Diabetes 101

diabetes and the feet

Great diabetes picture from here. One of the main ideas that you must realize is: Everyone with Diabetes is different. No-one is truly the same. It is hard to compare because you will find someone going against the grain of thought. For instance, If someone is taking Insulin and someone is taking a “diet” plan- it means nothing. Not one is more worse than the other. Some Diabetics seem fine at high blood sugar levels and that is where their body seems comfortable, but when my wife, who had Gestational Diabetes, went a squeak over 7, she was very ill.

We need some background, as in, why these things occur to our feet. If we know why they are occurring we can then have a good understanding about prevention and ways to treat.

Diabetes Mellitus (DM), or sugary water, is all about the use of the hormone Insulin. Normally, Insulin is released continually from the Pancreas- a basal amount, and at meal times a larger amount, or bolus, is released. And medication is used to try and emulate this natural process.

What is the point of Insulin? It regulates our uptake of the sugar Glucose. One of its jobs is to tell your body's cells to open up and accept Glucose, which they use as fuel to live.

Therefore the body always produces glucose for us to live, so the body has to always produce Insulin. If we increase our activity we use up more “fuel” and the body responds by creating more Insulin to counter the increase in Glucose.

Diabetes monitoring

Glucose attaches to your blood and your blood stays active for 3 months until it is broken down and replaced. With this simple knowledge Diabetes can be monitored and a more accurate prediction of blood sugars over a 3 month period can be found. The HbA1c is basically the amount of sugary blood cells that are floating around. The units are a percentage. So a reading of between 4-7% is good and shows a “normal” level of Diabetic control. An HbA1c reading of over 7% or under 4% can show over (hyper) or under (hypo) glycemic readings respectively over a 3 month period. It is a good system because of the range over a long period of time that can be detected.

Therefore it is beneficial because it demonstrates if the patient has been “good” with their Diabetic control.

However, lower than expected levels of HbA1c can be seen in people with shortened red blood cell life span, such as with sickle-cell disease or any other condition causing premature red blood cell death. On the other hand, higher than expected levels can be seen in people with a longer red blood cell life span, such as with Vit B12 or Folate deficiency.

blood test for diabetes

“Prick finger tests”.

Usually done on the fingers because glucose concentrations are more in those areas and the area is usually painless. These tests show to the clinician and the patient how their Diabetes is doing at that point in time. A lot of drug companies give away blood testing machines for free. However they usually charge for the testing strips.

The urine test.

This is where the patient urinates on the strip and then you match up the changed color with the chart on the testing tube. These are OK if you want to know a very quick way of determining if you are Diabetic or not. However some urine tests will only tell you if you are Diabetic if your readings are over 10. Which is not good, because how about if you were 8 or even 9 it will never get picked up, so you wouldn’t worry about it!?

Types of diabetics

DM is usually split up into 2 separate “forms”. However there are other forms of Diabetics:

Type 1 DM or Insulin Dependent Diabetes Mellitus.

This is where there is no or not enough Insulin produced. The cells do not get their fuel and the person will die in time from various processes, one namely Ketoacidosis if they don't have Insulin. Ketoacidosis is very serious and involves the body trying to find fuel for itself and the only place it can get it from is itself. So it breaks down fats and proteins to give itself energy. In some instances Insulin users will stop using Insulin all together if they feel unwell. Insulin users need to take Insulin constantly because there has to be a continual amount of Insulin running through the body at all times.

Type 2 DM or Non Insulin Dependent Diabetes Mellitus.

For some reason the Insulin that they are producing is not working that well, or the body's cells are not recognizing the Insulin that is being produced. Or the Pancreas is not producing a sufficient amount of Insulin.

There is also secondary DM.

This is where something has caused direct damage to the pancreatic cells (where insulin comes from) which in turn has caused DM. The direct damage factors are: severe malnutrition, pancreatic destruction and removal, Cushings Disease, Steroid therapy and Thiazide therapy.

Pre-Diabetic

There is a condition called Pre-Diabetic and sometimes patients get this muddled up with being “boarderline” or “diet-controlled Diabetes”. Some Doctors call Pre-Diabetics Impaired Glucose Intolerance or Impaired Fasting Glucose. A Pre-Diabetic is just under being diagnosed as a Type 2 Diabetic, and most Type 2 Diabetics were Pre-Diabetic. But with higher than normal blood sugars, the stage can be set for complications to exist. The scary thing is, there are 79 million people in the US alone who are Pre-Diabetic. However, not all is lost with an adjustment in diet and exercise a Pre-Diabetic can prevent the development of Type 2 Diabetes.

Diabetic info

Hyper or hypo glycemic?. Predominantly affecting Insulin dependent Diabetics these are 2 serious problems which the patient needs to be aware of. Also the patients family members need to be aware of hypo’s and hyper’s so that they can react quickly in a critical situation.

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