One of the most common complications of uncontrolled diabetes is diabetic neuropathy – but do you know what it is? Here are the basics of what it is, how to avoid it, and how to treat it if necessary.
- Diabetic neuropathy is the most common complication of diabetes.
- Neuropathy is short for “peripheral neuropathy” which means nerve damage in the peripheral nervous system.
- The peripheral nervous system includes all the nerves outside the brain and spinal cord, and connects the central nervous system to the hands, legs and organs.
- Diabetic neuropathy is caused from damage to the small blood vessels that supply the nerves.
- Blood vessels are damaged by high blood glucose levels, having diabetes for many years and abnormal blood fat levels.
- Smoking and excessive alcohol use can also cause diabetic neuropathy, as can mechanical injury to the nerves (like carpal tunnel syndrome).
- Symptoms can include numbness and tingling in the hands and feet, erectile dysfunction, dizziness, muscle weakness and changes in vision.
- Some common signs of peripheral neuropathy are sharp, jabbing pain that may get worse at night, and pain when walking.
- Diabetic neuropathy can’t be cured, but there are treatments to help the symptoms.
- The best treatment for neuropathy is good blood sugar control, which will prevent the condition from getting any worse.
All diabetics know that foot care is really important, but do you know why? Preventing foot ulcers is an essential part of keeping your feet healthy. Here are some great tips.
- Foot ulcers are skin ulcers where the skin has broken down under the foot and you can see the tissue underneath it.
- Diabetics are at greater risk of foot ulcers because high blood sugar for a long period of time can damage the nerves in the feet, which means you won’t be able to feel pain and might not notice a foot injury.
- A diabetic foot ulcer can develop after even the smallest injury, like stepping on a little stone with bare feet. Ulcers are easily infected and can take weeks or even months to heal.
- 15% of people with diabetes may develop a foot ulcer.
- More than half of all diabetic foot ulcers become infected.
- Foot ulcers are the most common reason for diabetics needing to go to hospital.
- Luckily, they are also easily prevented: by carefully controlling blood sugar levels to prevent nerve damage.
- It is very important to check the feet, including the areas between the toes, for cuts and sores – every day.
- Keeping the feet clean and dry is essential – but do not soak them.
- Be sure to have your feet checked once a year by a doctor or podiatrist.
Newly diagnosed with diabetes? We get to grips with what your medical scheme can do for you, and what you might have to budget for yourself.
- Join a medical scheme
Diabetes is a chronic condition that’s on the Medical Scheme Act’s Prescribed Minimum Benefits (PMB) List. All registered medical schemes in SA have to provide basic funding for your diagnosis, treatment and care.
- Register your condition
Make sure your condition is registered with your scheme, and be sure to do this again each time you switch. Find out how the registration process works: you’re likely to have to complete a form with the help of your doctor.
- Stay on a scheme
If you leave your current scheme, or join a scheme for the first time, the new scheme may impose a waiting period of 3 to 12 months. During this time, your costs may not be fully covered. Do your research before you join a new scheme and avoid breaks where you don’t belong to a medical scheme at all.
- Use a healthcare broker
Understanding what’s covered by all the schemes out there can be complicated. Do your research with the help of a healthcare broker. Their services are free of charge.
- Reassess your plan
Once a year, you can shift from a basic to a more comprehensive plan, and vice versa. Ask your scheme for your medical records and check what you’ve had to pay out of your own pocket during the year. Do the math to see if it makes sense to upgrade or downgrade your plan.
- Check which meds are covered
Even the most basic plans cover diabetes medication, as long as you choose from the formulary (the list of approved medication). Ask for this list before you choose a plan. Your prescribed medicine might not be available on the scheme’s most basic plan, but it could be on another, more comprehensive plan, or on another scheme’s formulary list.
- Stick to Designated Service Providers (DSPs)
These healthcare providers (doctors, pharmacists and hospitals) have an agreement with your scheme, which means their rates are usually fully covered. Get hold of your scheme’s DSP list and use them. Expect a co-payment if you use a doctor outside of this network.
- Go for your consultations
This will depend on your plan, but some of your doctor’s visits will be covered up to an agreed rate. Some schemes, for example, cover annual visits to the GP, dietician, podiatrist, ophthalmologist and other specialists in full.
- Check up on tests and equipment
Diagnostic tests are usually covered in full, as well as annual HBA1c, creatinine microalbumin and lipid tests. Insulin pumps and other specialised equipment might only be covered by top-tier plans, or not at all.
- Use those additional benefits
Many of SA’s schemes offer free coaching, education and reward programmes. Make use of these benefits – they’ll help you to manage your condition better, saving you money in the long run.
Want to keep healthy all-year round? Try these smart immune boosters to keep in the best possible health.
- Did you know that if your blood sugar remains high, you’re more likely to get infections? Balanced blood sugar is the key to good health.
- Getting an annual flu vaccination can help to build your winter immunity.
- Don’t overdo it! Chronic stress can run your immune system down.
- Drink up! Increase your intake of healthy drinks like water and rooibos. Hot water with a slice of lemon is a delicious variant.
- Eat a healthy and balanced diet, with plenty of fruit and veg. Try foods high in vitamin C (oranges, naartjies, kiwi fruit and berries), vitamin B (cheese and eggs), beta and mixed carotenes (carrots and sweet potato), vitamin E (sunflower seeds and almonds) and selenium (fish and bran). Don’t forget those leafy greens like spinach, kale and broccoli.
- Get off the couch! Whether you go for a walk or do an indoor class, keep up your exercise regime to boost your immune system.
- Rest more and get more sleep (if you can!)
- Get a vitamin B injection to give you an energy boost.
- Try pre- and probiotics to balance the bacteria in the gut and boost immunity.
- Eat more of these immune-boosting foods: cabbage, garlic, chicken soup, ginger, honey, lemon, mushrooms, oats, salmon, and oysters.
All you need to know about going on holiday with diabetes – Type 1 or Type 2.
- Make sure you have enough medication to last your whole holiday – including insulin injections or tablets, testing strips, needles and lancets. Take a little extra if you can, and don’t forget things like batteries for your glucometer.
- If you are on insulin, take a copy of your prescription and a letter from your doctor that says you need to carry your injections with you at all times. Some security checkpoints will ask for this, so it’s best to be prepared.
- Insulin needs to be kept at a constant, cool temperature – never above 30°C and never below freezing. Be sure to take a cooler bag to keep it at the right temperature wherever you travel.
- Never leave your medicine in direct sunlight! Check that if you’re on a long bus trip, it’s kept close to you and out of the sun.
- Always carry some sugary snacks with you in case of hypoglycemia. A roll of Super Cs or some sugar packets will do the trick.
- Be aware of the effects of exercise on your blood sugar. If you’re exploring a new city, you may be walking more than usual so your blood sugar could go lower than it normally does.
- If you’re going overseas, sign up for medical insurance or ask your South African medical aid what their overseas policy is. You want to know exactly what to do in case of emergency.
- If you’re travelling across time zones, adjust the time you take your long-acting insulin slowly (over a few days) so your body has time to adjust to the new time zone.
- Try to stick to somewhat-recognisable food so that you can accurately guess the carb content and know what it will do to your blood sugar.
- Have fun! Don’t let diabetes stand in the way of you experiencing everything you can while you’re on holiday.
All you need to know about what cholesterol is – and how to deal with high cholesterol.
- Cholesterol is a fatty substance that is naturally present in your blood and cells.
- It is measured in four parts: total cholesterol; LDL (low-density lipoprotein) which is the “bad cholesterol”; HDL (high-density lipoprotein) which is the “good cholesterol”; and triglycerides (a form of fat that the body makes from food sources, such as sugar and alcohol).
- Your body needs some cholesterol for healthy functioning. But many people have too much of the “bad” type and too little of the “good” type.
- In some cases, high cholesterol is inherited, but more often it is the result of an unhealthy lifestyle and too much saturated fat in your diet.
- Having high cholesterol does not cause any physical symptoms that you would be aware of. That’s why it’s often called a silent killer.
- Doctors advise that you have your cholesterol tested at least once a year. If you have diabetes, you’re aiming for an LDL reading of less than 2.8mmol/l.
- People with Type 1 or Type 2 diabetes are at higher risk for cardiovascular diseases such as heart attack and stroke. This risk increases if your LDL cholesterol is high.
- Many of the things that help to control your diabetes will also help to lower your cholesterol. Four lifestyle changes that can make a huge difference: lose weight; exercise more; avoid saturated fat; quit smoking.
- “Good” HDL cholesterol helps your body get rid of the “bad” LDL cholesterol. Include more healthy monounsaturated fats in your diet to assist this process. These include avocado oil, olive oil, peanut oil, avocados and most kinds of nuts.
- Keep in mind that these lifestyle changes aren’t always enough. Some people may need cholesterol-lowering medication too.
All you need to know about your medication – and how to store it.
- Insulin is a hormone that controls the amount of glucose in the blood. It acts as the “key” that lets glucose (from food) leave the blood and enter the cells of the body.
- People with diabetes either do not make enough of their own insulin (Type 1 diabetes), or the insulin their body makes is not as effective as it should be (Type 2 diabetes). As a result, most people with diabetes need to take medication, in tablet form or insulin injections.
- While it is often possible to control Type 2 diabetes with diet and exercise at first, eventually insulin will be necessary for most people with Type 2, as diabetes is a progressive condition.
- There are three different kinds of insulin: short-acting, long-acting and combination.
- Short-acting insulin is taken at mealtimes to cover the glucose released from the food that is being eaten.
- Long-acting insulin has a slow release and works as a basal (background) insulin for a number of hours – it is usually taken once or twice a day in addition to short-acting insulin.
- Combination insulin is a mixture of long-acting and short-acting insulin, often prescribed to Type 2 diabetics.
- Insulin must only be taken on prescription from a doctor, as it is essential to take the right dose (prescribed for you) at the right time.
- Storing insulin correctly is important: it should not get too hot (over 30°C) or freeze. Spare insulin should be kept in the fridge, and the pen you are using can be kept at room temperature for 1 month. Always keep insulin out of direct sunlight.
- Learning how to inject properly will make the injections as pain-free as possible.
Foot problems are one of the things that those of us with diabetes need to watch out for. We’ve got some top tips to keep a healthy spring in your step.
- People with diabetes should have their feet examined by their doctor or podiatrist at least once a year, with thorough washing and daily inspections a part of everyone’s diabetes management plan. Be careful to wash and dry properly between the toes, and at the first sign of any sores, blisters and cracks see a podiatrist immediately.
- When cutting your toenails, be sure to cut straight across, without following the curve, and file the edges to smooth them. Be careful not to cut your nails too short. This will prevent ingrown toenails.
- Avoid walking barefoot and have any corns or calluses cut by a medical professional – don’t do it yourself.
- Don’t use hot water bottles or heaters near your feet.
- Moisturize daily to avoid any dryness. Even mild cracking can lead to ulceration. Avoid putting cream between the toes, as this encourages fungal infections.
- Nerve damage caused by high blood sugar levels can cause numbness in the feet. Together with lower production of sweat and oils that lubricate the feet, this can cause increased pressure on the skin, joints and bones of the feet, which in turn causes pain, redness, swelling, sores and ulcers to develop.
- Foot ulcers are reported to affect 1 in 4 people with diabetes in their lifetime. Constant foot care is vital in preventing and treating complications like these.
- Foot ulcers can be stubborn to heal and, in the worst cases, lead to serious lower body infection, disability and even amputation. Contact your podiatrist at the first sign of any problem.
- How do you recognize a foot ulcer? They are often not very painful, and can occur just about anywhere on the foot. When calluses are not removed correctly and often enough, it causes bleeding under the callus, which is how the ulcer begins.
- When it comes to footwear, choose comfort above all else. A good pair of shoes will go miles towards keeping your feet in their best condition.
The HbA1c blood test is something that all diabetics should have every few months. But do you know what it is? Here are all the basics so you can be informed.
- HbA1c stands for haemoglobin A1c, also known as glycated haemoglobin.
- What does this mean? HbA1c is formed when glucose sticks to the haemoglobin found in red blood cells.
- The longer the glucose in the blood is elevated (i.e. the longer you have high blood sugar), the higher the HbA1c will be, as more glucose is available to attach to haemoglobin.
- Red blood cells live for 100 to 120 days (3 to 4 months) before they are replaced: therefore, the HbA1c can give a rough estimate of your average blood glucose for the past 3 months.
- The HbA1c can be done without fasting overnight: the test results do not change even if you’ve just eaten.
- The HbA1c is measured as a percentage: 7% or below is the magic number to aim for.
- 7% HbA1c = an average blood sugar of 8.6mmol/l.
- Both Type 1 and Type 2 diabetics should check their HbA1c every 3 to 6 months depending on the level – every 3 months if your last test was above 7%, every 6 months if you are at 7% or below.
- The higher the HbA1c, the greater the risk of developing diabetes complications.
- All those with diabetes should know their latest HbA1c result and have an HbA1c every few months at their local clinic or hospital. It is a simple blood sample test.
Eye disease is a major risk for people living with diabetes. We round up all the facts you need to keep bright-eyed and bushy tailed.
- Of the eye complications associated with diabetes, diabetic retinopathy is the most common, but cataracts and glaucoma are also possibly serious consequences of poorly controlled diabetes.
- Diabetic retinopathy is a condition affecting the retina (the light-sensitive area at the back of the eye) and is caused by damage to the blood vessels. People with both Type 1 and Type 2 diabetes need to be on the look-out, and the longer a person has been living with diabetes, the greater the risk.
- Leaking or irregular blood vessels and swelling of the retina are early symptoms of diabetic retinopathy. A thorough eye exam at least once a year with an eye specialist will identify any warning signs early.
- A typical eye exam is painless and usually involves viewing a chart to check your eyesight at a distance, testing the pressure inside the eye, and having drops placed in your eyes to widen the pupils and inspect the interior of the eye.
- Glaucoma is caused by the excessive pressure of fluid inside the eye and leads to optic nerve damage. Diabetes makes you twice as likely to develop glaucoma.
- Extra caution and additional eye exams are necessary for pregnant woman with diabetes.
- If you experience any changes in your vision, contact your doctor immediately.
- Some symptoms to be on the alert for are: bad vision in dim lighting, blind spots, double vision or floating spots, blurry vision, pain in the eyes or headaches, and poor peripheral vision.
- Eye disease can often progress without any symptoms, so be sure to keep appointments with your eye care specialist and prevent complications by managing your blood sugar and blood pressure levels carefully.
- Have your blood pressure checked at least twice a year – a blood pressure of under 130/80 is safest for people with diabetes.
Why high blood pressure is a big risk for those with diabetes:
- Blood pressure is the pressure against the walls of the arteries as the heart pumps blood through them.
- Blood pressure is measured in two ways: Systolic pressure is the blood pressure when the heart is beating or contracting. Diastolic pressure is the blood pressure between beats when the heart is at rest. The systolic reading is usually written before the diastolic, and is measured in something called millimeters of mercury, for example 120/80mm Hg.
- People with diabetes are at greater risk of developing high blood pressure: 3 in 10 people with Type 1 diabetes and 8 in 10 people with Type 2 diabetes develop high blood pressure at some stage.
- The risk is increased if you are overweight, eat a lot of salt, don’t eat enough fruit and vegetables, don’t exercise a lot, or drink alcohol excessively. You’re also at greater risk if you have a family history of high blood pressure.
- Healthy lifestyle changes are essential in treating high blood pressure, but medication is often necessary if you have diabetes and your blood pressure remains at 140/80mm Hg or higher.
- If blood pressure remains high over an extended period of time, it can damage the organs of the body, causing heart attacks, strokes and kidney disease.
- Diabetic related conditions like retinopathy (damage to the back of eye) and nephropathy (damage to the kidneys) are more likely in people who have both diabetes and high blood pressure.
- Generally, a blood pressure reading of 140/80 mm Hg or higher is considered high for anyone with diabetes.
- Blood pressure is higher when you’re anxious, stressed or have just been exercising.
- High blood pressure itself has no known symptoms, so can go undetected unless checked regularly. A single test can’t diagnose high blood pressure – you have to have a series of tests (when relaxed) for a real diagnosis. Get tested today!