| FOOT CARE: People with diabetes are at risk for foot injuries due to numbness caused by nerve damage and low blood flow to the legs and feet. The most serious injury is a foot ulcer. Diabetic foot ulcers are at very high risk of becoming infected, and sometimes they cannot be healed. Non-healing foot ulcers are a frequent cause of amputation in diabetics. To prevent foot injury, diabetics should adopt a daily routine of checking and caring for their feet as follows: ? Check the feet every day, and report sores or changes and signs of infection ? Wash the feet every day with lukewarm water and mild soap, and dry them thoroughly ? Soften dry skin with lotion or petroleum jelly ? Protect the feet with comfortable, well-fitting shoes ? Exercise daily to promote good circulation ? See a podiatrist for foot problems, or to have corns or calluses removed ? Remove shoes and socks during every visit to the healthcare provider to remind them to examine the feet ? Stop smoking, because it worsens blood flow to the feet |
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Prognosis For many years, it was thought that the long-term complications of diabetes were inevitable. We now know that this does not have to be true for most people. Diabetes is frequently complicated by heart disease, stroke, kidney failure, impaired vision or blindness, diseases of the nervous system, and foot and leg amputations. Recent studies show that good blood sugar control can prevent these complications. The Diabetes Control and Complications Trial (DCCT) studied the effects of tight blood sugar control on complications in Type 1 diabetes. Patients treated for tight blood glucose control had an average HbA1c of approximately 7 percent, while patients treated less aggressively had an average HbA1c of about 9 percent. At the end of the study, the tight blood glucose group had dramatically less kidney disease, eye disease, and nervous system disease than the less aggressively treated patients. The United Kingdom Prospective Diabetes Study (UKPDS) studied the effects of tight blood glucose control in patients with Type 2 diabetes. This study also found dramatically lower rates of kidney, eye, and nervous system complications in patients with tight control of blood glucose (meaning an average HbA1c of 7%). In addition, there was a significant drop in all diabetes-related deaths, including lower risks of heart attack and stroke. Tight control of blood pressure was also found to lower the risks of heart disease and stroke. The results of the DCCT and UKPDS studies confirm that good blood sugar control reduces the risk of long-term complications in both Type 1 and Type 2 diabetics. Complications Possible complications include: ? Heart disease (the leading cause of death among diabetics) ? Stroke ? Eye disease (cataracts, glaucoma, blindness) ? Kidney disease leading to kidney failure ? Nervous system disease, especially affecting the hands and feet ? Amputation (due to foot ulcers or gangrene of the feet and toes) Calling your health care provider Go to the emergency room or call the local emergency number if symptoms of ketoacidosis are present: ? Increased thirst and urination ? Nausea ? Deep and rapid breathing ? Abdominal pain ? Sweet-smelling breath ? Loss of consciousness Go to the emergency room or call the local emergency number if symptoms of extremely low blood sugar ("hypoglycemic coma" or "insulin reaction") are present: ? Weakness ? Drowsiness ? Headache ? Confusion ? Dizziness ? Double vision ? Lack of coordination ? Convulsions or unconsciousness may follow |
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