Diabetes and the NCAA Tournament...athletes can live with it too!

Diabetes is a condition that affects all walks of life, young and old, people of all backgrounds, and even.... athletes. With the brackets and the NCAA tournament the talk of everyones lips, it is little known that Georgetown guard Austin Freeman was diagnosed with diabetes last season when he missed a home game loss to Notre Dame with what was originally thought to be a stomach virus. The "virus" continued to plague him, and he was just not getting better... and that's when the doctors knew it was something much more. This condition is not expected to affect his career; many athletes lead successful college and pro careers with diabetes. They just have to take careful consideration when training and playing with the conditions that diabetes presents, which is something all diabetics have to face whether a trained athlete or not. He will have to carefully monitor his blood sugars and make sure that he has enough hydration when on the court. Diabetics are not able to convert sugar to energy because the body can't properly use the insulin it produces, or, the pancreas just quits making insulin. In his case, he is a type 1 diabetic, and in his case, he no longer produces insulin. This means he needs daily insulin injections or the constant delivery of insulin through an insulin pump.

But the important thing is that one can live with diabetes with a lifestyle change, as demonstrated by Austin Freeman; it can be done.

Simple Home Diabetic Foot Exam

As a diabetic, it is important that you do a diabetic foot exam on your feet every day. First of all, as a diabetic, you should have a relationship with a podiatrist, or foot and ankle specialist, and he or she should have good communication with you and your primary care physician. As a team, the three of you can keep your diabetic feet healthy. Here are a few of the basic recommended things you can do at home to help with your diabetes foot care.

Daily foot exam: Take a look at your feet every day, top and bottom. It may be helpful to take a hand-held mirror and look at the bottom of your feet as well. You need to examine your feet every day and after any trauma you may experience no matter how minor you think it is. Trauma is just a fancy word for any sort of physical injury or bump to your feet. Tell your podiatrist about anything like this that happens.

Foot Cream: apply a moisturizing cream on your feet every day on the top and bottom of your feet, but never between your toes.

Socks: Avoid wearing tight elastic socks or nylons. They can cut off or impair your circulation without you being aware of it. Wear cotton or wool socks instead. Nylons can cause shearing and they trap moisture and do not allow your skin to breathe.

Clear the Area: Make sure the area where you walk is clear of clutter. get any items you're likely to trip over or bump into out of the way.

Footwear: Make sure to wear sturdy and comfortable shoes wherever possible to help protect your feet. You may qualify for diabetic shoes through the Medicare shoe program. At Prairie Path Foot and Ankle clinic and Schaumburg Foot and Ankle clinic, we are certified to fit our qualifying patients with Dr. Comfort brand shoes. Please visit our office in Elmhurst or Schaumburg Illinois to see if you qualify.

Taking these simple measures at home along with a comprehensive plan of diabetic footcare and surveillance with the help of your podiatrist will keep your feet healthy, and will keep you active and healthy.

Diabetic Foot Ulcers- Their connection to neuropathy?

According to the CDC, almost 24 million Americans have diabetes. That is merely an estimate! And, in addition, it is reported that about , six million of those individuals are undiagnosed. Along with diabetes, there are several other complications that may lead to serious conditions, including diabetic foot ulcers.

Patients with diabetes have a 15%-25% lifetime risk for developing a foot ulcer. Why and how does this happen? One of the common findings in patients with diabetes is diabetic neuropathy. This may manifest itself in the form of tingling and numbness in the fingers and toes. In the foot, patients describe the feeling of neuropathy as sharp shooting pain, tingling, burning, or just plain numbness. Due to the lack of sensation, an area of increased friction due to a bony prominence or an ill fitting shoe can easily break down the skin. In a person without diabetes, the breakdown of skin can be a blister or corn or callus and the person would feel pain. The pain would signal the nondiabetic person to remove their shoe, inspect the wound, or seek medical help. However in a diabetic patient with neuropathy, he or she is unable to feel any pain, blistering, or infection until is too late. An open sore forms, or an ulceration, and in this case, when an ulceration occurs, the risk for infection is present and may range in severity from a superficial area to one that pervades the bone. Infection is the leading risk factor for amputation among those with diabetic foot ulcers.

So please, if you are diabetic, seek help from a foot specialist. For example at our clinic, Prairie Path Foot and Ankle Clinic, we take pride in serving our diabetic patients with the utmost care. Your primary care doctor should check your feet at every visit, and you as a patient should be checking your feet daily as well. A visit to our office will put you at ease and answer any questions you may have about diabetic foot care and prevention. Leave your feet it in our hands!

Diabetes and Chocolate?

With the Easter holiday upon us, everywhere you turn its candy, candy, candy... especially chocolate. Many of my patients ask me, can diabetes and chocolate mix?

With so many consumers suffering from diabetes, there has been a great deal of discussion about which foods are OK and which ones are forbidden. As with all simple sugars, those patients with diabetes may enjoy an occasional chocolate treat if they exercise restraint and moderation. According to dieticians, the sugar in chocolate is absorbed more slowly than that found in many often consumed foods, such as white bread and even mashed potatoes. However when consuming chocolate, if it is part of a meal or as a small dessert, the food already in your stomach may delay the absorption of the sugar, and may slow the rise in blood sugar vs. if you eat chocolate alone or on an empty stomach. This means that the body has a bit more time to deal with the rise in blood sugar caused by sugar in chocolate. It is important to keep in mind, however, that too much chocolate can lead to obesity, which is a complicating factor for diabetics.

What about special "diabetic" chocolate? This type of chocolate is made with sorbitol, which is a sugar alcohol. If eaten in excess, side effects may include laxative effects or cramping. While the diabetic chocolate is designed to not raise blood glucose levels, it still has plenty of calories, and it is important not to think of this special chocolate as a license to overeat.

So the bottom line is this - whether you eat chocolate or not, as a diabetic, the key is to eat in moderation. Ultimately, checking with your doctor or dietician can determine whether you can safely eat traditional chocolate or "diabetic" chocolate with sorbitol. The most important fact to take away from this is that it is of the utmost importance to discuss your diet, chocolate or not, with your endocrinologist, diabetes educator, dietician, or primary care doctor. No one dietary plan will be right for every patient, and open and honest communication with the doctor is one of the best ways to avoid the complications that may result from having diabetes. They may have further insight into recommendations, and yes, you have to take their word for it if they determine that chocolate may not be right for you.

Over the counter orthotics in diabetics?

I saw a patient today who received orthotics, or insoles, from a shoe store. She was told that these were "custom"; however, there was really nothing "custom" about them! They were not prescribed by a podiatrist, and the material was not accomodative and instead quite rigid and uncomfortable. And the worst part about it was... the shoe store had labeled the orthotics wrong! The left foot orthotic was in the right shoe, and vice versa. Thank goodness there were no immediate ill effects with the wrong orthotics in the wrong shoe, but this could be potentially detrimental.
So, bottom line... when choosing orthotics, there are several things to keep in mind as a diabetic. The best option is really custom made orthotics made per your prescription from a podiatrist. This way, you know that your podiatrist has done a thorough exam and has accounted for all the issues with your foot, including possibly bony deformities and diabetic neuropathy, which will prevent you from getting sores. In addition, your doctor can determine if diabetic shoes are for you in addition to the custom insoles. Another option if the custom orthotics are not possible is a good semi-custom orthotic that can be purchased and accommodated by your podiatrist. The most important thing is to get your feet examined and checked often, in order to stave off potential foot problems.

Bret Michaels is a diabetic

Bret Michaels, the lead singer of the rock band Poison, is a type 1 diabetic. This is also called early onset or juvenile diabetes, because of when he was diagnosed at age 6. He is now a spokesperson and was selected as the face of diabetes by the American Diabetes Association. He has a public service announcement, and even incorporated his diabetes into his VH1 reality show "Rock of Love" where he tested potential matches by having the ladies practice injecting insulin into an orange!
His face as the face of diabetes is a good choice. It shows how mainstream diabetes really is... and that it is a disease that you can live with for a long time if you take precautions such as diet, exercise, and monitoring blood glucose levels very closely. Bret says he is used to using blood glucose monitors and it is part of his rock star touring lifestyle. He still uses insulin shots instead of the pump, but he says that is for "cosmetic reasons." Many diabetics use a pump that eliminates the need for insulin syringes and injections; that is his choice. He truly shows that diabetes has many faces... any many choices in managing it.

Can I start an Exercise Program?

In my office, I see a lot of diabetics for preventative foot care, and each and every one of them inevitably will ask me my opinion on exercising and the proper way to start. If you have recently been diagnosed with diabetes, or if you are overweight, it is important to speak to your pirmary care doctor before you start and exercise program, no matter how slow you start out.
Here are some other tips to keep in mind as a diabetic:

-Make sure you have proper fitting shoes. Very often our patients have prescription accomodative orthotics, or insoles, in their shoes to prevent areas of pressure from building up. Also, many of our patients have prescription diabetic shoes, either walking shoes or gym shoes, that are fitted by our certified medical assistants to make sure there are no pressure spots. We urge our patients to break in the shoes by wearing them an hour or two and gradually increasing the time worn each day, inspecting your feet for areas of redness or pressure.

-Make sure you have proper socks. I recommend a cotton blend with nylon or another material that "wicks moisture away" from the skin. This will prevent blisters in pressure areas, and also prevent fungus or athletes foot.

-Start off slowly, with a low impact activity such as walking. Build up the time gradually, either by distance or by time. If you have joint problems, consider swimming or aqua aerobics

-Keep water near by, and keep well hydrated, especially on hot days

-Always wear an ID tag indicating that you have diabetes to insure proper treatment in case there's a problem when you're exercising or you have an injury.

-Try to exercise at the same time every day for the same duration. This will help control your blood sugar. Exercise at least three times a week for about 30 to 45 minutes.