population are type 1 diabetic
The type 1 diabetes symptoms are polyurea,excessive thirst,bed wetting,excess hunger,fatigue,weight loss
They should undergo HbA1C(gives  blood sugar value for last 60-90 days),cholesterol,vitamin d status,microalbumin test and eye examination
These tests helps to precvent long term complications like nerve damage,kidney failure,heart diseases,blindness
Type 1 diabetics are insulin dependants
Educating about diabetes is more important like treatment
Along with insulin injecting techniques they should learn self blood glucose monitoring also.It helps to know blood glucose levels at any time by an instant reading in glucometers
It is also important to follow the dietician advise.
It is always better to consult your doctor whenever needed,Dont self medicate

Exercise in Diabetes

Exercise in Diabetes
Exercise is must in diabetes if the body permits to do.It plays a vital role in controlling diabetes
30 minutes exercise per day helps:
Proper utilization of insulin in diabetics taking insulin
stress release
lower blood sugar and blood pressure
reduces bad cholesterol
lose weight
makes heart,bones,muscles strong
keep joints flexible

SIMPLE EXERCISES
Walking - Simple to do and cost effective-requires a pair of shoe only
Swimming-one can walk in water or move the feet in water though they don't know swimming.It is also a sort of exercise
Gardening-watering,removing weeds,pulling flowers or plants is also a good exercise
Playing-playing with kids or grand kids in the park,throwing a disk are also good exercise

PRACTICE YOGA
Yoga also controls diabetes.Asanas like Dhanurasana,shavasana,bhujangasana,paschimottanasana helps in proper functioning of pancreas and insulin
Before doing any exercise stretching of muscles in the following manner helps to increase flexibility:
Standing wall pushes,hip stretch,quad stretch,calf stretch

Diabetics should not exercise immediately after injecting insulin
Dont exercise on empty stomach.It may cause hypoglycemia
Consult the doctor before starting any exercise
Always take the guidance of technician while practicing yoga
Avoid exercise if there is retinopathy,proteinurea,high blood pressure,high glucose levels
Avoid running,cycling,jogging if there is nerve damage

Weight loss tips

Weight loss tips:

Weight:How to access the correct weight i.e whether the weight is more or less than desired

Calculate the body mass index(BMI)

BMI=Weight/height in meter*2

Check height in meters

Find out weight in kilograms

Then calculate BMI

If BMI<19  underweight

   BMI is between 19&25  recommended weight range

   BMI is between 25&30  overweight

   BMI is more than 30 obese.

Waist size:Waist size gives the storage of fat around belly.Apple shaped bellies indicates obesity.Healthy waist less than 40inches in men and less than 35inches in women

One can monitor their BMI,body fat byusing body fat monitors analyzer scales like karadascan…..etc

Overweight leads to many diseases like high blood pressure,stroke,diabetes,sleep apnea,cancer,osteoarthritis,stress.

How to reduce the overweight:

Our body needs energy for metabolic activities. If the energy is released more than required due to excess food intake it is stored in form of fats in the body which leads to weight gain.

Reduction in calorie intake and increasing the physical activity helps in weight loss to a great extent

Consult a dietician to know about your daily calorie requirement

Strictly follow the suggested diet plan and adopt a daily exercise plan

The key factor for losing weight is determination of individual, if the diet and exercise guidelines suggested by experts implemented on day to day basis, it is not very difficult to reduce and manage the healthy weight

Click Here to know more about Body Fat Analysers

GESTATIONAL DIABETES

GESTATIONAL DIABETES
It is a type of diabetes that develops during pregnancy
During pregnancy to meet babys needs mothers body should produce extra insulin.If it doesnot happen gestational diabetes develop
It can be diagniosed by the presence of sugar in urine test during antenatal checkup and  blood glucose tests
Women with high blood pressure,obese,insulin dependent parent or sibling,late mothers(giving birth at older age) may develop gestational diabetes
Due to more sugar in the blood of mother the growth of baby increases which leads to difficulty in delivery
There is possibility that these babies may develop diabetes in future
Gestational diabetes can be treated by regular checkup with the doctor by controlling diet,by exercise,by monitoring blood glucose levels using glucometer regularly

Stress and diabetes

In diabetes its not only important to take balanced diet but also regular exercise and stress less life style
plays a vital role
The following are some of the ways to control the stress:
Healthy mind is the soul of healthy body
To maintain healthy body awareness on healthy food is necessary
Practise yoga and meditation.It refreshes the mind
Walk for at least 15min a day
Maintain hobbies like gardening,listening music,painting,cooking a new dish,dancing....etc.
Avoid junk food,caffeine drinks,alcohol.
Create time for your own.Spend sometime with your family/dear ones
Share the problems with your dear ones
Follow a schedule to prevent work backlog
Good sleep is necessary

Managing the emergencies in Diabetes

Managing the emergencies in Diabetes:

In case of any emergency,query,clarification do not delay to contact your doctor

The three emergencies of diabetes are hyperglycemia,hypoglycemia and keto-acidosis

HYPERGLYCEMIA:
In hyperglycemia blood sugar level dangerously rises high(above 250 mg/dl).It is seen more in type1 diabetes
Reasons: Neglecting or skipping the medicines such as insulin.
                 Infection.
                 Eating high calorie food.
                 High stress.
                 Avoiding exercise.....
Symptoms:Headache,blurred vision,excessive hunger,thirst,tiredness.In such cases its better to check blood sugar levels immediately.Glucometer can be used for immediate checking.
If sugar level is more than 250mg/dl contact your doctor immediately and drinking lots of water helps to lower the blood sugar level before reaching the doctor

HYPOGLYCEMIA
It is seen more in people with type 2 diabetes.This condion is charecterised with the blood sugar level droping below 70 mg/dl.If it is neglected it may lead to coma or death.
Reasons:It may be due to excess dose of medicine and staying without food within 15-20 min of dosage.
This rises the insulin in the body.
Symptoms:Excessive sweating,anxity,giddiness,speachless ness
If the sugar level drops during sleep nightmares,sweating & confusion while waking may occur.In such a situation consume chocolate,glucose tablets,biscuits,spoon of honey.Better check with a glucometer and rush to the doctor to prevent further complications.

KETOACIDOSIS

This is a serious,life threatening condition.It occurs due to dehydrated body in diabetics
If the sufficient insulin is not secreated  the body is not in condition to utilise glucose to release energy hence it breaks down the stored fat which
results in production of toxic waste productions called as ketones that is harmful to the body.High concentration of these ketones results into ketoacidosis

Reasons:Ketoacidosis may occur due to less insulin
              Stress
              High fever & Infections
              Vomiting & diarrhoea
Symptoms:Dry skin,dry mouth,vomiting,nausea,low blood pressure,low pulse rate,pain in abdomin ,breathlessness,increased thirst
In this situation check your blood sugar level immediately and if it is more than 300mg/dl approach  your doctor immidiately
It can also be tested by using urine test strip
In case of severe vomiting one can get into ketoacidosis very fast
Doctors give them i.v. fluids and initiate insulin to bring sugar levels to normal          

"Your doctor is better judge consult him "
             

Diabetic Diet

Diabetic Diet:
DIET: To manage diabetes everyday diet plays a vital role. Awareness on type of food, its calorific value and maintenance of time intervals is necessary.

VEGETABLES:(3-5 servings)-One serving can be 1cup of raw leafy greens/beans/carrots/sprouts or ¾ cup vegetable juice or ½ cup of chopped/cooked vegetables.

FRUITS:(2-4 servings)-One serving can be 1 medium apple/banana/orange or 1slice of melon/3/4 cup of fruit juice or ½ cup of chopped fruits/berries.

MILK:(2-3 servings)-One serving can be 1cup skimmed milk/1 cup buttermilk or one serving can be 1 cup non-fat yogurt/1cup fruit flavored yogurt.

MEAT & OTHERS:(2-3 servings)-One serving can be 30g cooked fish or 30g cooked chicken or 30g cooked meat.

PULSES(2-4 servings)-One serving can be 1 cup cooked thin, watery tur dal/moong dal/cowpeas/masoor dal or ½ cup cooked rajmah/channa/baked beans/lentils or 25g if uncooked.

CEREALS AND CARBOHYDRATES:(6 or more servings)-One serving can be 1 chappati/idly/dalia or ½ cup rice or ½ cup cooked cereals,3/4 cup dry flakes of cereal or 1 small baked potato/raw banana or 1 phulka/roti of 25g or 1 dosa(40g cooked)(1 idli 30g/1/2 cup upma.

FATS:1 serving can be 1 teaspoon of cooking oil or 1 tablespoon cheese or 2 tablespoons olive oil.

Insulin Injection Types

Insulin : Insulin is a hormone secreted by beta cells of pancreas
Insulin is a substance that controls the amount of glucose (sugar) in the blood
Insulin is always used in patients with Type1 Diabetes and may be required in Type2 or gestational diabetes
Insulin can be taken through delivery devices like syringe and Insulin pens

 Insulin Pens :
They are most convenient and easiest way of insulin administration
No need to use syringes and vials
No need to mix and measure the insulin
Accuracy in dosage
Can be easily carry in purse or pocket
There are two types of insulin pens:Disposable and permanent

Disposable pens: They are premixed,prefilled and ready to use by just dialing the dosage

Permanent Pens: These are reusable pens,Pen fills or cartridges (Insulin contents) are changeable after the completion of insulin
They are easy,convenient and accurate even at extremely low dosage
Needles are to be changed when ever there is  pain

Storage of Insulin :
Insulin is to be stored between 2 to 8 degrees centigrade without exposure to sunlight
Insulin vial should be used within 30 days of opening as its activity decreases after 30 days at room temperature
Always inspect the bottle before use make sure that  the expiry date has not passed and the bottle is not damaged
While travelling it should be carried along with coolants in thermocol box