Situations in which diabetics should avoid vigorous physical activities

Physical activities cannot be the same for every one all the time, in some special cases especially In type 1 diabetes, exercise can worsens hyperglycemia (>300mg/dl) and ketosis. Vigorous activities are best avoided.
Things to be noted in:
Hypoglycemia
Patients on insulin are at risk, added carbohydrate consumption is required if pre-exercise glucose levels are less than 100mg/dl and for patients on other medicines, preventive measures are not required
Retinopathy
Vigorous aerobic or resistance exercises- contraindicated and there is a risk of developing vitreous hemorrhage or retinal detachment.
Peripheral neuropathy
Excess physical activities may lead to loss of protective sensation; also there is a high risk of skin break down, infection and Charcot joint destruction. It is best advised to go for non- weight bearing exercises like Swimming, bicycling, arm exercises etc.
Autonomic neuropathy
Physical activities here can increase the exercise induced injury and also it can decrease cardiac responsiveness, postural hypotension, impaired thermoregulation, impaired night vision due to impaired pupillary reaction and unpredicted carbohydrate delivery from gastroparesis.
The best solution is to individualize the physical activity according to the cardiac status.
Some Special precaution to be kept in mind
**Feet should be inspected for any cuts blisters and infection
**Avoid exercises in extreme hot and cold climates
**Avoid exercises during periods of poor metabolic control
Benefits of exercise
**Improvement in insulin sensitivity
**Reduction of height
**Reduction in weight
**Improvement in lipid profile
**Improvement in cardiovascular function
**Sense of well being

Disclaimer: All opinions and Information published here is for medical education only. It is not intended as and does not substitute for medical advice. If you are a patient, please see your doctor for evaluation of your individual case. Under no circumstances will the authors be liable to you for any direct or indirect damages arising in connection with use of this website

Vaccum Assisted Closure (VAC)

The latest in Diabetic foot wound healing ……..now at M.V. Hospital

Diabetic foot ulcer is a cause for enormous suffering, loss in economic productivity and mortality. The outcome is poor because of the severity of the disease. Management is often sub optimal because of poor understanding of the subject and it is unfashionable and generally omitted from professional training and largely neglected in research. The result is that ignorance is endemic; management is guided by belief and habits more than by evidence and research allocation is minimal. The technology has been revolutionized and recent advances are a boon to man-kind. One such example is VACCUM ASSISTED CLOSURE device which works on the principle of negative pressure wound therapy (NPWT). It involves the delivery of intermittent or continuous sub-atmospheric pressure through a specialized pump connected to the wound surface maintaining a closed environment. The pump is connected to a canister, which serves to collect wound discharge and exudates. Studies have shown that VAC therapy system yielded a higher proportion of healed wounds, faster time to wound closure, a more rapid and robust granulation tissue response and reduced risk for a second amputation. Keeping pace with time and technology, the VAC system has been introduced recently at our centre. We at M.V. Hospital are using this technology in treating diabetic foot ulcers and have achieved good results. VAC therapy is indicated in larger, deeper and partial foot amputation wounds. However, they are contraindicated in small wounds responding to debridement.

Disclaimer: All opinions and Information published here is for medical education only. It is not intended as and does not substitute for medical advice. If you are a patient, please see your doctor for evaluation of your individual case. Under no circumstances will the authors be liable to you for any direct or indirect damages arising in connection with use of this website