Foot Care In Diabetes

Diabetes Awareness

Diabetes is a chronic disease affecting mankind all over the world.

Currently, India being the Diabetes Capital of the world, is home to 46.5 million diabetics.  According to IDF (2007), it is estimated that India would have around 80 million diabetics by 2025, a figure worth worrying about!

According to Elliot P. Joslin, a Clinician, "Diabetic who knows most of his disease lives the longest". Thus, education is very important and necessary for good management of this disease.

It is well known that prolonged diabetes affects many organs such as heart, kidney, eyes, nerves, skin, feet, teeth, etc.

 Neuropathy

20-30 million diabetics out of 246 million world wide suffer from Neuropathy, diabetes being the main cause. 

Diabetes affects the feet because the nerves in this region are the longest in the body. Deficiency of insulin causes under-utilization of glucose in the nerves. This glucose gets converted into toxic deposits in the nerves thus affecting circulation.
 

Neuropathy increases with age. High glucose levels damages the nerves and so there is loss of sensation  or reduced feeling of pain, temperature, numbness or tingling of feet, burning sensation, reduced blood circulation (peripheral vascular disease), weakness and wastage of small muscles of the foot leading to abnormal foot posture which increases the risk of foot injury. Foot infection is said to be the most common reason for hospitalization of diabetics.

Serious Foot Complications are caused due to:

Diabetic Neuropathy-

A lack of feeling accompanied by tingling, burning, pain, or numbness in the legs or feet due to nerves damage.

Peripheral Vascular Disease (PVD)

PVD causes poor circulation in the arms and legs that can affect the ability to heal a cut or sore leading to ulcers and gangrene.

Foot Injury- improper foot wear is the main cause

Foot Deformities- bunions, hammertoes

Warning Signs Of Foot Complications in a diabetic:

• Changes in skin colour 
• Elevation in skin temperature 
• Swelling of the foot or ankle 
• Pain in the legs 
• Open sores on the feet that are slow to heal 
• Ingrown and fungal toenails 
• Bleeding corns and calluses 
• Dry cracks in the skin especially around the heel.

Common Foot problems in diabetics can lead to serious complications such as:

Athlete's foot - It is a fungus that causes itching, redness and cracking. 

Fungal Toenail- Nails that are infected with a fungus may become discolored (yellowish-brown or opaque), thick and brittle, and may separate from the rest of the nail.

Calluses-  A callus is a build-up of hard skin, usually on the underside of the foot. Calluses are caused by an uneven distribution of weight, generally on the bottom of the forefoot or heel.

Corns- A corn is a build-up of hard skin near a bony area of a toe or between toes. Corns may be the result of pressure from shoes that rub against the toes or cause friction between the toes. Proper care is necessary if you have a corn.

Blisters- Wearing shoes that do not fit properly or wearing shoes without socks can cause blisters, which can become infected.

Bunions- A bunion forms when your big toe angles in toward the second toe. Often, the spot where your big toe joins the rest of the foot becomes red and callused. This area also may begin to stick out and become hard.

Dry Skin - It can crack and let germs enter thus increasing risk of infection.

Hammertoe- It is a toe that is bent because of the weakened muscle that makes the tendons shorter, thus causing the toes to curl under the feet.

Ingrown Toenails- It occurs when the edges of the nail grow into the skin causing redness, pain, swelling. drainage and infection.

Foot Ulcer- It is a break in the skin or a deep sore that can get infected.

Why has a Diabetic to take care of his feet? Here are some very important statistics that is an eye-opener for all the diabetics. They are as follows:

> Every 30 seconds, a leg is lost to diabetes somewhere around the globe.

> 70 % of all leg amputations world wide are caused by diabetes.

> Most amputations begin with foot ulcers. But the good news is that 85% of amputations caused by diabetic foot ulcers are preventable.

> 5% of Indian Diabetic population have one or the other foot problem.

Learn How To Prevent A Foot Problem If You Are A Diabetic:

DAILY FOOT CARE IS VERY IMPORTANT

• Check and examine your feet daily for blisters, cuts, scratches or other sores.
• Consult your doctor immediately if you notice any of the following danger signs:  swelling, colour change of a toe, nail or a part of the foot, pain or throbbing, thick hard skin or corns, breaks in the skin including cracks and blisters. 
• Check for redness, increased warmth, or tenderness when touching any area of your feet.
• Check for ingrown toenails, corns, and calluses.
• If you get a blister or sore from your shoes, do not "pop" it.
•  Use a mirror to look at the bottom of your feet. Call your doctor if you notice anything. If your eyesight is poor, have someone else do it for you.

• Wash your feet in lukewarm water using a mild soap. Wipe dry using a soft cloth. Do not rub.
• After washing, thoroughly dry your feet and moisturize them using a lotion.to prevent cracking. Do not put lotion between your toes.

REGULAR FOOT CARE IS EQUALLY IMPORTANT

• Smooth the corns or calluses using an emery board or a pumice stone

• Check and trim your toenails once a week.
• Cut toenails after bathing, when they are soft.
• Cut toenails straight across and smooth with a nail file.
• Avoid cutting into the corners of toes.
• You may want a podiatrist (foot doctor) to cut your toenails.

Protect Your Feet With Shoes and Socks

• Never walk barefoot, not even at home. You could step on something and get a scratch or a cut. Always protect your feet by wearing shoes or hard-soled slippers or footwear.
• Avoid shoes with high heels and pointed toes.
• Avoid shoes that expose your toes or heels (such as open-toed shoes or sandals). These types of shoes increase your risk for injury and potential infections.
• Try on new footwear with the type of socks you usually wear.
• Do not wear new shoes for more than an hour at a time.
• Look and feel inside your shoes before putting them on to make sure there are no foreign objects or rough areas.
• Avoid tight socks.
• Wear natural-fiber socks (cotton, wool, or a cotton-wool blend).
• Wear special shoes if your health care provider recommends them.
• Wear shoes/boots that will protect your feet from various weather conditions (cold, moisture, etc.).
• Make sure your shoes fit properly. If you have neuropathy (nerve damage), you may not notice that your shoes are too tight.

 OTHER IMPORTANT TIPS

• Regular monitoring of blood glucose and maintaining it near normal levels. 

• Put your feet up to maintain good blood flow.

 

• Smoking can make blood flow problems worse.

When Should I Contact My Doctor?

Visit your doctor or a Podiatrist for regular check-up of your feet, even if you don't have any foot problem.

REMEMBER

• The old saying,  "an ounce of prevention is worth a pound of cure" was never as true as it is when preventing a diabetic foot ulcer. The best way to treat a diabetic foot ulcer is to prevent its development in the first place.
• People should treat their "Feet" like they would treat their "Face" 

CONCLUSION

• Periodic examination of foot is mandatory for diabetics.
•  Identification of early foot problems prevents major events and costs.
• Achieving and maintaining of blood glucose is essential in prevention of foot problems. 

Kitchen Tools That Help You Stay Healthy

With the word ‘fitness’ we usually think about healthy food and exercise. Most of us know about healthy foods that can help you achieve fitness but do you know that using kitchen tools effectively can also go a long way in keeping you healthy. This article gives an overview of kitchen tools that help in cutting calories and fat for a healthier you.

 

In India today, our food portions are all distorted. Many of us are unsure of how much we should be eating and many of us don't really know what a "normal" portion is. It is really easy to overeat in today's society with restaurants often serving twice the recommended amount.

                               

 

 

Standard silverware spoons/tablespoons, plates, cups and bowls are not accurate for measurement because they all differ in size. And just "eyeballing" a portion can cause us to underestimate — especially in our own favor. Studies have shown that up to 80 percent of people underestimate what they are eating by as much as 40 percent.

Take the guesswork out of portion control by investing in some (or all) of these handy kitchen tools. Each of these tools will help you stay on track by being honest with yourself, leading to a healthier eating habits and will help you  eat the correct amount of food, insuring you don't under or overeat.

Measuring Cups: Invest in measuring cups to help you portion out servings. Wet and dry ingredients, however, have different volume measurements, so they require different measuring cups for accuracy.

Measuring Spoons: Use measuring spoons for oils and fats such as butter, salad oil etc. It helps in limiting the intake of calories in the recipe thus keeping you fit and trim.

 

Small Glasses and Cups:

                            

When it comes to glasses, researchers found that individuals pour more juice into short wide glasses versus tall narrow ones. Remember that when pouring juice or cocktail choose a taller, narrower glass but for water, choose the biggest goblet you can find. Many people mistake thirst for hunger, so staying hydrated can help you avoid needless snacking. These small glasses and cups can also be used to serve puddings, kheers, sweet lassi and desserts like custards, chocolate mousse etc. They look pretty and satisfy your sugar craving—but you control the calories, thus maintaining good health.

Food Scale:

Portion control is an easy way to watch your waistline without depriving yourself of the foods you love. Use the food scale to measure out meals and keep on track Thus, a food scale is an invaluable tool to accurately measure how much you are eating.

Portion Control Plates:

To make portion control even easier, one should invest in portion control plates, which are plates that have areas sectioned off for each food group such as cereal, vegetables, and pulses/meat group. These plates are a valuable tool in helping people limit portion sizes for each food group. There are also different types of portion control plates for people with different dietary and caloric needs such as diabetics and children.

Nine Inch Plate:

In the last few decades, the average dinner plate size has grown from 8 1⁄2 inches to 12 inches! Make sure your dinner plate is closer to 9 inches—about the size of today’s salad plate. Studies show that the bigger your plate, the more likely you are to load it up with food but you'll eat less if you eat from a smaller plate.  So, switch to smaller size plate or salad plate for your meals if you want to stay trim and slim!

 

Besides the tools for portion control, there are several other tools/gadgets that help you slash calories and fat and keep extra pounds away. They are:

Immersion Blender or Hand Mixer:

The hand mixer  lets you whip up smoothies, milkshakes, lassi etc and purée soups right in the pot- A ‘get-thin’ trick, since we know that having low-calorie soup (with no fat) before a meal helps you eat less. Thus, blending cooked vegetables or beans to add bulk without extra fat calories is a cinch with this handheld blender.

Steamer:

The steamer is great for cooking vegetables without adding oil—and for keeping most of the nutrients. This can also steam fish and Indian preparations like idlis and dhoklas. Best way to slash calories is to own a steamer in your kitchen.

 Oil Mister/ Sprayer:

Cut out unnecessary fat from your diet by using the Oil mister/sprayer. The tool gives you precise control over how much oil is used. Instead of drowning your cooking pan in excess oil, the mister will simply coat it in a fine spray, which is all you need! Fill it with oil you use for cooking at home- sunflower, ricebran, olive oil etc, and it will save you "significant calories." For example, every tablespoon of oil has 135 calories but with a mister, you can cover the whole bottom of a pan with just a teaspoon of oil that has 45 calories!

Herb Mill:

Cutting fresh herbs can be messier than measuring out dried. The herb mill is a great tool for measuring out dried herbs. Why use fresh herbs? They give amazing flavor to food, so you can skip extra salt that causes bloating.

Grater:

                                                

The grater is a very handy tool for grating cheese—you end up using less, thus restricting fat and excess calories. It’s also handy for grating small amounts of chocolate when needed. You can also grate carrots, potato, radish, lemons etc

Handheld Chopper:

The handheld chopper makes it easy to chop veggies—no more excuses for not getting your five-plus slimming fruits and veggies a day. Unlike a food processor, it will also chop nuts without turning them into paste.

Kitchen Scissors:

   

Invest in a good pair of kitchen scissors and keep them sharp. They make it easy to cut the fat off chicken, trim vegetables, cut pizza, and snip herbs. The flavor of herbs, more than makes up for what’s not going in your food—like butter and salt. 

Reusable Lunch Containers:

 

Sandwiches get boring fast. Use reusable storage containers to bring your lunch to work -- every day. Bring salads in them or fresh cut-up fruit so you won't be tempted by the vending machine. Freeze leftovers and pull them out of the freezer at a later date so you're not eating the same thing two days in a row. Say goodbye to greasy lunches and calorie-laden snacks and hello to a healthier, slimmer you!

Non-Stick Cookware:

                           

 

Quality cookware often plays a vital role in cooking food that is healthy, hygienic and also tastier. Non-stick cookware is gaining a lot of  popularity due to the demand for oil-free and low-calorie food in one’s daily routine. These are definitely expensive, but we could rely on them. Non-stick pans allow you to cook with little to no oil, which is essential for cutting fat from your diet. If you have to douse your pans with tons of oil or butter just to prevent food from sticking, you are already adding tons of fat that’s unnecessary and unhealthy.

Kitchen Knives:

     

Any smart weight loss program will call for plenty of vegetables, and a sharp knife will make all that cutting, chopping, and slicing much easier. Make sure you have a chef's knife, a slicer, and a paring/utility knife, plus a sharpener (dull knives make preparation work far less enjoyable). Armed with these, you can fill your containers full of cut veggies for easy snacking and to keep on hand as a healthy base for sauces, soups, curries and stews.

Food Processor:

                                   

    

 

Food processors are similar to blenders in many ways. The primary difference is that food processors use interchangeable blades and disks (attachments) instead of a fixed blade. Also, their bowls are wider and shorter, a more appropriate shape for the solid or semi-solid foods usually worked in a food processor

Food processors normally have multiple functions, depending on the placement and type of attachment or blade. These functions normally consist of:

• Slicing/chopping vegetables
• Grinding items such as nuts, seeds (e.g. spices), meat, or dried fruit
• Shredding or grating cheese or vegetables
• Pureeing
• Mixing and kneading dough

Thus, it becomes easy to have low calorie nutritious foodstuffs like salads, soups etc without spending a lot of time in its preparation. Also, since dough kneading is possible, intake of chappati/ roti can be increased.

Convection Oven:

              

A convection oven uses a fan to distribute heat evenly as your food bakes, and it comes in especially handy for low-fat bakery recipes.It can proof dough, bake cookies, cakes, pies, muffins and heat/reheat prepared foods in less time.

Juicer:

Although consumption of whole fruits is much better than taking fruit juice, yet many people go ahead and buy this tool so that they could have fresh juice as and when they want rather than depend on commercially available tinned or canned juices which have high percent of sugar in it.

 

Conclusion:

Now you may be thinking that this list is long. There could be many more tools/ gadgets that could have been added here, but not every piece of equipment is necessary for everyone—unless you cook all the time. Then, the investment will be well-worth it in the long run because you’ll save so much money cooking that the equipment will more than pay for itself even in the short-run.