The Diabetes Control and Complications Trial (DCCT); a 10-year study of diabetes tends to occur on the retina (inside surface of the back of the eyeball) …
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STAYING HEALTHY WITH DIABETES When it comes to diabetes, YOU are in control Taking care of yourself will help you stay healthy The information in this section will help you care for your feet, skin, teeth and eyes
Foot Care
It is important to take special care of your feet when you have diabetes High blood sugar and high blood pressure can cause foot problems such as poor blood circulation and damage to the nerves Nerve damage can: Cause your feet to lose sensation If this happens, a simple cut or sore can go unnoticed and lead to problems Change the shape of your feet, causing pressure points Blisters, sores and ulcers may form in these areas Inadequate blood flow to the feet can cause delayed wound healing Keep your blood sugar in control One of the most important things you can do is keep your blood sugar as close to normal 70 to 110 mg/dL as possible The American College of Endocrinology ACE recommends a blood sugar level of less than 110 mg/dL before meals and less than 140 mg/dL 2 hours after meals These guidelines apply to many people, but not to everyone Your goals may be higher or lower than these guidelines Talk to your doctor He will help you set
the blood sugar target that s right for you The Diabetes Control and Complications Trial DCCT; a 10-year study of 1,441 insulin-dependent diabetic patients, showed that keeping blood sugar as close to normal as possible can reduce the risk of nerve damage by up to 60 How to care for your feet 1 Check your feet every day Look at the top and bottom of your feet If you cannot see the bottom of your feet, use a mirror or ask someone to check for you Look for scratches, cracks, cuts or blisters especially between the toes and around the heel Check for ingrown toenails, corns, calluses and sores Also look for changes in color, shape or temperature For example, does the foot feel warm or cool to the touch? If you notice any of these problems, your doctor may want you to see a podiatrist a foot doctor 2 Wash your feet every day with mild soap and water every Do not soak your feet Soaking can cause your skin to dry and crack
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Gently dry your feet especially between the toes Keeping your feet dry can prevent fungus growth Keep your skin soft by rubbing a thin coat of oil, lotion or moisturizing cream on your feet Do not apply them between
toes
3 Take care of your toenails Cut your toenails after bathing, when they are soft and easy to trim If you cannot see well or if your toenails are too thick, have them cut by a podiatrist Cut toenails straight across and smooth with an emery board 4 Take care of corns and calluses Gently rub calluses with a pumice stone after you have washed your feet This will remove the extra skin that has built up Do not use commercial corn removers, commercial callus removers, razor, blades or knives on your corns or calluses Always see your doctor if you have any problems with your feet 5 Protect your feet Do not walk barefoot, even indoors Use sunscreen on your feet and legs in summer Break in new shoes slowly Wear new shoes for only 1 or 2 hours at a time Avoid shoes with pointed toes or high heels or shoes that are the wrong size Don t wear tight fitting shoes Always wear socks or stockings with your shoes Socks made of a cotton acrylic blend or wool feels the best Wool socks or others made of new materials that remove moisture are good for keeping your feet warm and dry 6 Maintain adequate blood flow to your feet Try to quit smoking, if you do Smoking decreases blood flow
to the feet Keep blood sugar, cholesterol and other lipid levels normal Be physically active every day Keep your feet warm, but do not use heating pads or hot water bottles on your feet Do not wear tight garters or socks 7 Work with your healthcare team Meet with them regularly Take off your shoes and socks every time you see your doctor or diabetes educator Thi 
s will remind them to check your feet Tell them immediately if you have any foot sores or wounds
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Skin care
With diabetes, your skin needs extra care too Skin problems related to diabetes range from bothersome itching to painful infections Basic skin care should include the following: Bathe every day with mild soap and water Use a small amount of lotion afterward to keep skin soft Take extra care to avoid scratches and cuts Wash cuts with soap and water and cover with sterile bandages Treat a skin injury immediately as directed by your healthcare team and call your doctor if it doesnt heal Dress warmly in cold weather
Dental care
Just as your feet and skin need special care, so do your mouth and teeth High blood sugar increases your risk for tooth and gum problems To help
prevent these problems, you should: Brush at least twice a day Gently brush your tongue, which can trap germs Floss every day or as directed by your dentist or hygienist See your dentist once in every 6 months to have your teeth cleaned Make sure to inform your dentist about your diabetes and the medications you take
Eye care
Diabetes can affect your vision, too Early vision damage related to diabetes tends to occur on the retina inside surface of the back of the eyeball Because of its location, the damage cannot be detected in a routine eye exam A special eye check up, called a dilated eye exam, allows your doctor to better check your retina for early warning signs of vision loss The dilated eye test is totally different from the one you have that determines your vision During a dilated eye exam, your doctor will use eyedrops to dilate your pupils He or she will then expose your eye to bright light so that your retina can be examined Why do I need a dilated eye examination? Early damage to the retina can begin even before you notice anything wrong with your vision The earliest changes in the blood vessels of the eye cause no symptoms In fact, you cant feel most of the eye
damage due to diabetes until damage is very serious Damage to the retina is one of the most common causes of blindness in diabetes And blindness due to retinopathy damage to the retina is nearly always avoidable when changes are detected at an early, treatable stage
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What can I do to protect my vision? Have a dilated eye exam done once a year Control your blood sugar and blood pressure High blood sugars and high blood pressure both damage the blood vessels of the eyes Together, they can cause more damage than individually The American Diabetes Association recommends a goal blood pressure of less than 130/80 Avoid smoking Immediately notify your doctor of any change in vision With diabetes, you should take care and pay close attention to keeping your feet, skin, teeth and eyes in good condition The extra effort will bring you benefits of a lifetime
Checklist
Here are some key things you need to follow to protect your health Keep this list handy and refer to it often Things to do every day: Test your blood sugar and write it down in your logbook Check your feet for cracks, sores, blisters wounds Follow your meal plan Take care of
teeth and skin Take your medicines regularly as directed Things to do at each doctor s visit: Take your blood sugar logbook along with you so that you and your doctor can review the results together Ask about your HbA1C level and determine your goal for your subsequent visit Have your doctor check your feet Taking off your shoes and socks will help you remind the doctor of your feet examination Have your blood pressure checked regularly Things to do once a year: Visit an eye doctor for a complete dilated eye exam Have your cholesterol checked Have your urine checked for protein called a micro albumin test Get a flu vaccination
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