47 Podiatrists Share Tips On Good Foot Care For Those With Diabetes

Here is exactly what we asked our panel of experts:
What tips would you give to someone who is newly diagnosed?
Why do you think a lot of people ignore their foot care when it comes to diabetes?
Featured Answer
Dr. Ira H. Kraus, President, American Podiatric Medical Association
A1: The most important tip I would give to anyone newly diagnosed with diabetes is to include a podiatrist in your care team. That may seem like a self-serving tip! But independent studies show that when a podiatrist is involved in caring for a person with diabetes, that person’s risk of hospitalization and diabetes-related amputations goes down dramatically. Seeing a podiatrist once a year can help you prevent diabetic ulcers, and if you do develop an ulcer, seeing a podiatrist can help reduce the risk of amputation by up to 80 percent.
I would also suggest that people newly diagnosed with diabetes simply pay close attention to their feet. Prevention can be the key. Watch your feet daily for any changes, and if you see something that concerns you, get in to see your podiatrist as soon as possible!
A2: A diabetes diagnosis can be overwhelming. It comes with a lot of lifestyle changes and a lot of concerns. Our feet are literally the furthest things from our minds, so it’s not surprising that many people overlook them as they’re growing accustomed to living with diabetes. Also, many people don’t understand the serious complications diabetes can cause in the feet, and by the time they realize there’s a problem, it is a significant problem. People do not realize that simple things that they ha Continue reading

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When to Check Blood Sugar

“I don’t get this diabetes thing,” Zach, a 50-year-old friend with Type 2, told me. “I check my sugars twice a day, and they’re always below 110. But my A1C is 8.4%. My doctor says that’s way too high. What’s going on?”
Zach’s problem is easy to explain. He’s testing at the wrong time. Every day he checks on waking and before dinner, when he hasn’t eaten for four hours or so. His numbers are always good because he doesn’t have a problem with fasting sugars.
If he checked after eating, he would find out where his high A1C level comes from. He probably runs high numbers for several hours after meals. Those highs are probably doing a lot of damage to Zach’s blood vessels.
Zach is hardly alone. Many people check (or “self-monitor”) at the same times every day. They’re not trying to learn anything new, just keeping a record for their doctor. This mindless testing is a waste of time, as I wrote about here.
So when should you check? Some things to consider:
• The best times to check blood sugar may depend on your medications. If you’re on insulin or an oral drug that stimulates insulin such as a sulfonylurea or meglitinide (or a combination drug containing one of these medicines), you have to worry about both highs and lows. You have to check more often. If you’re not on those drugs, you’re mainly interested in what causes high blood sugar levels and how to prevent them.
• You should check to answer questions for yourself. What foods raise your sugar (and by how much), and which ones don’t? How does your body respond to exercise? What ti Continue reading

Best Beverages for Staying Hydrated

Summer is quickly moving along, and soon the leaves will be turning. Hopefully you’ve been able to get out and enjoy the fine weather, and maybe take advantage of the longer days to walk, swim, golf, or play tennis. All great ways to be outside and do your body some good at the same time.
Physical activity, whether it’s indoors or outdoors, can often leave you sweaty and parched. So what should you drink, and when? Do you really need those fancy sports drinks? Or is plain old water just as good? Read on to find out how to stay hydrated before, during, and after being physically active.
Why rehydrate?
The answer is pretty obvious: to avoid becoming dehydrated. When you’re dehydrated, your body doesn’t have enough water to function properly. You lose water through sweating, breathing, crying, salivating, urinating, and having bowel movements. When you’re exercising, water is primarily lost through sweating and heavy breathing. If you’re an athlete or playing a sport, for example, being dehydrated can impair your performance. More importantly, dehydration can cause a number of symptoms, and some of them are potentially dangerous.
Symptoms of mild dehydration include:
• Dry mouth
• Being thirsty
• Headache
• Muscle cramps
• Dark urine
Symptoms of severe dehydration include:
• Dizziness
• Rapid heartbeat
• Rapid breathing
• Feeling confused
• Feeling very sleepy
• Heat stroke
Severe dehydration is a medical emergency, and needs to be treated promptly. Also, keep in mind that high blood sugar levels can increase the likelihood of becoming dehydra Continue reading

The Dawn Phenomenon and Somogyi Effect: What You Can Do

Waking up with a high blood sugar reading is not exactly the way you want to start off your day. Besides rushing to get ready for work or getting the kids off to school (or both), you now have to decide if and how you’ll deal with that reading on your meter. Maybe you decide to skip breakfast. If you take mealtime insulin, perhaps you inject a few extra units. Or you put in some additional time during your workout. Another option is to shrug it off and hope that your blood sugar comes down in a few hours. You might also ponder the reason your blood sugar is high. Could it be that you ate dinner later than usual last night? Or you ate too much carb at dinner? Or maybe it was your snack?
While it’s normal to have high blood sugars when you have diabetes, it’s time to pay attention when the highs become the norm. Morning hyperglycemia (high blood sugar) is frustrating for many people; figuring out the cause is the first step in dealing with (and preventing) it.
Dawn phenomenon: hormones that wreak havoc
It’s easy to blame your morning high on the plate of pasta last night. But while that could certainly be a factor, chances are, your “highs” are a result of hormones. An imbalance of insulin, amylin (a hormone released by the pancreas), and incretins (hormones released by the gut) is the likely culprit. Other hormones get in on the act, too, including glucagon, growth hormone, cortisol, and adrenaline. Why? Overnight, the body gets this idea that it needs fuel (glucose). The witching hour seems to be around 3 AM or so. At this time, the liver and muscles obligingly Continue reading

Somogyi effect: Causes and prevention

The Somogyi effect, also known as the rebound effect, occurs in people with diabetes.
Hypoglycemia or low blood glucose in the late evening causes a rebound effect in the body, leading to hyperglycemia or high blood glucose in the early morning.
This phenomenon, known as the Somogyi effect, is widely reported but remains controversial due to a lack of scientific evidence. It is reported more by people with type 1 diabetes than by people with type 2 diabetes.
Contents of this article:
What is the Somogyi effect?
Named after Michael Somogyi, a Hungarian-born researcher who first described it, the Somogyi effect is the body's defensive response to prolonged periods of low blood sugar. A dose of insulin before bed that is too high can be a cause.
When insulin reduces the amount of glucose in the blood by too much, it causes hypoglycemia. In turn, hypoglycemia makes the body stressed, triggering the release of the stress hormones epinephrine (adrenaline), cortisol, and growth hormone. The endocrine hormone glucagon is also released.
Glucagon triggers the liver to convert stores of glycogen into glucose, which can send blood glucose levels into a rebound high. The stress hormones keep the blood glucose levels raised by making the cells less responsive to insulin. This is known as insulin resistance.
Controversy
The Somogyi effect is widely cited among doctors and people with diabetes, but there is little scientific evidence for the theory.
For example, one small study found that hyperglycemia upon waking is likely to be caused by not enough insulin before bed. Researchers also fo Continue reading