Prevention of Diabetic Foot Ulceration

Foot ulceration in diabetic patients is one of the leading causes of disability, amputation, and even death in some instances, not to mention the physical and emotional trauma that comes along with it. However, detecting the condition in its initial stages and managing the risk factors associated with the disease can go a long way in preventing its onset. In this chapter we shall discuss the most effective ways and means to prevent ulceration in diabetic patients. The following list summarizes the steps involved in prevention of diabetic foot ulceration:

• Adopt a healthier lifestyle
• Manage lipid levels
• Control blood pressure
• Manage glycemic levels
• Abstain from smoking Let us look at these options in more detail.

Adopt a Healthier Lifestyle

The great majority of people who suffer from diabetes are overweight. Hence, weight loss must be a top priority for patients. Losing weight is the best way to normalize blood sugar levels. BMI or body mass index is a measure of the amount of fat in the body. The BMI is calculated based on the height and weight of a person. A BMI less than OR is considered normal. A patient whose BMI is more than OR is considered to be overweight.

Weight loss can be achieved by eating low-calorie, nutritious food and by taking regular exercise. Losing even a small amount of weight is enough to put you on the road to better health. You must set realistic weight loss targets for yourself and create a disciplined routine to achieve your goals. Start by making healthier food choices. Avoid all processed and junk foods such as hot dogs, chips, colas, and foods that are highly refined. These include all white flour products, including white bread, pastries, or cakes. Instead, make it a habit to eat brown bread, and lots of fresh fruits and vegetables. Lean meats such as chicken are also beneficial and a good source of protein when consumed in small portions.

The benefits of exercise can never be overemphasized. If you are new to working out, start with a low-intensity activity such as a long brisk walk, and gradually work your way up to jogging.

Starting a cardiovascular exercise routine such as jogging, running, and swimming is the fastest and most effective way to lose weight. Besides, these exercises keep your heart healthy and prevent the onset of ischemia. You should devote about 150 minutes a week to exercise to achieve your weight loss goals. You do not need an expensive gym membership or fancy equipment to work out. Almost any exercise can be performed indoors. If you are unsure about going outside, try

Low Impact Exercise

People with diabetes benefit from exercise, but you still must be aware go easy on your feet spot jogging on a mat for 10 minutes a day and watch the weight melt away. Calisthenics or body weight exercises such as push-ups, squats, and crunches are also a great way to bring your heart rate up and help you lose weight. Half an hour of exercise a day for five days a week is more than sufficient to lose weight and control your blood sugar levels.

Manage Lipid Levels

As discussed earlier, diabetic patients are at an increased risk of developing heart diseases. A major contributing factor is a condition known as dyslipidemia or an imbalance of lipids. What are lipids? They are a set of naturally occurring molecules, which include fats and fat-soluble vitamins, monoglycerides, triglycerides, and diglycerides. Lipids perform vital functions in the body, including the storage of energy and cell signaling. They also make up several structural components of cells. When the production of certain lipids is increased, insulin resistance occurs in the body, causing diabetes. The excess production of glucose in the cells in turn damages the blood vessels of the body, leading to reduced blood flow or ischemia of the heart and peripheral body parts. This is why it is very important for diabetic patients to manage their lipid profile. This can be achieved by consuming heart-healthy foods that are low in saturated fats. Here again, patients need to avoid foods that are greasy, deep-fried and highly processed. Chips, burgers, pizza, and all forms of junk food should be avoided by patients like the plague. Instead, eat moderate

Control Blood Sugar

The better you are at controlling your blood sugar, the healthier your feet will be over the long term.

amounts of foods that contain healthy fats such as dried fruits, nuts, or sea fish.

Control Blood Pressure Levels

Diabetic patients are predisposed to hypertension, which elevates blood pressure levels and triggers a host of cardiovascular diseases. The level of hypertension varies between patients with Type 1 and Type 2 diabetes. People who have Type 1 are at a greater risk of developing hypertension and high blood pressure. This is caused largely by the damage caused to the blood vessels that supply the kidney, causing poor kidney function, or nephropathy. When this happens, the kidneys are unable to filter waste out of the blood properly. The resulting build-up of toxins in the body, as well as the kidney disease itself, contributes to further rises in blood pressure.

It is important to diagnose hypertension early. This can be done by checking the blood pressure and undergoing a thorough physical evaluation of all vital organs, including the heart, lungs and thyroid. The work up should also include an electrocardiogram; analysis of the urine; a measurement of blood electrolytes in the body, such as the levels of calcium, potassium, and sodium; kidney function tests such as creatinine; measurement of serum glucose levels; and lastly, a lipid profile.

How is hypertension treated?

Medical practitioners recommend weight loss, eating a healthy vegetarian diet, increasing physical activity, decreasing the intake of sodium in foods, abstaining from smoking and most importantly, regularly engaging in activities and hobbies that are enjoyable and relaxing, so that you can reduce stress levels.

Managing Glycemic Levels

Managing glycemic or blood sugar levels is of utmost importance to diabetic patients as excess sugar is the root cause of diabetes. The strategies to achieve this include a combination of lifestyle choices and drug therapy. As stated earlier, patients must observe a strict diet that is very low in sugar. Second, they must take up exercise activities that enable them to burn the excess glucose in their bodies, and so lose weight. A sedentary lifestyle with little or no bodily movement can make diabetic control more difficult. If the patient is unable to exercise, or cannot manage blood sugar levels naturally, drug therapy such as insulin injections may become necessary.

Abstain from Smoking

Alcohol and smoking have been proven beyond doubt to be detrimental to personal health, particularly for diabetics. Cigarette smoke floods the body with toxins that not only affect the lungs but also damage the arteries and heart muscles by causing the deposition of fatty plaque inside them. This is called atherosclerosis. In time, the accumulation of plaque in the arteries obstructs the flow of blood to the heart and other organs, causing thrombosis, ischemia, and a host of other degenerative diseases that eventually lead to a heart attack and death.

FUN FACT During an average day of walking, the total forces on your feet can total hundreds of tons, equivalent to an average of a fully loaded cement truck.

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