Diabetes Awareness Month

2017-12-06 06:01
At the diabetes awareness event (from left) Shubnum Ismail (Netcare St Anne’s marketing), Sister Zinhle Zibula, Vernono De Camp, Sister Kate Bristow, Sister Melanie Stoffels and Sister Kamini Gounden. PHOTO: Supplied

At the diabetes awareness event (from left) Shubnum Ismail (Netcare St Anne’s marketing), Sister Zinhle Zibula, Vernono De Camp, Sister Kate Bristow, Sister Melanie Stoffels and Sister Kamini Gounden. PHOTO: Supplied

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NETCARE St Anne’s, in partnership with Kate Bristow Diabetes Specialist Nurse Educator and Ampath Laboratories, hosted wellness screening days for the public with the focus on diabetes awareness. Although the campaign draws to an end today, people are encouraged to follow these steps to manage diabetes.

How can diabetes affect my eyes?

Due to increased blood sugar levels specific changes can occur in the tiny blood vessels in the part of the eye called the retina. This is known as Diabetic Retinopathy, a collective term for eye damage due to diabetes. These changes to the blood vessels in the eye can damage the eye.

There are different stages of damage and different ways in which the eye is damaged by diabetes, but simply put, swelling or blockage of these blood vessels can occur or they can start leaking into the eye which causes blurring of vision and injury which if it is allowed to progress is irreversible. Over time sight can be partially or completely lost.

Prevention of diabetic retinopathy:

• Control of blood sugar levels to levels of 4-8mmol/l. Regular testing ensures that blood sugar levels are kept under control

• Regular interaction and assessment with your diabetes team.

• Lifestyle changes for good diabetes management such as dietary management and regular exercise.

• It is important that anyone over the age of 12, who has been diagnosed with diabetes, has at least an annual assessment by an ophthalmologist. If there is diabetic eye disease, these visits may need to be more often and on the advice of the specialist.

• It is also important to have eyes checked for sight and glasses by an optometrist - this does not replace the eye screening visit, and should be done every one to two years.

• Other tests that are important to manage eye health include having regular blood pressure and cholesterol screening and keeping both within normal zones.

• Smoking is not advised.

Treatment of diabetic eye disease

This depends on the stage of the disease. Laser therapy is commonly used to treat bleeds into the eye by swollen or damaged blood vessels and is a very effective treatment. There are also newer treatments such as injections into the eye – this would be done by your ophthalmologist but as always prevention is better than cure as a lot of these treatments are extremely costly.

Diabetes and kidney disease

Risks for kidney disease and diabetes are high and most people don’t know this. Forty percent of those with diabetes will develop chronic kidney disease. Without regular checks it creeps in silently and symptoms only develop late.

How to reduce your risk:

• Monitor your blood sugar regularly and work closely with your diabetes team to keep your blood sugars within goal range.

• Have regular screening for kidney disease – it can be slowed down if detected early.

• Increase the amount of exercise you do – exercise is beneficial in controlling blood sugar and blood pressure and reduces stress levels.

• Give up smoking – smoking decreases the blood flow to the kidneys and stops them functioning at their best. Smoking can also increase your blood sugar and makes it harder for your body to use insulin so your diabetes is that much harder to control. It also affects those who don’t have diabetes and increases the risk for other chronic conditions.

• Be careful with certain drugs if you are at risk for kidney disease. Regular use of some anti-inflammatory drugs such as Brufen can trigger kidney damage in any of us. Discuss long term use of medication with your diabetes team.

The role of kidneys in our bodies is to decrease toxins and excess water from our blood stream. They also help to regulate blood sugar levels as well as other minerals such as sodium and potassium and regulate the blood acidity. They also help to make red blood cells which are essential to move oxygen around our bodies.

Exercise and diabetes

People who exercise have lower blood pressure, lower heart rates and better circulation. Their cholesterol also tends to be lower and they have less body fat, burn fat more easily, and have better weight control.

Exercise also helps you sleep better and helps to decrease stress levels and anxiety.

Why exercise is important in diabetes

• It costs nothing and does not have side-effects.

• Regular exercise improves the body’s sensitivity to insulin and stimulates the muscles in the body, so sugar levels are better managed.

• Exercise also decreases body fat, especially around the tummy area.

• The benefit of exercise on glucose control lasts for 24-48 hours after the exercise, which is why it is important to try to exercise preferably five times a week.

• Exercise should be of moderate intensity for at least 30 minutes to show benefit.

Getting started

• Any exercise is better than none - choose something that gets the heart rate up.

• Ensure that you enjoy whatever you do - you are more likely to stick to it!

• Ensure that your diabetes team is happy that your condition is stable enough to start exercising.

• Start slowly - five to 10 minutes a day, and build it up from there.

• Test your sugar regularly when you begin to exercise so you can assess the effect it has on you. Remember that you could have low sugar levels afterwards so be aware of this.

• Do not exercise when you are unwell.

• Make sure that you have comfortable footwear that does not cause blisters or hurt you.

• Remember that the first two weeks of anything new are always the hardest – take time to get into a regular exercise routine.

Diabetes and foot care

Feet are a high risk area for those with diabetes. This is due to poor blood circulation to the feet (Peripheral Vascular Disease) and loss of feeling in the feet due to nerve damage because of uncontrolled blood sugar levels (Peripheral Neuropathy).

Prevention of damage to your feet with diabetes

• Regular screening of your feet by your doctor or a person trained in diabetes foot-care or podiatrist is important.

• Cold feet is a sign of poor circulation. Pain in the legs during walking or exercise which stops when you rest is called Intermittent Claudication and is also a sign of poor circulation and nerve damage.

• Exercise is a good treatment for poor circulation as it helps new blood vessels grow and improves circulation, as is good management of blood sugar levels and diet which help to prevent damage to the nerve endings and help circulation.

• Watch your feet for injuries such as cuts, blisters, pressure from a tight shoe which causes injury.

If you notice abnormalities see doctor immediately.

• Diabetic feet are high risk and if not properly cared for the risk of infection and amputations is high.

Ways to care for your feet

• Bathe your feet daily - use warm water and soap, and make sure you rinse them and dry them properly, especially between your toes. Use moisturiser if your feet are dry – do not use too much, and do not apply it between your toes.

• Cut toenails very carefully - straight across in a square shape.


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