>> >> Sugar Endocrine
Foot Care in Diabetes
Having diabetes puts you at risk for developing a wide range of foot problems- often because of two complications of diabetes – nerve damage (neuropathy) and poor blood circulation.

Know More

  • Diabetes affects the blood vessels of the feet causing them to narrow. Narrow blood vessels carry less blood to the feet thus slowing down healing and increasing the risk of infection.
  • Diabetes affects the nerves that supply sensation to the feet. This decreases the feeling of pain in the feet and thus patients with diabetes may not notice a cut or a blister (water filled boils)
  • Further changes over time caused by unusual pressure points may lead to poorly healing wounds and blister
    • Check daily for any changes
    • Wash your feet in lukewarm( neither hot nor cold) water
    • Dry your feet especially in-between toes and apply lotion if your skin is dry(avoid lotion application in-between toes)
    • Wear comfortable well fitting shoes to protect your feet
    • Don’t walk bare-feet even inside your house or place of worship(you can wear thick socks)
    • Cut your toenails regularly, preferably after bath

Sick Day Management
What to do when you are ill?

When you are ill, your blood glucose levels tend to go up. This may happen even if you cannot eat or are throwing up.

Conditions that may upset your diabetes include

  • Cold / flu.
  • Vomiting / diarrhea.
  • Urinary tract infection.
  • Ulcers or infection in the foot.

Signs indicating rise in blood glucose include

  • Excessive thirst.
  • Frequent urination.
  • More sugar than usual in your blood and urine.

Know More

Sick Day Guidelines
Golden Rules
  • Continue your diabetes medication, even when you are not eating much or vomiting.
  • If you check your blood glucose levels at home usually, its advisable to continue to do so more frequently ( at least 2 to 4 times a day).
  • Make it a point to drink plenty of water or sugar free fluids.
  • Record weight change / temperature.
When to seek help?
  • Blood glucose levels remain over 300mg/dl.
  • Ill for two days without much improvement.
  • Lost weight / have fever of 101 degrees Fahrenheit and higher.
  • If you are vomiting and cannot keep fluids down.
  • Worried and don’t know what to do.
Your personal health diary should have a record of your illness
  • All your blood sugar reading taken using your home device.
  • Date and period of illness.
  • Doses of medication taken / details of other medication taken ( if any).
  • Any loss of weight.
  • Other symptoms (if any) experienced.

What happens in Diabetes?
In normal people the body produces adequate amount of insulin. The food we eat undergoes the following changes before it is utilized by the cells to release energy.
  • The food we eat is broken down by the digestive system into nutrients and glucose is one of them.
  • Glucose thus formed is absorbed into the bloodstream and then the blood glucose level begins to rise.
  • As the blood glucose rises, the body sends a signal to the pancreas, which releases a hormone called insulin.
  • Insulin allows the glucose to enter the body’s cells.

Know More

Here’s how: Acting as a key, the insulin unlocks the cell wall so that glucose from the bloodstream can enter the cell. Once inside, glucose is used for energy right away. Some glucose is stored by the liver for later use.

After you eat a meal your blood glucose starts to rise. The pancreas senses this rise and responds by making insulin to help move the glucose into your cells (refer step 1 to step 4)

When your blood glucose is low – as can happen when you don’t eat- the liver senses this drop and responds by releasing glucose into the blood stream

People with diabetes have partial or complete lack of insulin production in the body.

The key to open the cell is not working and so instead, glucose levels pile up in the bloodstream.
Type 1 diabetes
People with type 1 diabetes don't produce insulin. The body stops making insulin because the cells in the pancreas have been destroyed.
Type 2 diabetes
People with type 2 diabetes produce insufficient insulin, or the insulin that they produce does not work properly and can't move glucose into the body's cells.

This causes glucose to accumulate in the blood and can cause hyperglycemia (high blood sugar levels).

Diabetes and its Complications
Diabetic Neuropathy (Nerve Complications)

Having high blood glucose levels for many years can damage the blood vessels that supply oxygen and nutrients to nerves. Damaged nerves send signals slowly or at the wrong times and sometimes may stop sending signals.

Warning Signs! Numbness or tingling in the feet, loss of bladder control, indigestion, sexual problems in both males and females, muscle weakness etc.

Know More

Diabetic Retinopathy ( Eye Complications)

Uncontrolled diabetes can lead to two key changes in your eye.

  • Retinopathy : This is when high blood sugar causes damage to the small blood vessels in the back of the eye.
  • Cataract: Too much sugar in your lenses can lead to them clouding up.

Warning Signs! Haziness, blurred vision, black spots, double vision, cloudy vision/ curtain like shadow in the eyes.

Diabetic Nephropathy ( Kidney Complications)

Uncontrolled diabetes over time leads to a build-up of sugar in the small blood vessels of your kidney. This makes them work less effectively in filtering out waste substances from the blood. The first sign of kidney complication is the presence of small amount of protein in the urine. As the disease progresses, protein content in the urine continues to increase and the filtration capacity of the kidney decreases.

Warning Signs! A diabetic should have their urine checked regularly for protein at least once every year.

Heart Diseases

Diabetes increases the risk of heart attacks as high blood sugar makes blood flow slow through the arteries and thereby increasing the risk of clot formation. When blood flow is reduced or stopped, one experiences heart attack or angina (reduced oxygen supply to the heart).

Warning Signs! Chest discomfort (tightness), shortness of breath, pulling sensation in the arms, sweating and fatigue are key indications to look out for. If you experience any of the above call the Emergency (1066) or rush to a nearby hospital.

Diabetic Foot Problem

Diabetes can affect your feet.

Tips to identify “diabetes foot”
  • Loss of sensation in the feet
  • Burning sensation in the feet
  • Slipping of footwear from your feet while walking
  • Redness and change in the shape of your foot
  • Fungal infection in between the toes of the finger
  • Swelling in the joints that are usually painful.
Diabetes Emergency
Hyperglycemia (High Blood Sugar >250 mg/dl)
  • Increased thirst
  • Increased urination
  • Increased hunger
  • Weight loss
  • Fatigue
Action Plan
  • Drink water
  • Keep checking your blood sugar
  • Meet your consultant if value continues to remain over 300mg/dl
Hypoglycemia (High Blood Sugar <70 mg/dl)
  • Weakness
  • Drowsy
  • Confused
  • Hungry
  • Dizzy

Treatment is very simple and requires you to doing one of the following

  • 10-15 gms of glucose, or 2-3 teaspoons of sugar in water or A teaspoon of honey or jam
  • After 10-15 minutes of doing the above if you still feel no change then, repeat it again. When the symptoms have gone (meaning your blood glucose levels are above 70mg/dl) you need to follow it up with a starchy snack such as a sandwich/ a small bowl of fruit / a glass of milk.
Reasons for Hypoglycemia
  • Exercising more than usual
  • Too much of insulin or overdose of oral hypoglycemic drugs
  • Drinking alcohol without food
  • Missing a meal or being too late for a meal or snack

Do remember to make a note of a hypoglycemic event (date/ cause/ blood glucose reading, pre and post meal in your personal health diary to help discuss with your consultant.

What are the symptoms of Diabetes?
A number of factors are responsible for you becoming a diabetic – genetic, family history, low physical activity, obesity, high blood pressure; but if you are experiencing some of the following symptoms it is important that you do not ignore them and visit a sugar clinic
  • Increased thirst – you feel like having liquids all the time
  • Increased hunger
  • Fatigued or tired
  • Unusual Weight loss
  • Blurry vision
  • Frequent urination

Book Appointment online