House call
Edited By Robert S. Benchley
Answers to some common questions about diabetes from Karen Stidd, Liberty Medical's director of clinical education.
Q. It's difficult to eat right when I travel. Do you have any suggestions?
A. If you take oral medications and/or insulin, you should always carry a simple form of carbohydrate such as juice, glucose tablets, candy or regular soda in case of hypoglycemia. Meals can be challenging, especially at airports, highway rest stops or food courts in shopping malls. Look for regular- or junior-sized meals or side orders (not super-sized, giant or deluxe). Avoid fried items. Watch the extra sauces and cheese, which can add hundreds of calories together. Try not to have more than one fast food meal/day while traveling.
Q. Now that I have diabetes, do I need to change the shoes I wear?
A. Amputation and foot ulceration are the most common consequences of diabetic neuropathy, and major causes of morbidity and disability in people with diabetes. It is advisable to wear well-fitted walking shoes or athletic shoes. The goal is to avoid shoes that pinch or rub or place undue pressure on any area of the foot. Blisters caused from rubbing can easily become infected. Increased pressure on the bottom of the foot might require cushions to redistribute the pressure and prevent calluses and ulcers. People with bony deformities such as hammertoes or bunions, may need extra-wide shoes or extra-deep shoes.
Q. Why do so many people with diabetes also have high blood pressure?
A. Diabetes and hypertension (high blood pressure) often go hand in hand. Both are linked to our aging population, sedentary lifestyle and obesity. There is also a metabolic link between diabetes and hypertension due to a resistance in the way the body reacts to insulin. Increases in blood insulin make the blood vessels widen. This widening affects the sympathetic nervous system and, directly or indirectly, makes the kidneys retain salt, which raises the blood pressure. Excessive blood insulin also promotes atherosclerosis, which hardens the blood vessels, further elevating blood pressure. Blood pressure should be treated to 130/80 in patients with diabetes.
Q. I was just diagnosed with diabetes. How do I find a support group near where I live that can help me learn to manage my disease?
A. Many hospitals offer diabetes support groups. Check your local newspaper, hospital or health department for support group locations and meeting dates. Endocrinologists (physicians who specialize in diabetes) may also offer support groups that are open to all patients. Check the yellow pages for "Endocrinologists" and give them a call. You can also check with your primary care physician. HM