This Device Can Warn You of a Foot Ulcer

One of the most commonly occurring complications of diabetes is  neuropathy  and foot ulcers can occur as a result. Foot ulcers are not easy to recognize or diagnose while they are developing. However, they do show some early warning signs … The place where an ulcer is likely to appear will be a warmer spot on your foot.

A new device uses temperature data to predict whether an ulcer will develop more than a month before it actually shows up. This information is very helpful because it gives more time for doctors to treat it.When doctors aren’t able to treat foot ulcers at an early stage, it  can lead to amputations.

Using the device is simple

“People who use it have nothing to do except  they have to keep it turned on and step on it each morning,” Doctor of Podiatric Medicine Robert G. Frykberg says. This takes a thermogram of their feet and sends off the data to a central server. A difference of four or more degrees Fahrenheit on two successive days will register an alert, which is then transmitted to the user and to his or her doctor for necessary treatment.

The U.S. Food and Drug Administration approved the marketing of the device in September 2015, and the United States Patent and Trademark Office granted a U.S. patent in February 2016. A start-up company, Podimetrics in Somerville, Massachusetts, makes the device and manages the system. Its Remote Temperature Monitoring System includes the Podimetrics Mat.

Managing Diabetes in the Monsoon

The rain brings relief from the sweltering heat and replenishes water bodies. But it is also a time when outdoor activities are curtailed, and when one has to protect oneself from infections. It is a trying time for people with diabetes.

They have to find alternate ways to exercise, keep themselves safe from respiratory infections and fungal infections, foot infections, and injuries.

Exercise: Don’t stop exercise. Walk around the house, help with routine work in the house, climb up and down the stairs, or use a treadmill. If going out of the house, be prepared with raincoat, umbrella and water proof shoes.

 

Foot and skin care:

Don’t walk in water. If footwear gets wet, change it or it can become a source of infection. Choose open toe, water proof foot wear. Keep footwear clean and dry.Don’t miss your pedicure appointment. Don’t wear wet socks for a long time. Check feet regularly as small cuts can get infected easily. Don’t walk in puddles of water as contaminated water can cause foot infections.Be careful while walking to prevent falls.

Watch your diet. Stick to your prescribed diet. Stay away from hot fried snacks. Wash all vegetables well, especially green leafy ones, as they can harbour worms and larvae in this season. Drink boiled water to prevent water borne diseases such as typhoid and diarrhoea.

Be aware, that nausea, vomiting, and diarrhoea can lead to lack of appetite and dehydration. Low food intake can result in hypoglycemia. To prevent complications, apply sick day rules for medication if calorie intake is not enough.

Look after your health. Immunity is low during the monsoons. Be careful of insect borne diseases such as dengue and malaria and viral fever. The humidity, change in climate and getting wet can lead to upper respiratory tract infections such as pharyngitis and bronchitis.

Most important of all, be in good control of your diabetes.

Have Diabetes? Travelling Days are Not Over

Living with diabetes does not make people housebound for the rest of their lives. You can live a normal life and enjoy most of the activities along with the rest of your family.Travelling either on work or for pleasure is a common activity. For a stress free and enjoyable  time, be aware of the problems you may face, plan out and organize your activities, and make a few adjustments as required.

What are the problems one may face while travelling? Many factors such as missed medication, change in exercise routine, climatic factors such as temperature and altitude, illness,
change in diet, and changes in sleep timings upset blood glucose control. Infections , especially of the foot and the skin , and hypoglycaemia are also areas for concern.

Travelling in India can be challenging due to the different climatic and geographical conditions, lack of hygiene and overcrowding.

General care includes

• Care of the feet and regular checks for any changes
• Not walking barefoot in hotels rooms
• Comfortable sturdy shoes that don’t pinch the feet
• Using sunglasses, caps, long sleeved clothing and sun screen for protection from the heat and humidity.
• Precautions to prevent physical injury
• Avoiding the swimming pool.
• Clean, uncontaminated water and hygienically prepared food.
• A Diabetes Identification tag in case of emergency.
• Taking the minimum quantity of ‘prasadam’ if on a pilgrimage, as it is usually made of sugar and ghee,
• and not bathing in public spaces.
• Frequent monitoring of blood sugar levels.
• Quick snacks and medications at hand.
• Consuming plenty of water to prevent dehydration and hypoglycaemia in hot humid places.
• Good fitness levels when travelling in high altitude areas.
• Walking about to improve blood circulation during long journeys.

  If travelling by air…

1. Pack twice the quantity of all your medications and diabetes supplies to last the journey in case of unexpected delays or losses.
2. Keep medication in original packing and carry in the hand luggage. 
3. Be familiar with the generic name and brand name of the medications you use as many may be available under different trade names in other countries.
4. Get a letter from a diabetologist for security or customs clearance for medications and medical devices. It will also be helpful to replace lost or stolen or damaged medication or to get medical attention abroad.
5. Blood glucose is measured in different units in other countries . Know the conversion and have a conversion chart handy.
6. Monitor blood glucose every 4 – 6 hours while travelling long distances because changes in meal times and activity levels can upset blood glucose levels.
7. Pre- order diabetes friendly meals and carry snacks such as cereal bars, whole wheat or multi grain  sandwich, puffed rice and roasted Bengal gram and biscuits in case of delays.
8. Drink plenty of water.
9. If using insulin, learn to make dose adjustments according to the time if crossing more than 5 time zones.
10. Do not adjust your watch to local timing so that you get a better idea of the time.
11. Inform flight attendants or staff at destination about your condition.
12. Medication and monitoring equipment can be given to the flight attendants for storage.
13. Check opened insulin bottles for crystallization before you use them.
14. If using insulin pumps, continue with the normal basal and bolus doses till you reach your destination.
15. Carry extra batteries and supplies of insulin and syringes in case the pump does not work properly.

 If travelling by train or road – 

• Do not drive more than 12 hours at a stretch and do not wait for more than 6 hours between meals.
• Do not drink alcohol before you travel.
• Carry suitable snacks and inform travel companions in case you feel the signs of hypoglycaemia. Take immediate action in case you show signs of hypoglycaemia. In case of hypoglycaemic symptoms, stop and take some quick acting glucose.
• Do not drive if complications have started.
• People using oral medications can miss a dose and have a slightly raised blood glucose level for 6 – 8 hours rather than take 2 doses close together and get hypoglycaemia.
• If you are using medications such as caboose that prevent absorption of carbs, continue the usual regimen of taking it before meals.

The more you travel the easier it will get. People with diabetes who are travelling should meet with the diabetes educator before the journey to find out whether they are fit to travel, about vaccinations, travel
insurance, effect of weather on blood sugar level, diet plan to be followed, and storage of medications.
Talk to people who have travelled and share experiences. An informed person can make good
choices and travel confidently.

Live Well with Diabetes

What’s New in Diabetes Research ?

Keep up with the times
Social media and diabetes care
 
Social media has become a force to reckon with and has permeated through every known activity. Doctors can get greater insight into what patients are discussing regarding care, treatment, and needs especially in diabetes management. As managing diabetes is a continuous process, doctors can get to understand the day- today life and the impact of diabetes by reading patients’ tweets on Twitter. Doctors will be able to observe a lot more about the patient than they usually do through a short interaction at the clinic. 

To prevent the development of foot ulcers in people with nerve damage in their lower limbs, a UK research team is testing new technology to help find a way to raise an alarm if pressure is too high. The
‘biofeedback’ system uses special insoles in shoes to record foot pressure and relays this information to the screen of a ‘smart watch’. When the system beeps or vibrates as a warning of high pressure, the user can use corrective measures to reduce the pressure.

Gut bacteria –
‘The forgotten organ’

 Possible links have been observed between gut bacteria and the rise in obesity and Type 2 Diabetes mellitus.

An ideal balance of gut bacteria is important to our health and any changes can play a role in the development of conditions such as inflammatory bowel disease, colon cancer,asthma and so on.

There is now growing evidence that changes to the balance are also involved in the development of both Type 1 diabetes mellitus and Type 2 diabetes mellitus.*

Increasing evidence suggests that gut bacteria are an important bridge between genes and lifestyle, environment, immune system and risk of Type 2 Diabetes mellitus.

Animal studies show that obesity is linked to changes in the composition and function of the gut bacteria. Diet and physical activity both have an effect on gut bacteria. – a healthy diet low in fat and high in fibre has been linked to more diverse bacteria when compared to a diet high in fat and low in fibre*.

Experiments show that gut bacteria help to digest otherwise indigestible sugars in our diet, store energy as fat, and use energy by burning fats. By doing this, they can either contribute to or help protect against weight gain, resistance to insulin in body cells and Type 2 Diabetes mellitus.

Excess of gut bacteria due to eating too much fibre can change the way the liver processes fat and can lead to the development of metabolic syndrome, a precursor of Type 2 Diabetes mellitus *.

Further studies could open the door to completely new ways to treat obesity and T2DM.*

Diabetes mellitus is a group of diseases that
result in too much sugar in the blood, or
high blood glucose.
The most common types are:
Type 2 diabetes - A chronic condition that
affects the way the body processes blood
glucose
Type 1 diabetes - A chronic condition in
which the
pancreas produces little or no insulin.
Pre diabetes - A condition in which blood
sugar is high, but not high enough to be
Type 2 diabetes.
Gestational diabetes - A form of high blood
sugar affecting pregnant women
Consult a doctor for medical advice. 

 

Diabetes and Menopause

Whether you have Type 1 diabetes or Type 2 diabetes, menopause can affect your diabetes management:

•      Hormone levels can make blood glucose levels erratic
•     Weight gain can mean an increase in the medicine you take
•      Hot flushes and night sweats can affect your sleep and indirectly affect your diabetes management.

Talk to your diabetologist
 You can help yourself by…

•  

Having a healthy balanced diet. 

• Keeping active. 
• 
  
• Checking blood glucose levels regularly and seeing if it is affected by any changes  you have made in medication to deal with highs and lows.
• Hormonal changes during menopause increases the chances of developing Cardio vascular disease in women. Lower oestrogen increases the risk of osteoporosis.To reduce  the risk…
•  Keep active with weight bearing exercise such as walking and dancing.
• Increase calcium rich foods- leafy greens, dried fruit, tofu and yogurt.
•     Vitamin D is also important for healthy bones – eggs, milk, oily fish and sunshine.

Watch the waist line.   

It usually starts to expand between 40 -50 years for men and women because of less activity, more alcohol, hormonal changes, busy life style and generally expands without your noticing it.

For men, testosterone starts to drop during middle age and can result in reduced muscle mass, lack of energy,or  depression. Men with low testosterone levels are more likely to be resistant to insulin. A lot of men with Type 2 diabetes have low testosterone levels.

People who learn more about diabetes usually have better control of their condition.