When a person gets diagnosed with diabetes (either type 1 or type 2) he or she must accept the fact that the disease itself is a lifelong condition. Diabetes symptoms can be regulated and suppressed, but the diseases itself cannot be reverted or cured permanently. With type 1 diabetes the body is unable to produce insulin due to the damaged pancreas. With type 2 diabetes the body can produce insulin but is unable to properly process and use it. Insulin is used to regulate blood sugar. Having too high or too low blood sugar is considered dangerous and may lead to serious problems and in extreme cases also to death.
There is a type of diabetes that is only temporary and that is gestational diabetes. Gestational diabetes (sometimes also referred to as the “type 3 diabetes”) is high blood sugar (glucose) that develops during pregnancy and usually disappears after giving birth. Often case a woman diagnosed with type 3 diabetes also develops type 2 diabetes later in life.
Living with diabetes
With the diagnosis of diabetes, the patient’s education about the illness begins. Education about diabetes is an important component of diabetes treatment. In early stages of the illness the patient needs to learn a lot about the disease so that they can control it successfully. A medical doctor will provide instructions to the patient on how and when to use the medications, how to self-control blood glucose and other crucial details such as the importance of proper nutrition and exercise. For some diabetes type 2 patients exercise and proper nutrition might be enough to control blood sugar in early stages of the disease. Exercise helps manage type 2 diabetes by lowering blood sugar levels and improving insulin sensitivity throughout the body.
Diabetes symptoms and dangers
Usual diabetes symptoms are the following:
• frequent urination (often at night)
• tiredness or weariness
• unexplained sudden weight loss
• increased hunger
• blurred vision
• numbness or tingliness of hands and feet
• dry skin / skin issues
Diabetics often have foot problems. They are caused by nerve damage (neuropathy), narrowing and hardening of the blood vessel walls (atherosclerosis) and high blood sugar (hyperglycaemia). Therefore, the importance of proper foot care should not be overlooked.
What can lead to diabetic foot and what are the consequences?
With nerves being damaged the patient looses or has dramatically lowered sensitivity of what is going on with their feet. With the absence of basic sensitivity to touch, change of temperature or pain the foot is prone to getting severely injured. The damage can be momentary (for example cuts) or prolonged (for example swelling). Since sensitivity of the leg is dramatically lowered the patients may also find it difficult to assess the temperature of the bathing water, so they may get burned. This insensitivity can lead to further weakening of the foot muscles and consequently to increased formation of dry and dead skin in exposed areas.
Atherosclerosis impairs the blood supply to the legs and feet, and poorer blood circulation means reduced transport of oxygen, nutrients, and antibiotics, which can lead to tissue death and lesser resistance to infections.
High blood sugar interferes with normal wound healing and infection is a common complication, especially in patients with chronic ulcers.
About 15% of diabetics develop foot ulcer(s) during the course of the disease but following the advice of medical staff can prevent serious complications.
What can a patient do to prevent complications?
Patients are recommended to sit with both feet on the floor and take a short walks every hour or so. Pedicure can be performed exclusively by pedicurists who are professionally trained to work with diabetics. In case of a new ulcer or other disease change, it is necessary to seek medical help immediately.
Diabetics need to make sure the skin of their feet is always clean and dry. Diabetics should wash their feet with lukewarm water (in case of insensitivity of the feet, it is necessary to check the water temperature with a thermometer or by hand) and a mild soap.
After washing, the feet should be thoroughly but gently dried with a soft towel. Attention should be paid to the areas between the toes as moist might still be there after drying. After washing, it is recommended to use special moisturizing creams for dry feet.
Wearing diabetic socks
The feet should be protected with the use of diabetic socks and diabetic shoes, which must be comfortable. Before putting on shoes it is necessary to check the inside of the shoe for any objects that could irritate or damage the foot. Barefoot walking is also not recommended for diabetics, as this can lead to injuries as well.
If a patient has problems with cold feet, they need to wear warm socks. Heating items such as heating pads or heating blankets may burn the feet, therefore the use of these should be avoided.
In general, diabetics should have their feet examined regularly for any minor injuries that may turn into infections.
Since diabetics do not feel stimulation to the foot due to neuropathy, it makes sense to inspect the socks thoroughly every day if there are visible spots of discharge or any bleed marks on them. That is why it is recommended that the socks for diabetics should be of light colour (preferably white).
Footwear for diabetics
Socks for diabetics at first glance look the same as any other socks except that it is not quite so. Diabetic socks are made in a special way. A plain seam in regular socks can irritate and damage the toes of diabetics, so diabetics should avoid wearing non-diabetic socks.
The elastic at the top of the diabetic socks should not squeeze the leg as the blood circulation can be further disrupted. Socks should fit patient’s feet smoothly, without wrinkling. Damaged (for example torn) diabetic socks should not be patched, rather they should be replaced with new ones.
In terms of material, cotton and wool have long been considered the best choices when it comes to best diabetic socks, however new high-quality synthetic materials are emerging on the market.
Other, more modern solution are emerging on the market, too. One of such are the so called smart diabetic socks. Smart diabetic socks are made of very special wool fibres containing microsensors that constantly monitor the condition of the user’s feet. These sensors measure the temperature of the user’s feet so that when they detect a sudden rise in temperature (which is a potential indicator of an ongoing inflammation) the user is alerted immediately through the application on their phone.
When it comes to shoes, it is important for diabetics to buy quality shoes that have a soft inner upper layer, ample toe space, a thick rubber sole and a removable insole. Shoes should not be too loose or too tight, therefore it is best to shop for diabetic socks and shoes in the afternoon when the feet are already slightly swollen.
Diabetic foot and prevention
Diabetic foot is a serious complication of diabetes. For diabetic patients with diabetic foot the nerve damage, poor blood circulation and infection may lead to gangrene and amputation of the foot. Injuries, infections, inadequate foot care and inadequate pedicures increase the risk of such complications.