With the newer insulins, there are many ways to be creative about this. For everyone with diabetes, it is important not to "hide" your diabetes from your co-workers. This is especially true if you take insulin. Some people have difficulty discussing their diabetes with others.
Occasionally, this is such a problem that self-management tasks are not performed blood sugar testing, for example. These fears need to be addressed and occasionally require the help of a psychologist. Another important but complicated topic is the effect of diabetes on different types of relationships.
For children, diabetes can affect their relationships with parents, siblings and friends. Kids often feel "different" and this can create significant problems--occasionally resulting in behavior changes. It is important for parents to make sure their child with diabetes does not feel "different. Everyone should be served the same food. In teens with diabetes, issues pertaining to dating are often a concern. Both girls and boys often have difficulty in dealing with their diabetes when confronted with the opposite sex.
Again the key is for the family to be supportive of an open discussion of any concerns that the teen may have. This may include discussions about the effects of alcohol on diabetes control.
Diabetes can affect relationships in adults as well. Issues can be just as complicated: relationships at work, at church and at the golf course can all be affected by diabetes. Many of these problems are due to others being uneducated about diabetes. Explaining to others about diabetes can be the most important solution to problems that may arise.
There are a variety of different "adaptive aids" to help with the various aspects of diabetes. Perhaps the most common one is the use of the specialized shoes to protect the feet in people with severe peripheral neuropathy.
Feelings of sensation in the feet are lost and special protective shoes can protect these feet from developing an ulcer. These ulcers often become infected and cause many problems, but the special shoes can assist in preventing this. Similarly, the use of "orthotics" for the feet help to redistribute the weight so that areas that are prone to callus formation have a better opportunity to heal.
There are a variety of new aids for actual blood glucose management. Home blood glucose meters have become quite simple to use, requiring small amounts of blood. Several meters can use blood from the arm or thigh, so there is no more pain from the fingersticks which tend to cause more pain.
We are also using more sophisticated software systems to download the meters to help assess trends in blood glucose readings. This is particularly helpful for people who test frequently and most of the meter software can be purchased directly from the company for your PC.
Insulin pump use continues to grow. In the US, there are over people using pumps and this is also growing in people with type 2 diabetes. The pump delivers small amounts of fast-acting insulin--usually lispro Humalog or aspart Novolog -- continuously around-the-clock and a "bolus" of insulin is infused by pressing a button before a meal.
The amount of insulin to infuse is based on the blood glucose reading at the time and the amount of anticipated carbohydrate intake. Obviously, exercise also has an influence in how much insulin to administer.
Stress can have a major impact on blood glucose control as it causes an elevation of adrenalin also called epinephrine , in addition to other hormones. Adrenalin makes one more resistant to the effects of insulin, so no matter if you have type 1 or type 2 diabetes, stress can raise the blood glucose levels.
One recent study showed that if one can relieve stress, the HbA1c can decrease on average by 0. The best strategy for relieving stress is to learn how to avoid the emotional upset that may occur. This is easier said then done, as it takes time to change the way one reacts to stress.
For some people, getting exercise works well. This is particularly helpful for people with diabetes as the exercise directly works against insulin resistance. For many, it also makes the stress less bothersome. For others, the main problem is lack of sleep--the stress keeps people awake, and the next day, the stressed-out person has difficulty functioning due to lack of sleep.
It would be important to discuss this with your physician as there are safe medications that could be used for a short period of time to help with this problem. For people with type 2 diabetes, there is a higher rate of sleep apnea due to obesity. If you snore and are exhausted during the day, also ask your doctor about this possibility. For many with overwhelming stress, it may be best to discuss with your physician.
Divorce, loss of a loved one, loss of a job are all major "stressor events" which may require more formal treatment either by discussing with a psychologist or with anti-anxiety medication. There are a variety of important resources for people with diabetes. Based in Alexandria, Virginia, the ADA funds diabetes research, has extensive education programs for patients with diabetes and health-care professionals, and manages camps for children with diabetes.
They have a monthly journal "Diabetes Forecast" and a regular e-newsletter for important updates in relevant news. For both type 1 and type 2 diabetes, research is focusing both on prevention and cure. Another major focus of research is improvements in current therapies. For type 1 diabetes, a large study asking if small doses of insulin could prevent type 1 diabetes in high-risk individuals showed this strategy did not work. Scientists are now looking at other strategies, perhaps an "immunization".
For example, a group from Israel showed that injecting a small protein could slow the progression of diabetes in newly diagnosed individuals with type 1 diabetes. More research on this is anxiously awaited. As far as a cure in concerned, some progress has been made with islet cell the cells that make insulin transplants. Newer ways to prevent rejection of the transplanted tissue are now being studied.
This makes sense since weight loss and metformin also improve insulin resistance, one of the main mechanisms for type 2 diabetes. Research has also resulted in an explosion of new drugs and technologies for the treatment of diabetes. This explosion shows no sign of a slow-down as we expect more new pharmaceutical agents to be released over the next five years.
This will include new classes of oral agents to improve both insulin resistance and insulin secretion in type 2 diabetes and new insulins for those both with type 1 and type 2 diabetes. It is also hoped there will be better weight-loss drugs as our understanding of obesity improves.
It is also likely glucose sensors will become more often used as telemetry-based glucose sensors should be available by This would allow a sensor placed under the skin to relay "real-time" blood glucose readings to you on a monitor you could wear on your belt or like a watch.
Another development, the "Glucowatch" by Cygnus, will work similar to this and should be available in the near future. It is hoped that the sensors will progress to the point they can be attached to an implantable pump and thus work like a normal pancreas. The study of exercise and its effects on blood glucose is one of the earliest types of diabetes research. Dietary research also continues to evolve especially as we learn more about heart and kidney disease. There have been tremendous advances in our understanding in dietary recommendations as mentioned above.
There is also better understanding on the impact of anxiety and depression on the impact of diabetes. People with diabetes tend to have more mental health challenges than those without diabetes and effective management of these often tends to improve diabetes care.
For example, some people when stressed or depressed tend to eat more. Others find it difficult to measure their blood glucose during these times. Treating any mental health problems often makes diabetes management easier. Since diabetes is treated surgically only in a very small minority of patients, treatment programs are based on many other factors: appropriate diet, regular exercise and a variety of medications which often includes insulin.
As opposed to many other conditions, diabetes is a chronic medical condition that first and foremost requires active patient participation to result in good outcomes blood glucose control. At the current time, the possibility of programming cells with new genes to produce insulin or perhaps stem cells early types of cells which can "differentiate or transform into islet cells, the cells that make insulin is a goal of many scientists. Of course, there are both technical and political barriers with this type of research.
Nevertheless, diabetes, especially type 1 diabetes, is a condition for which gene therapy or stem cell research could produce a breakthrough advance. Diabetes is not one disease but rather is at least two diseases grouped as type 1 and type 2 diabetes.
In actuality, there are many other types of diabetes, but the vast majority can be classified into these two types. Type 1 diabetes which usually presents in children or teens can present at any age. It is caused by the body destroying the cells in the pancreas that make insulin the B-cells of the islets , and therefore insulin is required for survival.
In type 2 diabetes which affects Hispanics, Blacks, Asians and American Indians more frequently, one must have both a resistance to the effects of insulin so more insulin is required to maintain a normal glucose and some degree of insulin deficiency.
People with type 2 diabetes are usually but not always overweight and often have other risk factors for a heart attack or stroke including high blood pressure and dyslipidemia high triglycerides low HDL cholesterol.
People with type 2 diabetes often have their disease for years before they are diagnosed which is why the American Diabetes Association recommends screening for all high-risk individuals which would include everyone over 45 years of age, people with a strong family history of type 2 diabetes, and women who had diabetes during a pregnancy gestational diabetes.
Control of blood glucose for both type 1 and type 2 diabetes can reduce the risks of complications especially those involving the eyes retinopathy , the kidney nephropathy and the nerves neuropathy.
For the blood pressure, there are advantages to using the class of drugs called ACE inhibitors. Also a daily aspirin has been shown to reduce risks of a heart attack. People with diabetes should have the following tests performed on a regular basis by their doctor:. If despite following the physician's advice, a person with diabetes still cannot meet the specific HbA1c blood pressure or cholesterol goals noted above, or the physician refuses to perform the standards of care from the ADA outlined above they can also be read at www.
Doctors specializing in diabetes are called endocrinologists and it may be wise to consider seeing an endocrinologist if this situation occurs. You are here Home Diabetes Basics. Basics of diabetes Diabetes is a condition caused by lack of a chemical in the body a hormone called insulin. Immediate medical attention Uncontrolled diabetes presents with frequent thirst and urination.
Facts and myths Diabetes does not "skip" generations. Prognosis Diabetes needs to be considered a very serious condition. Lethality Diabetes can be deadly. Pain High blood glucose levels do not cause pain. Debilitation Diabetes can be debilitating and there are many reasons for this.
Diabetes can also be debilitating in that people with it have an increased risk of stroke. Comfort Diabetes usually does not cause discomfort. Curability Diabetes is currently not curable. Fertility and pregnancy The topic of diabetes and pregnancy is complicated. Independence In the vast majority of cases, patients with diabetes should have no problems with independence.
Mobility Again in the vast majority of cases, diabetes should have no impact on someone's ability to move about. Daily activities For the vast majority of people with diabetes, there should be no alterations of daily living. Energy Extremes in blood glucose levels can cause fatigue. Diet Over the years, there have been many changes to the proper diet for people with diabetes. It is first important to note that the diet for people with diabetes has to be individualized based on a variety of issues such as: the type of diabetes the ethnicity of the patient the presence or absence of kidney disease the presence or absence of obesity the presence or absence of heart disease or high cholesterol levels the amount of physical activity planned and age.
Relationships The interactions between relationships and diabetes are greatly underappreciated. Incidence For type 2 diabetes which is the most common form, the gene or genes responsible have not yet been identified. Acquisition For type 2 diabetes, besides having a genetic predisposition, most people are also obese especially those less than 60 years of age.
Genetics As noted above, genetics plays a large role for both type 1 and type 2 diabetes. Communicability Neither type 1 nor type 2 diabetes appears to be contagious. Lifestyle risk factors For type 1 diabetes, there are no known risks for acquiring the disease although a recent study from Europe suggested that ingesting cod liver oil may prevent type 1 diabetes in children. Prevention The prevention of both type 1 and type 2 diabetes are major research goals.
Anatomy Diabetes can affect almost every organ in some way or another. Initial symptoms Many patients with type 2 diabetes have no symptoms or signs. Symptoms High glucose levels "spill" into the urine, resulting in water following the glucose. Progression The symptoms of high blood glucose frequent urination and thirst do not change over time. Secondary effects Much of the discussion above relates to the effects of blood glucose sugar on the various organs of the body: the eyes, the kidneys, the nerves and the vascular system, including the heart and all of the blood vessels.
Conditions with similar symptoms In considering the symptoms of high blood glucose hyperglycemia only, there are only a few conditions with similar symptoms.
Causes No one knows the cause of type 1 diabetes. Effects High blood glucose sugar has an impact on almost every tissue and organ in the body. Diagnosis Diabetes can be diagnosed only with a blood glucose level performed in a laboratory, not a fingerstick glucose level at home or a HbA1c level.
Peripheral edema is swelling in the feet, ankles, and legs. It can occur in one or both of your lower limbs. If you have diabetes, you need to take extra precautions when you have edema. Fluid can build up when tiny blood vessels are damaged or when they leak into surrounding tissues.
The result is swelling. People with diabetes often have problems with blood flow. When blood doesn't circulate well, wounds heal slowly or not at all.
Swelling makes it harder for wounds to heal. That's why it's so important to control it. This article explains how diabetes and other health conditions could cause your lower legs to swell. It also offers some advice on how to treat it and when to get medical care. If you have edema, you may notice:.
Your legs may swell for reasons that have nothing to do with diabetes. Some examples are:. If you have swelling in one leg or foot but not the other, it may be:. Swelling can also come from heart disease , blood flow problems, liver disease, and kidney disease. Diabetes can increase the risk of each of these conditions. Some diabetes medications can cause swelling.
Actos pioglitazone and Avandia rosiglitazone maleate both cause swelling. They may also cause heart problems. These medications should not be used by anyone with congestive heart failure. This is a condition in which the heart doesn't pump well, causing blood and fluid to back up into tissues. People with diabetes are twice as likely to have heart disease or heart failure.
If diabetes has damaged your nerves, you might not notice the symptoms. That's why it's vital to let your healthcare provider know if your legs or feet swell. Swollen legs or feet may or may not be related to diabetes. Also, make a point to check your feet regularly for wounds to avoid infections.
Swelling in the feet can occur with or without diabetes, although having diabetes is frequently associated with leg swelling due to multiple causes. Home remedies such as elevating your feet, exercising, and staying hydrated can sometimes combat swelling. Find out everything you need to know about diabetes here. Get information on type 1, type 2, and gestational diabetes. Discover symptoms, causes, and…. Injuries and subsequent inflammation…. Poor circulation is most common in your extremities, such as your legs and arms.
Learn more about the symptoms and causes of poor circulation. Foot numbness is the loss of sensory nerve function, usually caused by a decrease in blood flow, to the foot's nerves. Causes include frostbite and…. Diabetes is more prevalent in certain racial and ethnic groups, including Black Americans. This may be due to genetic, social, and health factors. NPH insulin is an intermediate-acting insulin that helps keep your blood sugar stable between meals or overnight.
Learn more about how long it takes…. Human insulin is synthetically made in a lab and is able to replicate the insulin naturally found in your body. Learn more about the pros and cons of…. An insulin pump is an alternative to giving yourself multiple daily insulin injections. It's mostly used for type 1 diabetes, and has both pros and…. Here's how. Health Conditions Discover Plan Connect. Medically reviewed by Maria Prelipcean, M.
Diabetes and swelling Use compression socks Elevate your feet Exercise regularly Lose weight Stay hydrated Limit salt Stop sitting Up your magnesium Try essential oils Soak with Epsom salt When to see a doctor Takeaway Excess swelling of the feet and ankles caused by accumulation of fluid in the tissues is called edema.
Swelling in people with diabetes is usually due to factors associated with diabetes, such as: obesity poor circulation venous insufficiency heart problems kidney problems, medication side effects In rare cases, edema may be due to an increased tendency to have leaky capillaries or sometimes from taking large amounts of insulin.
Diabetes and swelling. Use compression socks. Elevate your feet. Exercise regularly. Lose weight. Talk to your doctor about safely incorporating a magnesium supplement into your routine. Magnesium has been shown to regulate nerve function and stabilize blood sugar levels. By taking to mg of magnesium per day, you can help treat swollen feet from diabetes. Epsom salt has been shown to help relieve swelling-associated pain and reduce inflammation in the body.
For best results, put a sufficient amount of Epsom salt in a foot bath of cool water. If you have diabetic neuropathy in your feet, make sure that you double check the water temperature to avoid exposure to extreme temperature. Proceed to soak your feet and ankles for about 15 to 20 minutes.
Regular exercise is important for a number of reasons—it helps to improve your bone health, increase circulation, and stabilize blood sugar levels. Exercising is a great way to manage your diabetes in a healthy way and avoid excessive swelling. Since rigorous exercise can be dangerous, start with basic workouts and slowly increase the intensity. Take it slow and be consistent to reap the benefits. The more you weigh, the more pressure that your lower extremities are under.
To help treat swollen feet, try to get to a healthy weight and maintain it.
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