Prevention of diabetes
related complications
Education and prevention are the most important factors in reducing the
risk of diabetes related complication.
Take
charge of your own health !
Choose the best health care team for yourself !
Effective
preventive care typically includes lifestyle modifications such as
careful and frequent self-examinations, watchful control of blood
glucose and blood pressure, firm weight management and diet, and
increased daily activities.
Should secondary complications arise
despite preventive care then early detection and prompt effective
response by a professional health care team is essential.
The
most effective health care is preventive care !
Watch
for the early signs and symptoms of diabetes related complications and
act upon them ! Quick and correct response to the early
warning
sings could prevent more serious complications.
The following
paragraphs will guide you on how to recognize early warning signs or
symptoms and it will list some preventive measures for the most common
diabetes complications. If these symptoms remain untreated
minor
complications can lead to severe problems such as:
- eye - retinopathy and
blindness
- skin - serious
dermatological complications and infections
- teeth and gums
- parodonthosis and loss of teeth
- kidney and bladder
problems - kidney failure
- feet problems -
gangrene and amputations
- cardiovascular
problems – heart attack, cerebral stroke
1. Eye
Hyperbaric oxygen therapy has been recognized as an effective treatment
method for various eye complications associated with diabetes,
infections, intoxications, injuries, degenerative deseases or radiation
threapy.
Diabetes related comlications:
Prevention:
- Maintaining blood glucose level under control may prevent
damage to
the small blood vessel supplying the eyes.
- Regularly check your blood pressure and try to keep it
within the normal values.
- Avoid activities that can raise the blood pressure. Also,
birth
control pills can increase the blood pressure
- If eye problems develop then early intervention such as
laser treatment
for retinopathy can decrease the risk of blindness by 90%
Yearly visit to ophthalmologist can confirm some of the following early
signs of diabetes:
- Trouble reading books or traffic signs
- Problems distinguishing familiar objects
- Other visual problem such as spots, “floaters” or cobwebs
in your
field of vision, blurring or distortion, detection of blind spots, eye
pain or persistent redness
- Increased pressure inside the eye may be the warning sign
of glaucoma
- Sudden blindness or partial blindness (one eye) can be
caused by the
rupture of the vessels supplying the retina
Hyperbaric Oxygen Therapy (HBO) used in eye complications:
- HBO improves visual sharpness (acuity) and reduces the
incidence of blindness caused by lack of oxygen.
- HBO improves retinal blood flow and circulation.
It its also
effective in reducing swelling and thereby the risk of developing
glaucoma
and cataract.
- HBO reduces scar formation after surgery
- HBO speeds up the healing after surgery and reduces the
complications
- HBO suppresses infection either directly by destroying
bacteria or
assisting white blood cells in phagocytosis.
- HBO improves the immune system response.
- HBO enhances the effect of some antibiotics.
2. Skin
Learn to love your body ! Carefully and regularly inspect
skin all over your body for any changes.
Prevention:
- Keep your skin clean and hydrated.
- Use non-aggressive soaps and do not rub your skin too hard.
- After washing, dry off skin well especially between toes,
under
armpits, in the groin, breasts areas and other skin folds where fungal
infections can develop.
- Do not rub dry skin. Breaks or scratches could
lead to infections and possibly hard to heal ulcers.
- If your skin is dry, use moisturizers. Do not use
moisturizers
between the toes or where the skin folds are. For those areas and other
skin folds use baby powder.
- All minor skin
problems such as cuts and scratches should be treated immediately by
cleaning off the injured area and putting on bandages.
- Seek professional help if you discover more serious
problems.
Early warning signs:
- Infection, bacterial (redness, swelling, pus or pain) or
fungal (athlete’s foot, vaginal itching).
- Insulin injection sites covered with rashes or bumps.
- Blisters or bumps on the extremities which are signs of
poor glucose control.
Hyperbaric Oxygen therapy (HBO) in treatment of skin disorders and
infections:
- HBO increases the tissue oxygen tension and provides
adequate oxygen supply to low oxygen supplied area
- HBO arrests infection and prevents sepsis development
- HBO enhances some antibiotics and anti-fungal activity
- HBO acts as an antibiotic (bactericidal and
bacteriostatic),
therefore impairs metabolism of microorganisms
- HBO produces free oxygen radicals that are toxic to
bacteria
(inhibition of alpha-toxin production in gas gangrene)
- HBO assists leukocyte in bacteria elimination (phagocytosis)
- HBO speeds up wound healing
- HBO in bone infections helps in removal of necrotic bone
(osteoclastic function) and speeds up new bone formation (osteogenesis)
3. Teeth and
gums
Prevention:
- Take special care of your teeth and gums.
- Have regular dentist check up every six months. Brush at
least twice
a day, also cleaning gums and your tongue.
- Use dental floss, but take care not to provoke bleeding.
Gum disease could lead to parodonthosis.
Warning signs of diabetes could be the following:
- Gum disease (tenderness, swelling, frequent bleeding, pus
appearing
at touch, retraction of the gum line from teeth)
- Persistent bad breath and taste in the mouth
- Changes in the alignment of the upper and lower jaw when
biting
- Change in the fit of dentures
- Parodonthosis
4. Kidney
problems – nephropathy
High
blood pressure and diabetes can interfere with normal kidney functions
disturbing the process of filtering waste products from the
blood. It can also causing excess secretion of proteins in
the
urine. Fortunately, a normal kidney will have significant
excess
filtration capacity effectively delaying the onset of more serious
symptoms. Noticeable problems of the kidney will not appear
until
80% of the kidney is damaged. Kidney damage appears more
frequently in type I diabetes, however it is common in type II diabetes
in association with hypertension.
Prevention
- Maintain blood glucose levels under control
- Maintain blood pressure under control
- Maintain normal body weight and reduce the amount of salt
intake
- Maintain a low protein diet
Early warning signs
- Fluid buildup and swelling
- Sleeplessness and tiredness
- Vomiting
- Weakness
- Excess of proteins in urine
Prolonged kidney complications can lead to kidney failure, requiring
dialysis and possible kidney transplant.
Hyperbaric Oxygen therapy in kidney and bladder problem:
- HBO helps to reduce urinary urgency and frequency
- HBO helps in preventing and reducing kidney and bladder
infection
5. Feet
Prevention:
- Be
kind to your feet! Check and pamper them daily! Do not try to save
money when buying shoes. Good fitted shoes of good quality will pay
back many times.
- Custom made shoes for feet with partial
amputation with good fit and appropriately balanced shoe for
non-amputated foot. People with already amputated or partial amputated
foot are at greater risk of developing wounds on other healthy foot.
- If
blisters or wounds are developed make sure that the pressure is taken
away from the wounded areas either by wearing pressure relieve bandages
or cutting holes in the shoes
- Never walk bare feet. Use cotton socks as cotton allows the
proper circulation of the air around the toes.
- Wash
your feet daily in the warm water with mild soap and dry well after
washing, especially between the toes where fungus can develop. Limit
soaking your feet to 10-15 minutes.
- Use the moisturizing lotions or creams for the dry skin but
avoid applying between the toes where you can use baby powder.
- Dry
skin on the feet and the calluses rub off gently with the fine file. Do
not apply any force since the dry skin can break easily and make
pathway for infection. For deep cracks in skin (fissures) use a special
cream for cracked skin for diabetics.
- Avoid having your feet
too close to the fireplace or soaking them in hot water as well as
exposing them to too cold environment because the sensitivity in
diabetic people is impaired which can cause burns or frostbites without
a person noticing it.
- Check your feet with the mirror every day
and watch for any redness, calluses, blisters, fungus, cuts or wounds.
For painful pressure points use pressure-relieving bandages. Minor cuts
or wounds clean with the cleaning solutions, first and apply the
bandage. Treat funguses with anti-fungal cream. If the problem persist
seek professional help
- Cut your toenails once a week,
preferably after washing when nails are soft. Do
not cut
nails too deep, avoid cutting into the corners, because you may cut the
skin. File the nail edges carefully, since the sharp edges can make a
sore that can get infected. If you cannot reach your toes or
you
cannot see well, see a pedicure that is knowledgeable in handing
diabetic feet.
- Wear comfortable shoes that have enough room for
toes. Avoid pointy shoes, if you have any foot problem, such as partial
amputation, developed wound, bunion, hammertoe or flatfeet wear a shoe
adapted (customized) for this condition.
- If you haven’t done it already, quit smoking!
- On thick, hypertrophic nails reduce thickness with file
- If necessary, use orthotics such as insoles, arch supports,
toe dividers, that can be customized
- Avoid wearing tight socks as they may limit the blood
circulation to your feet.
- Wear socks in bed if you easily get cold feet.
- To reduce swelling elevate legs during rest
- Avoiding positions with cross legs and prolonged standing
would provide good circulation
- Take care of regular intake of prescribed medications
- Inspect
and shake out shoes before putting them on. Due to insensitivity in
your feet you may not feel small stones that could be trapped inside
the shoe, causing the wound.
Problems:
Hyperglycemia in diabetic people can cause 2 main problems to your feet:
- Nerve
damage or so called neuropathy which basically the lack of feeling or
sensation. With damage nerves you may not feel pain, heat or cold in
your legs or feet, you might let a wound or a cut on your foot get
worse because you do not feel it is there. This can lead to infection
and quickly develop into a gangrene that may require amputation
- Poor
blood flow or so called peripheral vascular disease is the problem when
not enough blood is coming into your feet, making smaller skin problems
such as cuts or small wounds quickly developing into larger and more
serious wounds resistant to heal
Guidelines for buying shoes
When
buying shoes keep in mind that a fit is the primary concern and fashion
secondary. Do not try to save money when buying shoes. Good fitted
shoes of good quality will pay back many times.
- Avoid the shoes that are larger or smaller than your feet.
- With your fingers check your shoe for the proper feet
because the sensitivity in your feet could be reduced
- Shoes
should bend where the toes bend. Best is to buy shoes made of soft
lather and have the heal height not more than one and a half inches.
- Make sure that shoes are brought and deep in the toe area.
- Seams and straps on shoes should be placed to avoid
pressure areas
- Do not use dress shoes for long walks
- If your feet tend to swell in the afternoon, take an extra
pair with you if you are away from home
- Avoid slippers, sandals and loafers if going for a walk,
because these type of shoes provides very little support
6. Cardiovascular
problems
Most
of the cardiovascular complications related to diabetes are due to a
slower blood flow or a blockage of the blood vessels throughout the
body. Slowing of the blood flow in diabetes is generally due to
increased blood viscosity (thicker blood), whereas clotting of the
blood vessels could be due to increased amount of lipids (fats) in the
blood, that more readily stick to the blood vessels wall when there is
increased glucose in the blood. Reducing the fats and cholesterol in
your diet would decrease the blood lipids, like cholesterol and
triglycerides.
When blood vessels are narrowed or clogged, the blood
supply to the heart is reduced, causing chest pain or so called angina.
When a blood vessel in or near the heart becomes blocked, this can lead
to heart attack People with diabetes are 2 to 4 times more likely to
get heart disease. More than half of the death in older people with
diabetes is due to cardiovascular disease.
Prevention:
The goal is to increase the amount of oxygen going to the heart!
- Keep under control your blood sugar levels and blood
pressure
- Stop smoking!
- Keep blood cholesterol and other blood fats as close to
normal by eating a healthy high-fiber and low-fat diet
- If
prescribed, the pills for blood and blood pressure and diabetes they
have to be taken regularly, and preferably at the same time every day
- Some doctors may tell you to take an aspirin every day to
help protect your heart
- Find the physical activity you like and stay active
Signs and symptoms
- Shortness of breath
- Pain in the chest, arms, shoulder or back
- Tiredness
- Weakness, sweating
- Nausea
- Indigestion
- Swollen ankles or feet
If you are at risk of
developing diabetes or currently living with it, you need to pay close
attention to your circulation and how well it delivers oxygen.
Oxygen deficiency is typically caused
by poor microcirculation. Lack of oxygen is
the basis
for serious illnesses where tissue and organs start to break down.
