Sunday, December 5, 2010

Oh Those Sugary Treats

It's the holiday season and the smell of amazing baked goods, candies and treats fills the air. So what is the harm in having just one of these treats if you are diabetic? Well, let's take 2 diabetic people and see what these treats can do.

"Janie" has had diabetes for 20 years. She checks her blood sugar daily and takes her medications as instructed. She is careful about the amount of carbohydrates and sugars she eats daily and exercises regularly. So for Christmas dinner, she indulges with a small piece pecan pie. She also drinks plenty of water. That evening she checks and her sugar is slightly higher, but returns to her normal routine the next day without the sugar treats. All is good for Janie.

"Robert" was recently diagnosed with diabetes 1 year ago and still refuses to check his sugar daily because he doesn't like to stick his finger with that needle. In fact, he hasn't checked it in 4 months. He takes his medications, most of the time. As he says, "I get busy and sometimes forget". He thought about exercising a year ago, but just hasn't found the time to fit it into his schedule. When he saw his doctor 6 months ago, he was urged to take better care of himself so he switched from regular Coke to Coke Zero. From Thanksgiving to Christmas, he enjoys all the wonderful breads, cakes and munchies homemade by his friends and family...all full of sugar and carbohydrates. Christmas night he becomes dizzy and confused and his family calls 911 after he becomes unconscious. He spends the next week in ICU at the hospital in a diabetic coma with sugars over 800.

So, it is obvious that Janie is in better control and much more attuned to what she can and cannot eat. Robert on the other hand knew he shouldn't eat the "sweet" treats, but did it anyway. But didn't realize the breads and other food full of carbohydrates like potatoes and pasta does the same thing to his body as the sugary stuff.

Educating yourself about what foods do to you as a diabetic is so important in preventing what Robert went through. But realizing you cannot bury your head in the sand and it will all go away is the most important. Take control of your diabetes. Check your sugars daily so you can actually see what that pasta meal does. Take your medications as prescribed. If you have questions, ask your doctors. Become a member of the American Diabetes Association which is a vast amount of resources to help you gain control.

Enjoy the holiday season and don't let those sugary treats tempt you! It's not worth it!

Saturday, October 30, 2010

The Journey to a Texas Ironman

Off days…love them! It is the one time I can catch up on reading and a bunch of other items on the to-do list. Recently, I tripped across an article in the New York times referencing how 40 somethings are turning to triathlons. Leave it to someone to come up with this acronym: Mamils. Mamils stands for Middle Aged Men In Lycra. So if the over 40 male crowd is a Mamil, then I guess you can lump Dr. Crane and I in the Mafil category.

I’ll take it. I think Mafil is pretty cool. Here we are living a healthy lifestyle, dedicated to the sport, with the occasional luck of placing in the top three of either age or weight division and enticing people everyday to become more active and live healthier lifestyles. Many of our friends think we are nuts. I’ll take that as well. I think you do have to be nuts to a certain extent to plan out and execute daily workouts on top of work and all the other curve balls this thing called life pitches to us.

As I read the article, it mentioned the median age group is 41 years of age. I would agree with that. The average salary however which was listed at 175,000 may be a bit grand. You see, there are many who do not necessarily fall for the paying full price on the latest gear. I am one of them. I cannot remember the last time I paid full price for anything except for race entries and the bike jersey from each race. Thanks to the internet, and social websites, you can learn a lot from clothing to bikes to running shoes. Many people I meet are do not necessarily have the best of the best however they often are the winners of their respective age group. Sure, the pros have the latest and greatest…then again it sure helps to be sponsored by the brands plastered all over their clothing, helmet, shoes, bike, wetsuit, running shoes…well, you get the picture.

It all boils down to the athlete. You need to train and put time into all three disciplines. You also need to eat right, maintain life balance and sleep. Sure, I do adore my bike and the few upgrades I have done (discounted items of course) but the bike isn’t going to obtain the level of endurance needed for the IronMan. It comes down to training. So for those who think they must be of a certain income level to be in triathlons whether long or short distance your wrong. You can join in on the great fun of the multisport lifestyle just like the next guy……but you do need to train.

Talk to ya next week,

Monday, October 25, 2010

Why Do Diabetics Lose Their Legs?

You have had problems with your foot for years. Your doctor now tells you that the foot needs to be amputated. How did this happen? Do you have to go through with the surgery? What will happen if you keep your foot?

Diabetes is a devastating disease. It can be managed, and many of the complications of diabetes are preventable. This takes much dedication of the patient and a team of doctors. Discovering you have diabetes and making life changes to prevent life threatening complication of the disease is very difficult. Thus, many people still run into problems associated to diabetes. Foot problems are among one the most common complications. 70% of all limb amputations are due to diabetes!

There are several reasons diabetics have foot problems but let’s talk about the three big causes. When the nerves are exposed to high levels of glucose or high blood sugars, they are slowly damaged. Thus, many diabetics suffer from peripheral neuropathy, a disease in which they slowly lose protective sensation in the feet. This can be very dangerous. I have had patients who had glass, needles, tacks and other objects stuck in their foot and they never remember how it happened. I have also had patients burn themselves in the bath tub. Their feet can no longer perceive temperature and they can easily burn or freeze their feet!

Diabetics also suffer from poor circulation. Blood carries many nutrients and oxygen that is essential to keep tissues healthy. Poor blood supply makes it extremely difficult for damaged tissues to heal. When a patient has a wound or ulcer on the foot, their poor blood supply makes it is so hard for the area to heal. Diabetics also have a compromised immune system. The body is weakened in its defense mechanism to fight off infections. Infections kill good tissues and leaves dead necrotic tissue behind. Infections can spread very fast from soft tissue to bone and joints and even into the blood supply. Infections can be life threatening.

When the threat of infection is too severe and can no longer be managed by antibiotics, the doctor may suggest an amputation. To remove all or as much dead tissue as possible helps prevent the infection spreading to other areas of the body. A doctor may also suggest amputation if the foot has become non-functional.

The thought of losing a part of your body is a very difficult concept to deal with. It is not uncommon for the doctor to suggest therapy to help the patient cope with process of surgery and rehabilitation. It is important to note that amputations are a part of medical plan to keep you as health as possible. It is important to discuss your fears and concerns with your doctor and to seek second opinions if you do not feel comfortable with your doctor’s advice. It is your leg and should be fully aware to the risk and consequences of keeping and amputating portions of your limb.

Tuesday, June 29, 2010

Antioxidants May Hold The Key To Diabetic Complications

Over the years, oxidative stress has been implicated with causing many of the complications of diabetes.  Although diabetes and increased blood sugars are the true cause, oxygen free radicals are usually the mechanism for causing the damage to blood vessels, nerves and cells.  Some studies even implicate oxidative stress for heart disease.

Oxidative Stress:  As the cells go through the normal oxygen cycle, active oxygen species are produced that are usually reduced by the enzymes of the body.  If the reactive oxygen species are produced in higher amounts than the body can reduce, we get free radicals.  These free radicals react with tissues and produce the stress that causes tissue to malfunction.  This malfunctioning is called oxidative stress.

Antioxidants have long been utilized to reduce the free radicals and improve oxidative stress.  A new study states that Vitamin C may improve complications of diabetes, consistent with the antioxidant benefits.  Although this study was run using vitamin C at a dosage injected into the blood stream, it shows that antioxidants may be a valuable option to reduce complications of diabetes.  More is to come......

Tuesday, June 1, 2010

Aerobics Trumps Walking for Health Benefits

I found this article very interesting. We always prompt our diabetic patients to start a walking program, but perhaps we should be encouraging them to go to the gym and start an aerobic exercise program! Things that make you say "Hmmmm!."

Aerobics Trumps Walking for Health Benefits

Sunday, April 25, 2010

Diabetic Foot Surgery

When discussing surgery with patients, I often hear "I'm diabetic, is it safe for me to have surgery?". There are several factors to consider when you are diabetic and contemplating foot surgery. There are times when surgery is not an option, when it is necessary due to infection to prevent limb loss. But there are times when foot surgery is needed to prevent pressure areas that can become ulcers. And as I have discussed previously, ulcers when not treated lead to amputation.

The first thing to know when discussing foot surgery is do you have enough blood flow to the foot to heal the surgery. If your pulses cannot be easily felt by hand then a noninvasive test can be performed to give us a picture of how much blood is reaching the foot. If there is a significant decrease, then a referral to a vascular surgery is necessary before surgery is performed.

Second, understand that you are at higher risk for infection post op due to your diabetes. If your diabetes is not controlled this increases your risk even further. You will be given an antibiotic immediately preop and depending on the procedure may even take an antibiotic for a few days post op to reduce your risk of infection.

Third, are you healthy enough to undergo surgery and the post op requirements? A complete physical needs to be performed to make sure your heart, lungs and kidneys are working properly and there are no surprises.

So, it is ok for foot surgery in diabetic patients. A complete work up should be done before your surgery and you should ask as many questions as you can so that you understand the surgery and why it is needed. At Foot and Ankle Associates of North Texas, we strive to make sure all our patients are fully informed of their procedure and the associated benefits, risks and complications.

Wednesday, March 31, 2010

Summer is Approaching.. Diabetics Check your Feet!

Summer time is almost here. The weather is becoming nicer and all I can think about is ditching my boots and closed toe shoes and putting on my sandals. Are my feet ready. Have I been taking care of them all winter long? Are they dry or possibly cracked?

Here are a couple things to think about before you make the leap to sandal time:

1. Make sure that the sandal you pick has a sturdy sole with good arch support. One with a strap that holds your foot in place is a great shoe. Those flat flip flops that are 5 dollars at walmart are going to kill your feet.

2. Your feet should not have any open lesions if you are wearing an open shoe. Check your feet for dryness, cracks, blisters, or any signs of redness. Cracks or blisters can open during the day and bacteria can cause a skin infection. A cream that has a urea base to it will help get your skin sandal ready in just a couple of weeks.

3. Make sure that you are checking your feet every day. Look in between your toes and at the bottom of your feet. Make sure to check them muiltiple times a day when you are wearing a new sandal or water shoe.

4. Remember that sandals do not have the same support as your walking shoes. Do not wear your sandals when going on long errands, to the mall, or to an amusement park. It is better to save the open toe shoes for short errands, lunch with a friend and for pool time.

5. Always remember that as a Diabetic you have a higher risk for developing sores, blisters and other problems with your feet. If you notice any issues seek medical attention with a podiatrist.

Monday, March 22, 2010

Nutrition May Be The Key To Limiting Complications

Diabetic complications are becoming more well known.  In fact, many people are advocating aggressive control of diabetes to control the diabetic complications.  Some nutrition changes may further help limit these complications also.  Let me list the 4 key elements that will help limit diabetic complications:

1.  Avoid excessive alcohol.  Alcohol has been shown to to increase the oxidative damage to nerves that can further lead to neuropathy.  Although regular alcohol use should not increase this risk, excessive alcohol can even cause neuropathy without other causes.  Limit your alcohol consumption to reduce neuropathy risks.

2. Well balanced diet.  Eating a quality diet helps provide the necessary vitamins, minerals and essential amino acids that are utilized by the body to repair tissues and maintain the functioning thereof.  If a diet has limitations in any essetial nutrient, increased risks of complications will present.  Some common vitamins that have been associated with diabetic complications include vitamin B6, B12, Folic Acid, and B1.  Often supplementing this nutrients may improve complications, even the presentation of neuropathy.

3.  Avoid smoking.  Although not exactly a nutrition aspect, smoking has been associated with decreased circulation to the feet (from the nicotin) and can cause significant complications to the extremities (feet and hands).  Not smoking is therefore a key point to consider.

4. Exercise.  I have long felt that exercise of any level is an important part of nutrition.  Eating correctly can only help to a point.  Activities can improve the functioning of all the internal systems, improving the metabolism of foods, the digestion of foods and even the bodies use of these foods.  This is one of the reasons exercise has been shown to not just limit complications but even improve symptoms of diabetes.

If you want to limit your diabetic complications, following these 4 steps can significantly help.  So lets limit your complications from diabetes... For additional information, visit our Diabetes Page.

Saturday, January 30, 2010

How to Get Rid of Your Winter Alligator Skin

Get Rid of My Dry Skin Dry skin! As the air gets cold, the moisture in the air decreases. The air will steal moisture from your skin and as a result, your skin will be drier this time of the year.

Chapped lips and itchy skin goes hand in hand (or foot and foot) with the season. If you already have dry or sensitive skin, the winter can be especially brutal. How to tackle the dry air or just dry skin in general. What else can cause dry skin? Having sweaty feet can cause dry feet! When your feet sweat, they are pulling out the moisture from your body. Thus, many will notice that after they allow their feet dry, their skin will be very dry.

Fungus, will also eat up the moisture in your foot and leave the skin dry and flakey. There are many different skin conditions that can cause dry skin. Psoriasis is the most common, but there are several other common conditions that will leave you dry. If the your feet are dry and cracking open, it is best to seek a medical professional such as a podiatrist to address the problem. When cracks or fissures are forming, there is often a systemic disease that is causing problems in the skin and other organs. If the condition has been there for many years or does not respond to at home treatments, a more aggressive treatment may be necessary that can be provided by medical professionals

When shopping for a lotion to sooth your skin, make sure to read the label. The lotions should be water based and contain little to no alcohol. Shea Butter is a natural moisturizer that does wonders to the skin on many different levels. It can be found in many common over the counter lotions today. If your feet are exceptionally dry, you can apply lotion to your skin at night and wear socks while you sleep. Creams are better than lotions for thick skin areas, like the soles of your feet.

Do not apply lotion between your toes and avoid this area with any moisturizing product. The skin between your toes in very thin and sensitive and can easily macerate when too moist. When shopping for shoes, choose light colors and materials that allow air flow. Synthetic materials tend to reflect heat and cause the feet to sweat. Socks can also help you control the moisture in your foot. Fabric made up of a mix of cotton and polyester can help wick away sweat from your foot and will decrease the amount of moisture that evaporates of your skin.

Whether it is the dry air or something you are fighting all year long, it may be time to give your feet a special gift this season. Fill up the bath, soak your feet, and enjoy some nice relaxing lotion. Soothing your feet is like soothing your soul.

Tuesday, January 19, 2010

Dance for Diabetes: Podiatry School Gives Back

On January 16, 2010, Scholl College of Podiatric Medicine (SCPM) in conjunction with Rosalind Franklin University of Medicine and Science (RFUMS) hosted the 23rd Annual Dance for Diabetes at the Millennium Knickerbocker Hotel in Chicago, Illinois. This annual event helps raise money to donate to the American Diabetes Association (ADA) to help fund research on preventative medicine and education on Diabetes.

Scholl College of Podiatric medicine has been dedicated to raising money for the American Diabetes Association for the past 23 years due to its close professional tie to diabetes. Ask any podiatrist out there about diabetes link to their profession and they will go on for hours about how diabetes affects the lives of many of their patients.

In the past 20 years diabetes has become an epidemic in American society. Currently affecting more then 24 million people in the United States, Diabetes is projected to keep increasing in prevalence over the next decade if the Americans do not change their lifestyles. The reason for the huge increase in the number of people diagnosed with diabetes is strongly correlated to obesity rate of this country.

Diabetes is a disease that really affects the entire body but has special effects on the lower extremities which is why diabetics are frequent visitors to Podiatry offices. Diabetes leads to peripheral neuropathy which causes diabetics to lose sensation in their extremities. Peripheral neuropathy can lead to ulcerations of the feet which can lead to further complications such as infection.

Due to the fact that podiatrists see the devastating side effects of diabetes in their patients many of them become very passionate about raising awareness for Diabetes prevention and research. Undoubtedly this is why SCPM students and faculty work so hard every year to raise money through Dance for Diabetes to donate to the ADA. This year the college was pleased to announce that they donated $21,278 to the American Diabetes Association which is the second largest amount raised by the college in the last 23 years and the most donated since SCPM merged with RFUMS. Congratulations to the all the students and faculty at Scholl College of Podiatric Medicine for raising awareness for a cause that they feel so passionate about. Hopefully Dance for Diabetes will be a tradition that lives on for many years to come.