Diabetes and Wound Care

Diabetes and wound care has grown to be a critical subject over the years. Approximately 5 million Americans suffer from some sort of chronic wound or open sore, 15% of these are diabetics. Chronic wounds can become infected, develop gangrene or require amputation.Diabetics are at a greater risk of developing chronic wounds because of poor circulation, slow healing times, vascular disease and neuropathy (numbness).Diabetic ulcers are the most common foot injuries leading to lower extremity amputation.

Because of this fact we will focus on diabetic foot ulcers, the most common of all diabetic chronic wounds. We'll discuss how ulcers form, what treatments are available to you and how to prevent ulcers. Patient education regarding foot hygiene, nail care and proper footwear is crucial. Let's get started.

What is a Foot Ulcer?

Foot ulcers are open wounds that develop on the sides, top or soles of the feet. Diabetics are prone to these wounds because of poor circulation and other problems that arise from having diabetes. Diabetes and wound care should be taken seriously. They are notoriously difficult to treat and the treatment can be lengthy and frustrating. Lower extremities, particularly foot wounds account for one quarter of all diabetic hospital admissions in the U.S. and Great Britain.

Who Gets a Diabetic Foot Ulcer?

Almost anyone who has diabetes can develop foot ulcers.

Who is more likely to develop foot ulcers? Statistically it's African Americans, Native Americans, Hispanics and older men.

Who is at risk? People who use insulin and those who suffer diabetes related ailments such as heart disease, kidney and eye problems are equally at risk. If you are overweight, smoke and use alcohol you are at a greater risk of developing foot ulcers.

How Do Diabetic Foot Ulcers Form?

There are 4 major causes of diabetic foot ulcers.

• Neuropathy (numbness). Neuropathy is a condition when you lose sensation in your limbs and lower extremities. Prolonged elevated glucose levels over time cause this to happen. This condition has a way of creeping up on you. Often you are not aware of the problem until it's too late.

Because of numbness patients can't feel small cuts on their feet, wounds can go untreated for days even weeks. Also neuropathy can cause a patient not to shift or move their feet when pressure points develop. This can lead to wounds developing.Your doctor can check your feet using a simple painless test with a tool called a monofilament.

• Foot deformities. Because of neuropathy patients can break bones in their feet and not be aware of it. Foot deformities can put unnatural pressure on certain areas of the foot and cause wounds to develop.
• Vascular Disease. This disease causes narrowing of blood vessels and can lead to wound development. Restricted blood flow and circulation make treating foot ulcers frustrating and lengthy. This condition reduces the body's ability to heal itself--which increases the risk of infection.
• Skin irritation and friction. Patients with neuropathy (numbness) cannot tell when they have skin irritation, problems with friction or pressure points. The only way to know for sure is to check your feet often for redness, peeling skin or blisters.

How Should a Diabetic Foot Ulcer be treated?

Prevention, prevention prevention. Diabetes and wound care is all about prevention. You know what they say about an ounce of prevention. Untreated wounds can lead to infection. The quicker you treat the wound the less likely you are to develop a problem.

There are 3 commonly used treatments for foot ulcers.

• Offloading - That's offloading off-roading. It means quite literarily putting your feet up. Reducing pressure on a wound is probably the single most important and most neglected factor in chronic wound treatment.

It could mean anything from using crutches or a wheelchair to complete bed rest. Taking a load off sounds like a nice idea but it could take anywhere from 6-12 weeks for your wound to properly heal. That's a lot of downtime.

This is where doctors have a problem. Their patients rarely ever follow the proper protocol. So, listen to your doctor!

It's a little technical, written for doctors by doctors but it's very informative.

• Debridement - The removal of dead skin and tissue. Dead tissue can slow or impede the healing process. The dead skin can appear yellow, tan or black in color. A doctor usually includes debridement as part of complete diabetes wound care protocol.

There are 4 ways to debride a wound, autolytic, mechanical, enzymatic, and surgical.

• Applying medication or dressings - This is usually used in conjunction with other treatments. Your doctor will advise you what medication or dressings to apply. In most cases you will be responsible for changing the dressing and keeping an eye on the wound. The medication could be a course of antibiotics or simply an antibiotic ointment. With diabetes, wound care can be a big responsibility for the patient.

How to Keep a Foot Ulcer from Becoming Infected If you want to keep a foot ulcer from becoming infected, there are a few things you need to do.

• Control your blood sugar levels - It is vitally important that you control your blood sugar level. It's especially important during the time you are receiving treatment for diabetic foot ulcers.

Try to avoid and reduce the risk of infection while undergoing treatment--consult your doctor about the steps you should take to control your blood sugar. Eat right, exercise and check your levels daily.

• Keep the wound clean and bandaged - The old way of thinking about wounds, "let it breathe", is not correct it can impede the healing process. Keep a wound clean, covered and moist is the way to go.

Clean the wound daily. Cover it with a medical bandage. Keep the wound or ulcer moist--with creams or antibiotic ointments.

Not moist as in; whirlpools, peroxide, soaking or full strength Betadine. These things are not recommended for healing a wound or ulcer. They can in fact make things worse.

• Do not walk barefoot - Diabetics often suffer from neuropathy (numbness). As a result, they won't feel it if they accidentally step on a tack or a piece of glass.

The subsequent wound could be difficult to heal, or worse, become infected and lead to serious consequences. So, keep your feet covered.

• Never reuse a syringe - As a rule our skin acts as a good barrier to most infections. But if you are on insulin, you routinely have to breach the surface of the skin and puncture the underlying tissue.

From the minute you uncap the syringe it is exposed to the atmosphere of the room.

After drawing in the insulin, the needle is moist. So you are administering a shot with a moist needle exposed to the room temperature and atmosphere.

It would be unwise to recap a moist syringe after puncturing the skin.

Make sure you always have a healthy supply of syringes on hand and that you never run out.

How Can a Foot Ulcer be prevented? The best and by far the easiest way to prevent a foot ulcer is.... never getting a foot ulcer! Other than the obvious, you can follow the steps recommended above.

Wear shoes; keep your feet covered with heavy or thick socks. They should fit snuggly but not too tight, you should avoid constriction.

Every time you buy shoes you should have your foot measured and sized correctly. Clean and inspect your feet daily. Try to correct any foot deformities such as bunions, corns or hammertoes.

Take care to reduce all risk factors such as; drinking alcohol, smoking tobacco and uncontrolled blood sugar levels.

Self-Care Products and Diabetic Wounds

There are many products available on the market today, so called "beauty aids" for the feet. It can be a treat on occasion to have a home pedicure. However, if you are a diabetic these products can lead to open wounds.

For example, there is the "pumice stone", a hard abrasive stone used to scrape away "dead" skin from the foot. If you're a diabetic this can leave cuts and abrasions on your feet that won't heal.

There is something called a "corn plane", this device operates exactly like a wood plane. Instead of shaving away wood pieces, you are shaving away skin.

In the category of corn and callus removal, there is salicylic acid. The way this acid works is to slowly erode skin that makes up warts, corn and calluses.

All of these products come with a strict warning for diabetics to refrain from use, as their sole (get it "sole", foot "sole") purpose is to abrade the skin.

The most common of these self-care products is the nail clipper. Most people cut their nails too close to the cuticle. If you are diabetic you should cut your nails straight across. The object is to avoid getting a hangnail.

See a podiatrist regularly and let your doctor advise you on the best way to care for your feet.

By Jennifer L Williams

10 Best Home Remedies for Diabetes

This article is dedicated to the best Home Remedies for Diabetes. First of all let me tell you what is Diabetes?
Diabetes is a disorder of metabolism the way our bodies use digested food for development and energy. It is widely accepted as one of the leading causes of death and disability in the United States. It is connected with long-term complications that affect almost every part of the body. It is a chronic and progressive ailment that has an impact upon almost every part of life. Diabetes grows when the body can't use glucose properly
Insulin is a hormone that is essential to convert sugar, starches, and other food into energy. Insulin permits glucose to move from the blood into liver, muscle, and fat cells, where it is used for fuel. In diabetes, the immune system molests and destroys the insulin-producing beta cells in the pancreas. When type 2 diabetes is diagnosed, the pancreas is frequently producing enough insulin, but for unidentified reasons the body cannot use the insulin effectively, a condition called insulin resistance.
Type of Diabetes
Type 1 Diabetes
The body stops producing insulin or produces too little insulin to regulate blood glucose level. Type 1 diabetes occurs when the body's own immune system destroys theinsulin-producing cells of the pancreas (called beta cells).
Type 1 diabetes is an autoimmune illness. Type 1 diabetes grows most often in children but can occur at any age.
Type 1 diabetes comprises about 10% of total cases of diabetes in the United States. Type 1 diabetes is typically recognized in childhood or adolescence and can occur in an older individual due to destruction of pancreas by alcohol, disease, or removal by surgery or progressive failure of pancreatic beta cells, which produce insulin.
Type 2 diabetes
Type 2 diabetes is gradually more being diagnosed in children and adolescents. Type 2 diabetes is more ordinary in older people, particularly in people who are overweight, and happens more often in African Americans, American Indians, some Asian Americans, Native Hawaiians and other Pacific Islander Americans, and Hispanics/Latinos.
The pancreas secretes insulin, but the body is partially or completely not capable to use the insulin. Type 2 diabetes is classically recognized in adulthood, generally after age 45 years. Type 2 diabetes is usually controlled with diet, weight loss, exercise, and oral medications
Here is a list of some best Home Remedies for Diabetes:-
Home Remedies for Diabetes
1) Most effective Home Remedy for Diabetes is Bitter gourd and proved helpful in controlling diabetes. For better results, the diabetic should take the juice of about four or five Bitter gourds each morning on an empty stomach.
2) Take juice of bilva and parijataka leaves in identical parts for natural remedy of diabetes.
3) Indian gooseberry, with its high vitamin C content, is measured important in diabetes. A tablespoon of its juice, mixed with a cup of bitter gourd juice, taken daily for two months, will rouse the islets of Langerhans, that is, the remote group of cells that secrete the hormone insulin in the pancreas. This mixture diminishes the blood sugar in diabetes. This is another effective Home Remedy for Diabetes.
4) The seeds of parslane are helpful in diabetes. A teaspoon of the seeds should be taken each day with half a cup of water for four to five months. It will boost the body's own insulin and help in curing diabetes.
5) Including grapefruit in the diet is an outstanding natural home remedy for diabetes.
6) Take two teaspoons of powdered Fenugreek seeds with milk. Two teaspoons of the seeds can also be consumed whole, every day.
7) The tender leaves of the mango tree are considered as good Home Remedy for Diabetes. An infusion is made by soaking 15 gm of fresh leaves in 250 ml of water overnight, and squeeze them well in the water. This filtrate should be taken every morning to handle early diabetes. As an option, the leaves should be dried in the shade, powdered and preserved for use when needed. Half a teaspoon of this powder should be taken two times a day.
8) The juice of Margosa is a cooperative natural home remedy for diabetes.
9) String bean pod tea is a superb natural Home Remedy for Diabetes and can be substituted for insulin.
10) Eat 10 fresh fully full-fledged curry leaves each morning for three months. It avoids diabetes due to genetic or heredity factors.

By Ashi Jas

Discover the Positive Effects of Exercise for Diabetes Sufferers

There are two main types of diabetes, type I and type II. Type I diabetes is characterized by the pancreas making too little or no insulin. An individual with diabetes type I will have to inject insulin throughout the day in order to control glucose levels. Type II diabetes, also known as adult onset diabetes, is characterized by the pancreas not producing enough insulin to control glucose levels or the cells not responding to insulin.

When a cell does not respond to insulin, it is known as insulin resistance. When a subject is diagnosed with type II diabetes, exercise and weight control are prescribed as measures to help with insulin resistance. If this does not control glucose levels, then medication is prescribed. The risk factors for type II diabetes include: inactivity, high cholesterol, obesity, and hypertension. Inactivity alone is a very strong risk factor that has been proven to lead to diabetes type II.

Exercise will have a positive effect on diabetes type II while improving insulin sensitivity while type I cannot be controlled be an exercise program. Over 90% of individuals with diabetes have type II.

Exercise causes the body to process glucose faster, which lowers blood sugar. The more intense the exercise, the faster the body will utilize glucose. Therefore it is important to understand the differences in training with type I and type II diabetes. It is important for an individual who has diabetes to check with a physician before beginning an exercise program. When training with a diabetic, it is important to understand the dangers of injecting insulin immediately prior to exercise. An individual with type I diabetes injecting their normal amount of insulin for a sedentary situation can pose the risk of hypoglycemia or insulin shock during exercise.

General exercise guidelines for type I are as follows: allow adequate rest during exercise sessions to prevent high blood pressure, use low impact exercises and avoid heavy weight lifting, and always have a supply of carbohydrates nearby. If blood sugar levels get too low, the individual may feel shaky, disoriented, hungry, anxious, become irritable or experience trembling. Consuming a carbohydrate snack or beverage will alleviate these symptoms in a matter of minutes.

Before engaging in exercise, it is important for blood sugar levels to be tested to make sure that they are not below 80 to 100 mg/dl range and not above 250 mg/dl. Glucose levels should also be tested before, during, after and three to five hours after exercise. During this recovery period (3-5 hours after exercise), it is important for diabetics to consume ample carbohydrates in order to prevent hypoglycemia.

Exercise will greatly benefit an individual with type II diabetes because of its positive effects on insulin sensitivity. Proper exercise and nutrition are the best forms of prevention for type II diabetics. It is important for training protocols to be repeated almost daily to help with sustaining insulin sensitivity. To prevent hypoglycemia, progressively work up to strenuous activity.

As with individuals with type I diabetes, carbohydrates should also be present during training to assist in raising blood sugar levels if the individual becomes low.

The information contained in this article is for educational purposes only and is not intended to medically diagnose, treat or cure any disease. Consult a health care practitioner before beginning any health care program.

Emily Clark