Podiatry: Diabetes

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Lack of energy - could it be the big D?

The big D - diabetes, affects more than 3% of adults in the UK. More worryingly, it is estimated that there are over a million undiagnosed diabetes cases in the UK. More worrying that that however, is that diabetes in UK children is on the increase. OK - so what is diabetes, how can it affect us, and what can be done to help reduce this worrying trend?

Diabetes is a disease in which the body cannot utilize sugar, needed for energy. There are two types of diabetes:

• Type 1, where the body produces no insulin, necessary to break down sugars so that the body can use them effectively. Once diagnosed the patient must have a daily dose of insulin, (given by self-injection). Type 1 diabetes usually develops before the age of 40.
• Type 2, where the body produces some insulin, but not enough to cope with daily sugar intake. This can be controlled by diet, or diet and tablets. Type 2 diabetes is often called late onset diabetes, and normally develops after the age of 40.

What are the signs of diabetes?

• Rapid weightloss.
• Increased thirst.
• Increased visits to the loo.
• Low blood sugar (characterized by a woozy, sick feeling).
• No energy - no get-up-and-go.

As a podiatrist I'm concerned about diabetes from two angles.

• The first is loss of feeling - what we call loss of protective sensation - in the feet.
• The second is poor circulation. The arteries (the motorways which deliver blood to muscle, bone and tissue) harden and narrow, reducing blood flow.

The two can combine to make up a deadly duo which can sometimes (more often that you might think) involve major loss of tissue (toes, feet or legs). This scenerio is not uncommon, as any health professional who works with diabetes can tell you. The patient has poor circulation and they have little or no feeling in their feet. Unaware. they tread on a pieces of grit/ burn themselves by having bathwater too hot/ have a blister on the foot. The circulation cannot cope with the healing process - the insignificant wound develops into an ulcer - the ulcer cannot heal because of the poor circulation etc etc. Often amputation, with its' attendant risks, is the only answer.

What to do

If you have any of the above symptoms you must visit your GP who can carry out simple blood and urine tests for diabetes. Patients with diabetes always do better under medical supervision. There is no doubt that diabetes goes hand-in-hand with overweight. Maintaining a healthy bodyweight and a general high level of fitness will help enormously in reducing symptoms in the case of Type 2 diabetes, and will decrease risk factors in Type 1 diabetes.

For further information on diabetes, check out www.diabetes.org.uk. For more information on diabetes and feet, or foot problems generally, check out my website www.ortho-pedclinic.com.

Please feel free to use the enquiry form at www.ortho-pedclinic.com for all foot-health and foot-related matters.
David Holland BSc(Hons), MSc(Dunelm), MChS
Consulting Podiatrist.