Living With Diabetes

Diabetes is diagnosed by using one or more tests to measure whether blood sugar levels are abnormally high. In people with type 1 diabetes, symptoms like frequent urination and excessive thirst usually prompt diagnostic testing, while those with type 2 may undergo testing if they have certain risk factors for the disease. It is important that once you are aware of your diabetes that you take the necessary steps to manage it.

People with diabetes can develop serious problems with their feet that can affect how easily they can walk, and even lead to amputation. Many of these serious problems can be prevented by taking good care of your feet and your health:

Manage your diabetes, including keeping your blood pressure, blood sugar (glucose) and cholesterol at levels your health care provider recommends. Don't smoke. Smoking reduces blood flow to the feet. Make healthy food choices. Stay at a healthy weight. Be physically active every day. Take your medicines even when you feel good. Have your doctor give you a comprehensive foot exam every time you visit (but at least four times a year). Check your feet for sores and other injuries every day. Wear shoes that fit right and do not rub or pinch your feet, or cause blisters. Never walk barefoot or while wearing just socks.

Research shows that diabetes often causes problems with feet and legs, and these problems can be severe. In 2008 alone, more than 70,000 people with diabetes had a leg or foot amputated. Amputations in people with diabetes account for more than 60% of the amputations of legs and feet not resulting from an injury, such as from a car crash. People with diabetes were eight times as likely to lose a leg or foot to amputation as people without diabetes, according to CDC research.

These are some of the ways that diabetes can harm your feet:

Diabetes reduces blood flow to certain areas of the body, especially limbs such as the legs, which makes it harder for your body to heal injuries. Diabetes nerve damage may cause you to no longer feel pain in your feet, and you may not realize you have a wound or injury that needs treatment.

Diabetic nerve damage appears to be more common in people with the following conditions: problems controlling blood sugar levels, high cholesterol, high blood pressure, overweight, or older than 40 years.

If you experience any of these symptoms, contact your health care provider or a podiatrist (foot doctor) right away. You may feel pain in your legs or cramping in your buttocks, thighs, or calves during physical activity. Your feet may tingle, burn, or hurt. You may lose the sense of touch or not be able to feel heat or cold very well. The shape of your feet may change over time. The color and temperature of your feet may change. You may lose hair on your toes, feet, and lower legs. The skin on your feet may become dry and cracked. Your toenails may turn thick and yellow. Fungus infections such as athlete's foot may appear between your toes. You may experience blisters, sores, ulcers, infected corns, and ingrown toenails.

You want to make sure that you manage your diabetes, and that you see a doctor regularly or when something doesn’t feel right. Diabetes is a lifelong disease and is something that you will have to deal with and be aware of. If you do not manage your health and your diabetes, it can lead to some very serious complications, and even death.

Diabetes is a common disease, yet every individual needs unique care. We encourage people with diabetes and their families to learn as much as possible about the latest medical therapies and approaches, as well as healthy lifestyle choices. Good communication with a team of experts can help you feel in control and respond to changing needs.

Many people avoid the long-term problems of diabetes by taking good care of themselves. Work with your health care team to reach your goals. Follow your diabetes meal plan. If you do not have one, ask your health care team to help you develop a meal plan. Eat healthy foods such as fruits and vegetables, fish, lean meats, chicken or turkey without the skin, dry peas or beans, whole grains, and low-fat or skim milk and cheese. Keep fish and lean meat and poultry portions to about 3 ounces (or the size of a deck of cards). Bake, broil, or grill it. Eat foods that have less fat and salt. Eat foods with more fiber such as whole grain cereals, breads, crackers, rice, or pasta.

Get 30 to 60 minutes of physical activity on most days of the week. Brisk walking is a great way to move more. Stay at a healthy weight by using your meal plan and moving more. Ask for help if you feel down. A mental health counselor, support group, member of the clergy, friend, or family member who will listen to your concerns may help you feel better.

Learn to cope with stress. Stress can raise your blood glucose. While it is hard to remove stress from your life, you can learn to handle it. Ask friends or family members for help with coping, or if you need to, seek professional help.

Take medicines even when you feel good. Ask your doctor if you need aspirin to prevent a heart attack or stroke. Tell your doctor if you cannot afford your medicines or if you have any side effects. Check your feet every day for cuts, blisters, red spots, and swelling. Call your health care team right away about any sores that do not go away. Brush your teeth and floss every day to avoid problems with your mouth, teeth, or gums.

Check your blood glucose. You may want to test it one or more times a day. Use the card at the back of this booklet to keep a record of your blood glucose numbers. Be sure to show it to your health care team. Check your blood pressure if your doctor advises. Report any changes in your eyesight to your health care team. Talk with your health care team about your blood glucose targets. Ask how and when to test your blood glucose and how to use the results to manage your diabetes.