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Diabetic Foot Treatment & Diagnosis

Type 1 Diabetes

Type 1 diabetes, in the past was called juvenile diabetes or insulin-dependent diabetes, is a chronic condition known as an auto-immune condition in which the organ responsible for producing insulin the pancreas, produced little or no insulin at all. The human body needs insulin to allow sugars called glucose to the enter cells within the body to produce energy. Known as juvenile diabetes because it affects the very young unlike type 2 also known as late onset diabetes that tends to affect adults in the 4-5 decade of life.

Specialists are unsure as to what or why type 1 diabetes is caused, but evidence tends to suggest that there may be a link to a genetic predisposition and external factors. Type 1 diabetes tends to usually appears during childhood or adolescence, however it can also can begin in adults.

There is extensive research being done into type 1 diabetes, however at this stage there is no cure. This being said we have made some major clinical advances and diabetes can be managed very successfully with proper treatment and self-empowerment.

Short fact list for Type 1 diabetes

  • Occurs when the pancreas does not produce insulin
  • Represents around 10% of all cases of diabetes and is one of the most common chronic childhood conditions
  • Onset is usually rapid and the symptoms extremely evident
  • Symptoms include excessive thirst, increased urination,  weight loss, feeling lethargic, weak, fatigued and blurred vision
  • Blood glucose test (sugar levels in the blood) and insulin injections multiple times a day to keep the glycemic index at safe levels.

What will happen if I don’t take insulin?

If the human body is deprived of insulin the body will place itself into Ketosis, this is where the body burns its own fats supplies for energy. However this is a vicious circle because the body is unable to process the sugar released from burning its own fat stores, therefore the blood glucose level rises but the body still can’t utilize the sugar available. When the body is in a catatonic state dangerous chemical substances will accumulate and can be life threatening if it is not treated. This is a condition call ketoacidosis.

Basic understanding of insulin

It helps to think of insulin as a key to a locked door and the human body as an engine. Imagine that every cell in your body has a number of locked doors for various chemicals secreted and or consumed. The food people eat gets reduced down into a series of sugars, which in turn the human body needs to produce its fuel for the daily running of the engine. The sugar needed for fuel production cannot enter the cell without the key (insulin) thus the cell cannot produce the required fuel for the engine.

Type 2 Diabetes

Type 2 diabetes, also known as adult-onset, late onset or noninsulin-dependent diabetes mellitus, is a chronic condition that tends to affect people later on in life and is more prevalent in the 4-5 decade of life however this being said with the increase of childhood obesity type 2 diabetes is now common place amongst obese children. Multiple factors can attribute to type 2 diabetes:  gradual reduction of pancreatic function and thus insulin production, cell insulin resistance, a disturbance in our glycemic index to name a few.

Type 2 diabetes can be divided into 2 categories. The body either becomes insulin resistant or the pancreas does not produce sufficient insulin to maintain normal sugar levels in the body. Patients may have one or a combination of the two.

As in Type 1 diabetes unfortunately a cure is yet to be found for type 2 diabetes. As in type 1 diabetes patients can manage the disease by making healthy eating choices, exercising regularly and maintaining a healthy weight. In some cases no medication is required. If a healthy glycaemic index cannot be maintained there a range of Non injectable medication are available. This being said in some cases both injectable and oral medication may been needed to help maintain healthy sugar levels.

If diet and exercise aren’t enough to manage your blood sugar well, you also may need diabetes medications or insulin therapy.

Why do people get Type 2 diabetes?

Type 2 diabetes is associated with modifiable lifestyle risk factors. Type 2 diabetes also has strong genetic and family related risk factors.

If a patient’s family has a history of type 2 diabetes, the patient will have a genetic predisposition to contract type 2 diabetes.

Even though there is a strong genetic predisposition in the family, this does not guarantee that a family member will get diabetes. Certain risk factors, if avoided will greatly reduce the risk of contracting diabetes. If the patient maintains healthy blood pressure levels, healthy weight, regular physical activity, good diet and maintains low visceral adiposity (the weight around the waist).

What are the symptoms for type 2 diabetes?

As in type 1 diabetes the symptoms are similar if not the same.

Symptoms tent to include excessive thirst, increased urination, constantly feeling tired or lethargic, feeling hungry all the time, unexplained weight loss.

Management of the condition.

If diagnosed with type 2 diabetes early there is no reason why the patient cannot live a long, healthy and productive life style, as long as a healthy choices and the care plan implemented by the GP, podiatrist and dietician are followed. With diabetes self-empowerment is a powerful tool knowing the condition and the do’s and do not’s will put the patient on the right track to healthy living.

Gestational Diabetes

Gestational diabetes referred to as GDM is a type of diabetes that occurs when pregnant and normally self resolves itself after the baby is born. All pregnant females are normally tested in the 24th to 28th week of their pregnancy. A simple blood test will be performed and if the glycemic index is elevated, this may be a precursors to GDM. Pregnant women who have one or multiple risk factors for diabetes may be advised to have a diabetes test when their pregnancy is confirmed then again between 24-28 weeks if GDM was not confirmed at early stage pregnancy.

GDM is becoming more prevalent in Australia, affecting thousands of pregnant women. Studies have indicated that between 5-10% of all pregnant women in Australia will develop GDM. There is no specific factor why GDM occurs, however data indicates that you may be at risk of developing GDM if you:

  • Are over 25 years of age
  • Have a family history of type 2 diabetes
  • Are overweight
  • Are from an indigenous Australian or Torres strait islander background
  • Are from a Vietnamese, Chinese, middle eastern, Polynesian or Melanesian background
  • Have had past GDM with previous pregnancies
  • Have previously had Polycystic Ovary Syndrome
  • Have previously given birth to a large baby
  • Have a family history of gestational diabetes

What to do after being diagnosed?

We understand that this can be upsetting, however, a large percentage of woman with GDM have a healthy pregnancy and after the baby is born GDM tents to self-resolve. The treatment for GMD is similar to beginning stage Type 2 diabetes, healthy eating, and moderate exercise and daily checking and sustaining a healthy blood sugar level.

Is there a risks of developing type 2 diabetes?

Unfortunately once you have been diagnosed with GDM, yourself and your baby are at increased risk of developing type 2 diabetes later in life.

GDM treatment

As aforementioned GDM can be managed through diet and moderate exercise. However, there are exceptions to the rule. With some GDM patients, insulin injections will be essential for the duration of their pregnancy term.

Prevention

How can we prevent diabetes?

When we talk about diabetes prevention we refer to late onset diabetes or type 2 diabetes.   In the case of Type 1 or gestational diabetes when pregnant, unfortunately we are either genetically pre disposed or pregnancy are the cause and cannot be prevented. At present, according to the National Diabetes Prevention Program in the United States approximately 58% of type 2 diabetes can be prevented.

Type 1

As for mentioned presently, we cannot prevent type 1 diabetes from occurring and some specialist believe that we are genetically predisposed to the condition. What we do know is that there is an auto-immune reaction in which the cells in the pancreas responsible for insulin production are destroyed. What triggers this reaction and how to prevent this from happening, we don’t know at the moment. Is it a genetic predisposition or are there external factors during pregnancy that may attribute to this auto-immune reaction.

Type 2

Type 2 or late onset diabetes tents to affect people later on in life and is more prevalent in the 4-5 decade of life. Multiple factors can attribute to type 2 diabetes:  gradual reduction of pancreatic function and thus insulin production, cell insulin resistance, a disturbance in our glycemic index to name a few.

Patients with a history of type 2 diabetes in their family may be able to delay or all together stop the disease:

  • Keeping a healthy weight
  • Exercise on a regular basis
  • Healthy food options (reduced sugar, fat and carbohydrates)
  • Keeping cholesterol and blood pressure at healthy levels
  • Generally making health choices in reference to lifestyle

Speak to your local GP or Pivotal Motion podiatrist about general prevention or there may be an active program in your state.

A podiatrist works to maintain the following:

Call Pivotal Motion Podiatry on 07 3352 5116 today if you need assistance with maintaining your foot health, or book an appointment online.