Posts for: March, 2014

Delaying medical help for foot problems greatly increases risk of amputation

March 7 2014. 

A study of foot care by Leicester University has highlighted the importance of seeking early medical care for people with diabetes withfoot problems.

The researchers reviewed 20 cases of foot problems in which care had been delayed. Out of the 20 cases, the average delay had been 18 weeks of symptoms until the patient received care. In one of the cases, the delay was 36 weeks.

The results showed that in 30% of those cases in which care was delayed, amputation was needed to prevent even more seriouscomplications occurring. The research was presented at Diabetes UK's Annual Professional Conference taking place in Liverpool.

Amputation is not just something that happens to others, it can happen to any of us with diabetes if a foot problem is not reported to our health team.

Commenting on the study findings, Diabetes UK's Director of Policy and Care Improvement, Bridget Turner states: "It is extremely worrying that some people are waiting many months to seek medical attention and this shows we need to do much more to raise awareness of the issue of lower limb amputation in people with diabetes and to make sure people who are at high risk are given information about what they need to do if they have problems."

Any change in the foot should be regarded as a foot problem and this includes in-grown toenails, bunions, dry skin, grazes, burns and wounds. Daily foot checks are recommended to help you spot any changes that may be occurring in your feet. Don't be tempted to rely on feeling alone as nerve damage is a common consequence of diabetes that can lead foot problems to occur without necessarily feeling it.

To assist people in learning about the importance of foot checks, as well as how to perform foot checks, Diabetes UK has produced the booklet 'How To Spot A Foot Attack'.

In addition to regular foot checks, maintaining good control of diabetes can significantly reduce the risk of suffering foot problems. 

We all need a little help at first to get blood sugar levels under control so Diabetes.co.uk, Europe's largest diabetes community site, has developed a unique diabetes programme for people with type 2 diabetes that are not on insulin and are unable to get test strips on prescription.

To find out more and to sign up, visit www.type2testing.com


Are high heels really bad for you?

 

The Times | March 7 2014. 

I’m not ashamed to say I have a shoe fetish, especially when it comes to high heels. In fact, I probably need to get some sort of therapy, such is my love for towering foot bling. Open my wardrobe and you’ll find them lovingly packed away in their original boxes, and I take great delight in matching my outfit to my footwear. When I walk out the door in a favourite pair I feel a million bucks.

 

My addiction to high heels is sometimes a problem given I’m five feet nine inches. Add an extra couple of inches or six to my frame and I end up well over six feet. So I use the shoes for strategic advantage in work situations. If I’m going to a meeting and I need to scare the client, I’ll make sure I wear the highest heels possible. But if I want to put the client in a position of power, I’ll choose lower ones.

Anyway, massaging my tootsies one evening after a particularly gruelling day got me thinking. Could I be doing myself damage by wearing my stilettos? Am I sacrificing long-term physical strength for short-term pleasure?

I posed this question to podiatrist Dr Paul Dowie from Melbourne’s Foot and Leg Pain Clinics. Surprisingly – and thank goodness – he says it’s normal to get sore feet if you’re on them all day and that high heels are not necessarily bad for you. He says it’s about wearing the right shoe for the job.

“If you work in retail and you’re in heels and on your feet all day, it’s all about your body and your genetics, the type of shoe you’re wearing and the structure of your feet. Some people are conditioned and adept at wearing high heels while others struggle,” Dowie says.

If you love wearing heels but you can’t cope with the pain, he suggests modifying your behaviour to reduce the impact of the heels. “If you have a desk job, think about how you get to work because wearing office shoes doesn’t always suit being in transit. If you catch the train and walk to and from the station, think about wearing runners instead. Wearing multiple pairs of shoes can help you to cope.”

In fact, Dowie says wearing flat shoes can be just as much of a problem for your feet as wearing heels. Take a look at the shoes you’re wearing at the moment and look at the ‘’pitch’’ or elevation of the heel. According to Dowie, a pitch of around four centimetres helps propel you forward and results in less strain and pain. But he says there’s no universal heel height that is considered ‘’right’’.

“You also have to factor in the psychological aspect. People who are vertically challenged often wear heels to increase their confidence,” he argues.

I’m pretty much flabbergasted when he says this – it’s not at all what I expected a foot doctor to say. But it’s a sentiment with which Jodie Fox, who runs Shoes of Prey, a business that allows customers to design their own shoes, agrees.

“If I go to a board meeting I wear high heels; it’s part of creating a sense of gravitas. Plus the two co-founders of the business are very tall and I’m not. So it’s also about standing at an even height,” she explains.

Fox says high heels are a way of expressing yourself in the workplace. “But you don’t have to wear bold party shoes. You might choose a shoe with coloured piping, to help give you confidence and perform at your best. And there’s lots of research that suggests that if you’re in a positive mind frame, even if you’re heading into a difficult situation you’ll perform better.”

She says wearing heels allows women to maintain their femininity, which can be an advantage in the workplace.

Fox also pooh-poohs the notion high heels are uncomfortable – in fact, on the Shoes of Prey YouTube channel you can watch her run the three kilometres between Bondi and Bronte in four-and-a-half-inch heels. It’s quite the feat.

As to whether heels damage your feet, Fox offers some practical tips. You can find videos on her YouTube channel that show women – and I guess men, too, if they’re into wearing heels – how to strengthen their calves, which are compressed by wearing heels, and stretch their legs after a long day in them.

“Heels raise your stature and confidence; they’re all about allowing women to express themselves in a work situation. I’m all for them,” she says.


Health alert: Are you at risk for type 2 diabetes and don't know it?

 

BrandPoint | March 11 2014

(BPT) - Diabetes is a serious disease that strikes nearly 26 million children and adults in the U.S., and 7 million do not even know they have it. An additional 79 million, or one in three American adults, have prediabetes, which puts them at high risk for developing type 2 diabetes. 

For 26 years, the American Diabetes Association has set aside one special day for people to learn their risk for developing type 2 diabetes. Held on the fourth Tuesday of every March, American Diabetes Association Alert Day (R) is a one-day "wake-up call" asking the American public to take the Diabetes Risk Test. This year’s Alert Day will be March 25. The Association will also be encouraging the public to start living a healthy and active lifestyle by asking them to join a Step Out: Walk to Stop Diabetes (R)event in their area. 

The Diabetes Risk Test asks users to answer simple questions about weight, age, family history, and other potential risk factors for prediabetes or type 2 diabetes. Preventive tips are provided for everyone who takes the test. For every Diabetes Risk Test taken, Boar’s Head Brand(R) - a leading provider of premium delicatessen products – will donate $5 to the American Diabetes Association starting March 25 through April 25, 2014, up to $50,000.

Risk factors for type 2 diabetes include people who are overweight, are under active, over the age of 45 or who have a family history of diabetes. African Americans, Hispanic/Latinos, Native Americans, Asian Americans and Pacific Islanders are also at higher risk. Understanding your risk for developing type 2 diabetes, or getting an early diagnosis, is critical to successful treatment and delaying or preventing some of its complications such as heart disease, blindness, kidney disease, stroke, amputation and death.

Carmen Micciche was diagnosed with type 2 diabetes at the age of 31. By then, at 400 pounds, he’d been feeling the symptoms for about six years, yet he ignored them.

“I didn’t even know what diabetes was when I was diagnosed,” says Micciche, now 56.

Micciche, a Subway (R) restaurant franchise owner, was so focused on building a successful business he ignored his health and suffered through numerous gall bladder attacks before finally seeing a doctor. After checking his blood pressure and testing for diabetes, he was sent to the hospital.

Twenty year later, Micciche now weighs about 185 pounds and has brought his A1C (average blood glucose levels) down from a staggering 12 percent to just over 6 percent, which is close to the normal range. He finally learned – with daily exercise and healthy eating – what it takes to be healthy.

“Eat right, exercise, listen to your doctors,” he says. “You have to do everything you can to maintain a healthy weight. The consequences are too high if you don’t.”

Micciche has helped raise more than $1 million for the American Diabetes Association to help Stop Diabetes (R), placing donation boxes and selling pin-ups in each of his 30 Subway restaurants . He wants everyone to know that a type 2 diabetes diagnosis doesn’t have to end your life.

Studies have shown that type 2 diabetes can often be prevented or delayed by losing just 7 percent of body weight (such as 15 pounds if you weigh 200) through regular physical activity (30 minutes a day, five days a week) and healthy eating. By understanding your risk, you can take the necessary steps to help prevent the onset of type 2 diabetes.

Be part of the movement to Stop Diabetes and take the Diabetes Risk Test by going todiabetes.org/risktest, the Association’s Facebook page where you can share the test with friends and loved ones, or by calling 1-800-DIABETES (1-800-342-2383).


Fashionable footwear is killing your feet

March 12 2014

More than half of Americans suffer from foot problems, and often those problems are directly related to shoes.

But no matter how cute a shoe looks,  Orly Avitzur, medical adviser at Consumer Reports, said that having fashionable footwear isn't worth the health risks.

"Wearing the wrong shoes can lead to lifelong deformities that require surgery to fix," she said.

According to a new study from the Institute for Preventive Foot Health, uncomfortable and ill-fitting shoes are a serious problem. Shoes that force feet into narrow or pointy toes can cause bunions or hammertoes, where the toes curl unnaturally downward.

But that doesn't stop women like Trisha Calvo and Jennifer Frost from wearing name brand heels.

"I feel fabulous in them," Frost said. "You feel fabulous in your shoes...not physically 
fabulous in them."

Studies show that high heels can shorten your Achilles tendon and can trigger planter fasciitis, an inflammation in the soles of the feet. Avitzur recommends foregoing high heels for something more comfortable.

"Opt for a lower heel to take some of the pressure off the ball of your foot," she said. "Make sure that there is enough room in the toe, and avoid thin-soled shoes that have little or no support."

But even flat shoes can hurt feet if they lack proper support and cushioning, especially if they're the wrong size.

One recent study revealed that up to a third of people wear the wrong shoe size, sometimes by up to one-and-a-half sizes. To combat that problem, Consumer Reports recommends measuring your feet each time you buy, especially for people over 40. After that, feet can grow up to half a shoe size every 10 years.


The Best Physical Activities to Do for Diabetes (and life)

 

By Sheri Colberg, PhD | March 7 2014.

As is widely known, the benefits of being active are innumerable, including prevention of type 2 diabetes, weight loss and maintenance, improved quality of life, longer self-care abilities, reduced arthritic pain in joints and increased mobility, better balance and falls prevention, stronger bones, and a better memory, just to name a few.

I recently read an online report promoted by the American College of Sports Medicine through social media outlets about five of the best exercises you can ever do. I agreed with them all in principle, but I just want to add my two cents as an exercise professional and diabetes expert about why these (and other) exercises are particularly good for people with diabetes. The online report stated that no matter your age or fitness level, these five activities can help you get in shape and lower your risk for disease: swimming, tai chi, strength training, walking, and Kegel exercises. For people with diabetes, however, I would change and update them to the following instead, including a new order of importance:

(1) Strength training

In recent years, the most compelling scientific evidence for diabetes management has been the inclusion of resistance/strength training as part of an exercise routine. Think of it this way: muscles are the main place we have to store excess carbohydrates that we eat, and the bigger the muscle "tank," the more carbs we can store there.

Aging by itself causes some loss of muscle mass over time, and being sedentary and having diabetes both increase the rate at which we are losing muscle. We get more insulin resistant when our muscle carb stores (glycogen) are full, which happens when we eat a lot of carbs and remain inactive. Any carbs that are unable to go into storage in muscle (or the liver) are converted into and efficiently stored as fat.

Only strength training recruits and preserves muscle fibers that you would otherwise lose as you age or sit around too much. Start doing strength training at least two to three days per week, even if it's only doing exercises using your own body weight as resistance (like planks, lunges, or wall push-ups). Resistance bands, dumbbells, and household items that can be used as resistance (e.g., water bottles and soup cans) will also all work.

(2) Daily walking

Since it's an activity that most people can do, walking should be included as a daily part of almost everyone's activity plan. Just simply taking more daily steps can help you lose weight and keep it off, lower blood cholesterol levels, keep your bones strong (since it's a weight-bearing activity), reduce arthritic pain in your hips and knees, lower your blood pressure, and improve your memory. You just have to remember to walk more every day.

When you have diabetes, it is particularly important that most of your walking be done wearing good-fitting and supportive shoes and socks that keep the dampness of your feet to a minimum. It is imperative to inspect your feet every day (using a mirror on the floor to reflect the bottom of your feet, if necessary) to catch problems areas sooner rather than later. Walking has not been shown to cause ulcers to recur if they have healed properly, but any skin irritation discovered and treated early on has less chance of developing into a bigger problem in a diabetic foot.

If your fitness level is low, start by walking for up to 10-15 minutes at a time. As you are able, walk farther and faster until you reach a goal of at least 30 minutes most days of the week. If you do not have time to time a single walk for that length of time, it is perfectly acceptable to walk more times during the day for a shorter amount of time to add up to that total.

(3) Tai chi, yoga, stretching, and balance exercises

Tai chi is made up of a series of graceful movements that work on stretching, strength, and balance all at the same time, but most people have to sign up for a class to help get started and learn the proper form. You can find tai chi programs at your local YMCA, health club, community center, or senior center.

Equally helpful and important are other activities that also work on balance and flexibility, such as yoga, dynamic or static stretching, and balance training. The latter can be as simple as practicing standing on one leg at a time without holding on (or with minimal support), first with your eyes open and later with them closed. Stretching is easiest to do after warming up by doing a light aerobic activity first.

Improving both your flexibility and balance is critical to preventing falls, which are even more common in people with diabetes as they age or if they develop peripheral neuropathy. Diabetes also accelerates the loss of flexibility due to glycation of collagen in joints, and having less range of motion around joints increases the likelihood of injuries, falls, and self-imposed states of physical inactivity due to fear of falling. It never pays to neglect these important activities.

(4) Swimming or other aquatic exercise

When you swim or exercise in the water, your added buoyancy takes the strain off painful joints so you can move them more fluidly. Among the non-weight-bearing activities, it is probably the best one of all. The only drawback is that it does very little to stimulate better bone mineral density and should, for that reason, be combined with other activities that are weight-bearing.

While swimming is an excellent activity, engaging in aquatic classes (like water aerobics) in either shallow or deep water is also challenging and beneficial. Many of these activities incorporate both a stretching component and a strength-building element that can improve joint mobility, overall strength, and aerobic fitness all at the same time.

(5) Kegel exercises

Kegel exercises strengthen the pelvic floor muscles that support the bladder and help prevent urinary incontinence (which can be a deterrent to doing many other physical activities). More women than men are familiar with these exercises, but they benefit men equally as well.

You can practice your Kegels by squeezing and releasing the muscles you use to stop urination or prevent yourself from passing gas. Work up to doing three sets of 10-15 Kegel exercises every day, and alternate quick squeezes and releases with longer, 10-second contractions and relaxations. Work up to doing three 3 sets of 10-15 Kegel exercises each day for best results.

In conclusion, never forget that many other daily activities count as exercise, including yard work, gardening, ballroom dancing, playing with your kids or grandkids, walking the dog, doing housework, and standing up. It's still recommended that you aim to do at least 150 minutes a week of aerobic exercise and a minimum of two days of strength training a week, but keep in mind that doing any activity at all (even if less than recommended) is better than doing none. So, get up and get active!

 

Copyright © 2013 Diabetes In Control, Inc. 

 

 




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