What Is Diabetes?
Diabetes mellitus, commonly known as diabetes, is a chronic metabolic disease which causes high blood glucose levels.
Insulin is a hormone that helps move glucose from your blood into your cells to either be stored or used for energy.
Diabetes is a result of this process breaking down by not creating enough insulin or unable to use the insulin effectively.
Types of Diabetes
Type 1 Diabetes – is an autoimmune disease which affects about 10% of people with diabetes.
Type 1 diabetes happens when the immune system attacks and destroys the process in which insulin is made.
Type 2 Diabetes – is a chronic disease that occurs when the body becomes resistant to insulin, therefore type 2 diabetes results in excess amounts of glucose in your blood stream.
Pre-diabetes – is a disease that occurs when the blood glucose level is elevated higher than normal, however not high enough to be diagnosed with diabetes.
This disease may require minor dietary or lifestyle changes for management, and may be able to be reversed.
Gestational diabetes – can occur during pregnancy, when insulin blocking hormones produced by the placenta are therefore elevating blood glucose levels.
Patients with diabetes are at risk of developing the following symptoms:
- Increased hunger
- Increased thirst
- Frequent urination
- Weight loss
- Blurry vision
- Extreme fatigue
- Sores that do not heal.
Diabetes symptoms may be mild and often hard to detect. It is important to review with your doctor if you may be experiencing any of these symptoms.
It is important to have a screening and risk assessment review if you are experiencing these symptoms so appropriate management and treatment can be advised.
Diagnosis For Patients With Type 1 or 2 Diabetes:
Fasting Plasma Glucose test to assess the amount of glucose in your blood after you’ve fasted for 8 hours.
HBA1C test provides an assessment of your blood glucose levels over a 3 month period (fact: lifespan of red blood cells are roughly 120 days).
Visiting a health care professional such as your doctor for a medical review.
Common Diabetes Assessment Questions
What Are Common Risk Factors?
- Family history – if a parent or sibling is diagnosed with diabetes type 1 or type 2 diabetes.
- Weight – the more fatty tissue is present, the more resistant your cells can become.
- Cardiovascular disease
- High cholesterol
- High blood pressure
- Poor diet
- Inactivity – Physical activity uses glucose as energy, making our cells more sensitive to insulin. Less physical activity puts you at a higher cardiovascular risk.
- Age – as we age, we tend to exercise less, lose muscle mass and potentially gain weight.
- Other health issues; having a history of gestational diabetes, poly cystic ovary syndrome
Why See A Podiatrists?
As health professionals, we are able to complete an annual risk assessment (of developing further complications) and examination in the same clinical setting of your routine general treatment appointment. We provide education and support in the patient’s management of diabetes related health conditions.
We complete a diabetic assessment, which includes a Doppler waveform assessment, monofilament, vibration, muscle and joint testing. Through examination this enables us to determine your risk of developing non-healing wounds as well as other complications. If a patient with diabetes is determined to be high risk of developing further complications, appropriate management can follow.
We want to make sure you have enough blood flow to your feet, enough feeling to detect if something changes, and no obvious muscle weakness’ which may require further management.
A doppler is a machine that can assess and measure the blood flow coming down to your foot, specifically dorsalis pedis (top of the foot) and tibialis posterior (inside of your ankle) pulses.
The blood volume and waveform’s are to assess whether you have adequate blood flow for healing and muscle activation.
We as podiatrists are also able to perform an examination using a monofilament. A monofilament is a device that is used to assess sensory nerves by applying direct pressure to 10 sites on each foot.
The monofilament applies 10 grams of pressure to different areas of the foot, as this is seen as the standard of what we should be able to feel.
A vibration tuning fork can also be used as another test to assess the level of vibration sensation in your feet.
Both the monofilament and vibration assessments are helpful to indicate a potential diagnosis of peripheral neuropathy, and then further monitor the progression of peripheral neuropathy. This is a helpful assessment as it forms a picture of how at risk a person with diabetes is at for developing non-healing wounds (ulcers).
From the evaluation of the assessments, we deem a patient low, medium or high risk of developing lower limb diabetic complications to complete a health management plan. We then notify the doctor of the result of these assessments.
Self Management Tips
Newly diagnosed diabetics will require more education and medical assistance to control diabetes and their overall health. A diabetes educator may be able to assist with this education.
It is also important to review with your doctor regularly so they can refer and manage any ongoing concern to prevent deterioration.
It is helpful to check your feet (or use a kind friend to help you) daily for any cuts, bruises, blisters, or other damage to your feet that you may not be aware of.
Educate the patient of all the risk factors mentioned above.