Type I and Type II Diabetes - What It Means To Your Feet

(Photo credit: Wikipedia)Type I diabetes, formerly known as juvenile diabetes, appears early in life and means the body does not have the ability to produce insulin. Insulin is a hormone that converts glucose to energy. If glucose remains in the blood stream it can result in cell destruction. Type II diabetes is the inability of the body to produce enough insulin or break it down adequately.

Type I can strike at or before adolescence, where type II is more gradual to develop. While there are differences in the onset of diabetes, if treatment is not started early and pursued, the results can be devastating because both involve neuropathy, or the destruction of nerves in the body. You need to pay close attention to the feet, because this is a common location for nerve damage to first show signs. Early symptoms of neuropathy can include a numbing or tingling in the feet.

If you have diabetes, one of the major areas of concern is your feet. This is because the loss of feeling can allow a sore or break in the skin to go undetected, resulting in infection and possibly leading to amputation. People with diabetes need to make sure they are being evaluated by a podiatrist annually, or more frequently if needed.

Dr. Teichman can thoroughly check your feet, examine for sores, blisters, dry cracked skin, signs of athletes foot or other complications. He can prescribe a treatment program for your feet that will ward off more complicated foot problems. In conjunction to his examination and recommendations, he can educate you to precautions you can take. These include:

    •    Always wear shoes and socks to protect feet.

    •    Bathe feet daily pat dry and apply lotion.

    •    Examine feet daily and have your doctor treat minor problems of the feet and ankles. This includes corns, calluses, ingrown toenails, sores and athletes foot.

    •    Advise your doctor of sores or breaks in the skin. Seek immediate treatment.

    •    Wear closed toe and heel shoes that fit properly.

    •    Follow the diet and exercise program your doctor recommends.

With over 25 million people in the U.S., more than 8 percent of the population, the risks and complications from diabetes are staggering. If you are a person with diabetes, call Dr. Teichman’s office today at (610) 432-9593 to make sure you are scheduled for your annual exam. Never neglect your feet.

References:

http://diabetes.webmd.com/guide/understanding-diabetes-symptoms
http://www.diabetes.org/diabetes-basics/diabetes-statistics/

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Peripheral Arterial Disease, not a life sentence

Image via WikipediaAre you one of the many who has noticed pain when you walk, but the pain disappears after a few moments of rest? Ever experience coldness in your leg or foot? You may be showing early signs of Peripheral Artery Disease (PAD) and need to schedule an appointment with Dr. Teichman.

Other symptoms may include:

•    Leg numbness or weakness
•    Sores on foot or leg that will not heal
•    Shiny skin on your legs
•    Loss of hair on legs
•    Change of skin color on legs

Peripheral Arterial Disease is a major complication that can develop from Diabetes. If you are diagnosed with PAD, treatment has two goals. First is to reduce or manage pain so that you may resume your normal activities, and the second is to prevent the buildup of artery blockage, which could cause you a stroke or heart attack.  Dr. Teichman can do a thorough evaluation to determine your risk and educate you on what needs to be done to help you manage your situation. If need be, he can help with the healing of ulcerated skin, advise you in proper footwear, perform treatment on corns and calluses, prescribe medications and also make other recommendations. You may be able to manage PAD by making some lifestyle changes that would include stop smoking as well as changes in diet and exercise, but there are some cases where surgery may have to be performed. This might include a procedure to unblock the arteries.

If you have peripheral arterial disease and it is allowed to go untreated, you could possibly experience pain that is so severe it may affect your very lifestyle. If you continue to ignore the warning signs, you could be placing your life at risk. As with any medical concern, it is best to seek treatment early.  Do not allow the symptoms to become increasingly worse. This is not a disease that will disappear in time if left untreated, and you risk amputation or possibly your life. 

If you experience pain, coldness, numbness or sores or infections that take a long time to heal or do not heal at all, call Dr. Teichman at (610) 432-9593.  He can evaluate you and get you started on an individual treatment plan. Peripheral Arterial does not have to be a life sentence. There are treatments available. 

References:

http://eastpennfoot.com/video-library

www.mayoclinic.com/health/peripheral-arterial-disease/DS00537/

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Diabetes and Dry Cracked Skin

Image via WikipediaDo you find it annoyingly painful to walk due to dry cracked skin on the heels of your feet? Have you tried lotions and potions, yet still have a difficult time treating this condition? We are here today to offer some practical suggestions to try to help you make things a bit more tolerable.

Dry cracked skin is usually most problematic during the winter months. Thickening and drying of the skin occurs, and deep cracks can appear, which makes it painful to even walk. For some, dry cracked heels are a mere cosmetic annoyance, but for a person with diabetes, it can pose a greater problem and health risks. What causes dry cracked skin?

    •    Age

    •    Existing skin conditions like psoriasis

    •    Diabetes

    •    Thyroid problems

    •    Vitamin deficiencies

    •    Excess weight

As we age, the skin loses its normal elasticity. Skin conditions caused by medical disorders can contribute to dryness and weight bearing can become problematic, especially if we stand for long periods of time and the skin is under excessive stress.  Any combination of these conditions can increase the likelihood of dry cracked skin.

Symptoms of dry cracked skin include discoloration (yellowish) and thickening of the skin. If it goes untreated, the skin can crack and bleed. Deepening cracks can harbor infections. People with diabetes should check their feet regularly, because they may have decreasing sensation in their feet due to nerve damage.

    •    Bathe feet daily, test for proper temperature and dry thoroughly.

    •    Apply vitamin enriched moisturizers to the feet, but not between toes.

    •    Use a pumice stone to remove dry and calloused skin.

    •    Wear shoes and socks to protect feet. Check them for small objects that could cause injury.

    •    Check your feet daily for sores. People with diabetes are at greater risk for infection.

For the person living with diabetes, proper foot care is essential. Have regular medical checkups, and do not be bashful about exposing your toes. Still, tell your doctor immediately if you have a concern about your feet. Some doctors may prescribe orthotics to help relieve pressure on problem areas. Follow their instructions closely. If you implement a sound plan of prevention, you should make it through the winter with fewer problems, but if you have a problem, call East Penn Foot & Ankle Associates for an appointment.

So what’s worked well for your feet and dry skin? We’d like to know so comment below!

References: 

www.footsmart.com/healthcondition.aspx?ailmentid=83
http://diabetes.niddk.nih.gov/dm/pubs/complications_feet/#hurtfeet

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Diabetes – Harsh Climate Protection

Image via WikipediaPatients who suffer Type I or Type II Diabetes are at greater risk during the cold winter months. This is because they deal with the loss of feeling in their feet, as a result of nerve damage. Therefore, it is necessary that Diabetic patients use extra care to avoid lengthy exposure to the elements, especially during the winter months. Excessive exposure could cause frostbite, damaging skin and other cells.

When it is necessary to be outside, try to plan ahead. A common sense approach and a few items can be very helpful. Move around to stimulate circulation. Take more regular breaks to get inside out of the cold. Make sure your foot wear fits appropriately, is non-restrictive and allows enough room for an extra pair of socks. Keep an extra pair or two of warm, dry socks with you, in case your feet get damp or perspire. Make sure your outer footwear is waterproof, and replace inadequate shoes and boots as soon as possible. If you travel, allow for periodic rest stops to get out and get moving. This will allow for better circulation. Also, it is a good plan to pack along a blanket. Keep the blanket in the automobile passenger compartment with you, not in the trunk.

If you suspect that prolonged exposure to cold, snow, wind or sleet may have caused skin damage or frostbite, use caution and warm up slowly. The affected area should not be rubbed or massaged. This could cause further damage. Instead, wrap in a blanket and allow for gradual re-warming, allowing circulation to slowly improve.

If you are Diabetic and suspect over-exposure, it is recommended that you seek the advice of your foot-care specialist. The freezing of the skin or other tissue could have serious health consequences. Your doctor can advise you.

If you have any questions concerning diabetes and the affects it causes to the feet, contact Dr. Teichman at East Penn Foot & Ankle Associates on our website.

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Losing Weight with Diabetes

Image via WikipediaAs the New Year’s resolutions are either going strong or dwindling out, the ever so present goal of weight loss thrives around this time of year.  Makes sense though, with all the higher fatty foods from the holidays and not exercising as much due to the colder weather.  If you have diabetes and want to lose weight, great!  You just might want to do something differently than people who jump on the next diet craze or the hottest workout. 

Having diabetes only adds problems if you’re overweight and by losing weight you can actually reduce your risk of health problems.  To do this, you don’t need a fancy diet or a crazy workout plan, you just need to eat healthy and be physically active.  You should check out the blog we wrote earlier about making your diet a rainbow, it talks about a fun way to approach your meal planning. 

As for exercising, don’t go crazy pushing yourself too hard.  If you push yourself too hard, you’re asking for an injury or complications.  Take up walking or if you’re up for it, jogging.  Make sure you ease yourself into it, though, especially if you have not been physically active for a while.  This way, you will actually enjoy being active and you won’t burn yourself out.  You should also challenge a family member or friend to get out and get active with you, that way you’ll be accountable to each other and can challenge each other.  Don’t get crazy competitive though, and risk pushing yourself or your partner to giving up.  You could also join a swimming class at the rec center, or take up playing basketball with a group of family and/or friends.  You could go walking at a park or window shopping at the mall.  Find what works for you and enjoy yourself!

For more tips on how to lose weight with diabetes or how diabetes effects your feet, contact your diabetes specialist or contact Dr. Teichman at East Penn Foot & Ankle Associates.

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The Glucose Tolerance Test

Image by J. Star via FlickrIf you have ever been pregnant, you have probably had to endure the infamous Glucose Tolerance Test.  This test isn’t just for women who are pregnant when they test for gestational diabetes, but this test can be used to check for diabetes in general.  The most common form of this test is done by ingesting a set amount of glucose and then the doctor checking your blood about two hours later. 

In order for this test to work correctly, you’ll have to fast for at least 8 hours prior to the test.  For your comfort and for the best results, have the test done in the morning.  That way, you can eat dinner by 8pm the night before, and then just don’t eat anything before bedtime.  You can get a good nights’ rest and after 7 hours of sleep, go to the doctor first thing in the morning, without eating anything for breakfast of course, and have the test done.  Once you’re out of the test, go get something to eat and get on with your day.  It makes the process really easy and then you don’t have to starve yourself through the day to take the test.  One thing to remember though is that you are going to have to ingest a pretty good dose of glucose, so you might want to drink some water to get your stomach ready.  That way you be able to hopefully keep it down and not have to retake the test on a later date.

Dr. Teichman can point you in the right direction if you need a good doctor to check you out, because if you think you might have diabetes, you need to get checked out by a doctor asap!  If you have this test coming up in your future, though I have never taken the test myself, I have heard good things about the orange flavor of glucose.  Something to think about.

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What is Gestational Diabetes?

Image by o5com via FlickrYou might have heard the term “gestational diabetes,” but what is it exactly?  Well gestational diabetes is what women can get while they’re pregnant, being one of the most common pregnancy complications.  Often, there aren’t any symptoms that women who get gestation diabetes, but rather this condition is detected through screening measures.  Before you run out and see if you have it or not, there are six risk factors that your doctor will take into consideration before having you tested. 

The first risk factor is your age.  If you are older then twenty five years, you are at more of a risk than a women under twenty five.  Your ethnicity also plays a part, with non-Hispanic Caucasian women having the lowest risk than other ethnicities.  If you are overweight before the pregnancy, you run a higher risk and if you had problems with your blood sugar being too high before the pregnancy, chances are you’ll have this condition.  The last two factors are whether your family has a history of diabetes or not, and your previous pregnancy outcomes.  If you developed gestational diabetes in a previous pregnancy, chances are you’ll get it again, or if you had a a baby that weighed more than nine pounds, your risk is higher.

If you want to lower your risk of getting gestational diabetes when you’re pregnant, there are some things that you can do.  The first one is to make sure that you are eating healthy.  If you lower the sugar and carbohydrates, and eat more fiber, you’ll lower you risk.  If you do that before you get pregnant and keep it up during pregnancy, you’ll really lower your chances.  The other way is to be more physically active.  Don’t stop exercising just because you’re pregnant, but keep active.  No you don’t and probably shouldn’t be running marathons, but go for walks, take trips to the mall, park or wherever you like. 

If you have any questions on how gestational diabetes can effect your feet, or just pregnancy in general effecting your feet, contact us at East Penn Foot & Ankle Associates.

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Diabetes - Living with Diabetes

Image by Newbirth35 via FlickrImage by Getty Images via @daylifeWhether you have just been diagnosed with diabetes or have had it for years, you know that life is different (or going to be) for those with diabetes than for those without.  If you are new to it, know that isn’t the end of your life.  Living with diabetes is much easier these days then it use to be.  There are just a couple things you now have to deal with. 

First of all, you need to make sure you watch what you eat.  Things with a lot of sugar should be avoided (though they should be avoided by everyone) so that you don’t spike your blood sugar exponentially.  But you also need to make sure that you are getting enough in your diet to keep your blood sugar from dropping too low.  Too high and your be in risk of eye, kidney, heart disease and nerve damage.  Too low and your run into feeling lethargic, possibly shaking, and you even might lose consciousness, which is never a good thing.  Make sure to watch your blood sugar levels regularly, but don’t get crazy about it.  It’s too much stress to be taking your blood sugar every hour, not to mention how much your finger tips will probably not like you. 

Second, make sure you take your medication when you’re suppose to.  If you have type two diabetes, this means that you inject your insulin when you need it.  Your doctor will let you know how much and how many times you need to take insulin in a day.  If you have type one diabetes, this means taking your pills on time.

The third major difference is that you are at a higher risk of developing neuropathy, which is a nerve damage in your feet, resulting in a inability to feel your feet.  If you have this already, make sure you monitor your feet daily for wounds.  For more on how to take care of your feet, click here. 

East Penn Foot & Ankle Associates would love to talk to you if you have any questions on how diabetes can effect your feet.  Contact us if you have  any questions.

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Diabetes and Charcot Foot

Image via WikipediaWhen you read that title you might wander what charcoal has to do with feet?  Just know that this has nothing to do with charcoal, but Charcot (pronounced “sharko”) foot is a real problem that many, mostly diabetics, face.

Charcot foot is a extreme condition that happens to someone who can’t feel their feet.  The reason Charcot foot is more common with people with diabetes is because of diabetic Neuropathy, where the feeling in the foot is lost because of nerve damage.  Charcot foot is where your foot actually changes shape because of bones fracture and disintegrate.  The fact that you can’t feel the extreme pain because your foot is numb, allows you to continue walking on the foot, thus damaging the bones more.  If the Charcot foot is caught early, the problem can be treated with a total contact cast.  If the problem goes on without being treated, reconstructive surgery or amputation will be needed.

If you do catch it early enough, the cast you’ll get will be molded to fit your foot and will control your foot movement, supporting your foot in all areas.  This allows the foot to heal fully, as long as you stay off the foot, thus not damaging the foot further.  The cast will be changed frequently to continually move the shape of your foot back to normal or as close as possible without reconstructive surgery.  To get the total contact cast though, you must have good blood flow through you foot.

The other route you can go if the Charcot foot is caught early on is a custom walking boot, but this will take longer to heal because you’ll be putting weight on your foot.  The boot helps reduce the swelling in your foot, thus allowing your body’s natural healing processes to get into the injury and fix it.  The fastest way to heal a Charcot foot is to keep your weight off of it though.

If you have any questions on Charcot foot or how diabetes effects your feet, contact Dr. Adam Teichman at East Penn Foot & Ankle Associates.

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Diabetes Blog - Don’t Let Calluses Slow You Down

Image by Jill A. Brown via FlickrImage via WikipediaWhen a person has diabetes they also can develop neuropathy, which can cause damage to the nerves in the feet and can lead to loss of feeling and sensation, there is the heightened danger of developing ulcers from this loss of sensation or protective threshold.  Since people with diabetes lose the feeling in their feet, ulcers develop easier because they do not feel the discomfort that the ulcers cause. Since calluses are caused by the constant rubbing of a certain part of the shoe on a person’s foot, again – it isn’t felt and so the problem develops into a ulcer. Without neuropathy, this is usually felt and taken care of, but someone with neuropathy can’t feel the constant rubbing. Other issues can arise as a result of this rubbing – the next stage of an ulcer that hasn’t been taken care of can become very dangerous and can possibly lead to infection or even worse loss of limb.  

The danger comes in the next stage as a result of diabetic complications. A callus can be taken care of easily with routine visit to your podiatrist.  But the danger arises when a callus is fully developed and the constant rubbing continues to wear on the callus, the skin can and probably will split open and become an ulcer.  For a diabetic, a wound raises the risk of infections that can lead to that person having to have their foot amputated if it goes untreated or ignored.  This is why it is extremely important to make sure that if you have neuropathy, you need to check your feet daily!  If you catch the developing callus early, you’ll be able to take care of it before it gets worse.  It is highly recommended that you visit your podiatrist to treat the callus rather than getting treatments from the store, because your podiatrist can treat the callus more effectively and the callus will be controlled, rather than continue to develop and your podiatrist can make sure other problems do not arise.  Make sure you check your feet daily!  Getting that callus treated could save your foot from becoming a problem in the future!

If you do not have a podiatrist, Dr. Adam Teichman at East Penn Foot & Ankle Associates would love to be your podiatrist.  Check out our website at www.eastpennfoot.com or give us a call at 610-432-9593.

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Taking Care of Your Feet

If you have Diabetes, you need to constantly be on your guard for foot related injuries and problems.  So how should you take care of your feet?  Well here’s some helpful tips for you to follow as you seek to live pain free.

First, make sure you are inspecting your feet daily.  Check to see if there is any cuts, scrapes, redness, drainage, bad odor, rash, discoloration, loss of hair on toes, injuries, or if your nails have deformed, striped, yellowed, discolored, thickened or are not growing.  This way you’ll stay on top of any problems that might occur.  Another tip is to never ignore leg pain.  Leg pain could mean that you have a blocked artery, so make sure you contact your doctor immediately.  Make sure you trim your nails properly, cutting them straight, not curved.  Never trim your calluses or corns yourself and don’t use over-the-counter medicated pads, but rather contact your podiatrist to help you properly take care of the problem.  Do not go barefoot and make sure to keep floors free of sharp objects.  Also make it a habit to check your shoes and socks for any damage and make sure your socks are not bunched up anywhere on your feet. 

If you have diabetes, you should have your circulation and sense of feeling tested by a podiatrist to see if you have lost any feeling or circulation.  If you have, you probably won’t feel a cut or puncture on your foot.  That’s why it is important to inspect your feet daily, so that the wound can be taken care of properly and in a timely fashion.  That way, the wound won’t become an inflection, leading to an amputation of you leg.  Taking care of your feet is very important, to you and to us at East Penn Foot & Ankle Associates.  If you have any questions, please don’t hesitate to contact us or visit our website at www.eastpennfoot.com.

Is Your Diet a Rainbow? Diabetes and Colorful Food.

     This last week, a friend told me the rule in his house was that “Everyone had to have two colors at a meal.”  Now while one could argue that meat and potatoes are two colors, obviously he was talking about having different colored vegetables and fruits.  At East Penn Foot & Ankle, we think that this is another excellent way to introduce healthier habits to our patients.  It is an interesting way to put it for the young and easy to remember as for anyone who struggles with what the food groups are. Healthier eating tips for all age groups include more fruits and veggies on our plates.  What about the diabetic that has to watch the sugars and starches that are in fruits and veggies?  One tip to remember – green is good – most of your green veggies are lower in sugar and starch than the red or yellow veggies – so load up on those and use the red or yellow veggies to make your food taste fantastic.  Additional tips for diabetics, you want to make sure that you don’t overload on the sugary fruits, but that doesn’t mean you can’t enjoy a healthy load of these colorful, good for you treats.

     If you think about it, many fine restaurants strive on presentation, seeking their food to look delicious and desirable for all to eat.  How do they do this though?  They add more color.  A few tips for presentation and to give your food more flavor -  throw green herbs on top of food to make it pop.  Just remember, herbs can make food taste better but they aren’t a main source of nutrition.   

     So if you don’t have a well colored diet, there’s no better time to start than right now.  Make sure of course that you are going for the bright colors of the rainbow, you know the greens, yellows, oranges, and reds, etc.  If you don’t know what veggies or fruits would fit in those colors, you should take a trip down to your local supermarket, you will catch on pretty quick as you look at all the different fruits and veggies.  So next time your preparing dinner, throw a quick salad together – you can use already premixed packs at your local supermarket that work great.  If you are wondering how to do this at breakfast, throw a banana in, cut up an apple, or throw a cup of different berries into your Cheerios.  And as you send your children off to school this fall, help combat childhood obesity and juvenile diabetes by making sure that your children are eating a healthy, well rounded meal at lunch.  If you are concerned about their willingness to eat healthy, have them get involved in the shopping and preparation of their lunchtime ingredients.  Every meal should be a bright, colorful display of deliciousness – here is to a happy healthy way of life!  For more information on the correct eating habits for diabetics take a look at http://www.diabetes.org/ or our website http://www.eastpennfoot.com/diabeticfootandanklecenter.

Diabetic Feet Issues

One thing that is usually associated with diabetes is foot issues.  Why do diabetics have more feet problems than people without diabetes?  One major problem is that when a person has diabetes, their blood flow or circulation slows down.  So when the circulation slows down, the healing process also slows down.  So when a person with diabetes gets a injury on their foot, such as a puncture wound or a blister,  the healing process takes longer, making the risk of infection much higher than someone without diabetes.

The other problem is that a person who has diabetes usually has nerve damage.  This is especially true in the feet and is called neuropathy.  What can eventually happen is that the diabetic loses all feeling in their feet, making it impossible to feel pain in your feet even if you step on a nail or a jagged rock.  This is why it is especially important for diabetics to constantly be aware of their feet by making sure they are properly protected with shoes whenever going outside and sometimes inside.  Also they need to check their feet thoroughly everyday, checking for cuts, wounds, blisters and injuries.  For more information on how diabetes effects your feet, check out http://www.eastpennfoot.com/diabeticfootandanklecenter.

If you have diabetes, it is especially important for you to visit a podiatrist.  While you might be thinking, “Oh why do I need another doctor?”  It is worth it because a podiatrist will help you to avoid many foot problems in the future.  East Penn Foot and Ankle Associates would love to help you.  Call the office at 610-432-9593 and set up an appointment.  If you want in on a little secret, check out the website (www.eastpennfoot.com) and check out how much the first visit will cost you under the FAQ’s section of the website.  You will be pleasantly surprised if you check the website.