prosthetics and orthotics video


Tuesday, August 3, 2010

Diabetes Mellitus!

Transtibial stump as a result of diabetes
Diabetes i can say is a second main causes of amputation in Tanzania,after trauma,i hope even in your area diabetes is a problem but what differ is in which degree!.For that reason let us share this knowledge about diabetes
Diabetes mellitus.

This is a disease caused by deficiency or absence of insulin or rarely to impairment of insulin activity (insulin resistance) causing varying degrees of disruption of carbohydrate and fat metabolism.

Diabetes is a serious disease that affects your body‘s ability to change food into energy. Insulin helps you get energy from food .Some of the food you eat turns into a sugar called glucose. Glucose travels around your body in the blood. Your body stores glucose in cells to use for the energy. Insulin is the keys that open the door to the cells. In type 2 diabetes, your body does not make enough insulin, or has trouble using the insulin, or both. When you don’t have enough insulin or it doesn’t work right, the glucose stays in your blood .Over time, glucose will build up in your blood and spill into your urine. This can hurt your eyes, kidneys, nerves,heart, and blood vessels.

Insulin is made by the cells in the pancreas called beta cells. When you eat and at other time over the day, the pancreas releases insulin into the blood to take care of rises in glucose. If the beta cells die, insulin is no longer made. This is what happens in people with type 1 diabetes .This is why they must inject insulin to live, while a person with type 2 diabetes might inject insulin but does not depend on it to live.

Types 2 diabetes usually comes on slowly. may have only mild symptoms or not notice any symptoms at all for years. Some common symptoms are constant thirst ,constant hunger, frequent urination ,blurred vision, and fatique.You may also experience tingling ,numbness, or pain in her/his hands or feet; dry ,itchy skin; and infections of the skin ,gums, bladder , or vagina that keep coming back or heel slowly.

You are more likely to have type 2diabetes if you
- have relative with diabetes
- Are over weight
- Are at least 45 years old
- Have impaired glucose tolerance
- Have a high blood pressure or high blood fats
- Had gestational diabetes or delivered a baby weighing over 9 pounds.

How ever there is no cure for diabetes. Your health care provider can not give you any thing to make it go away. It is a chronic disease, but there things you can do to treat it yourself
(i)Health eating
(ii)Exercise is the best treatment for type 2 diabetes

Every one with diabetes find it is easier to control if they eat healthy meals and exercise daily.
Certain food rise your blood glucose .How much a food rises your blood glucose is based on type of food ,how it is prepared ,how much you it of it, when you eat it, and what you eat along with it. You can find out how the foods you eat affect your blood glucose level by testing your blood glucose after eating.
Exercise lowers your blood glucose level by using some of the glucose in your blood. It also helps your muscles use insulin better, so even more glucose is removed from the blood. When you add exercise such as 20 minutes walk ,to your daily schedule, you may lose weight too since loosing as little as 10 pounds can help some people get their blood glucose level back to normal.
But if health eating and exercise do not bring your blood glucose levels down to where you want to be, you may need diabetes pills. Diabetes pills are drugs that lower blood glucose levels, they are not insulin. If healthy food, exercise, and diabetes pills do not lower your blood glucose, you may need to take insulin

(i) Self monitor your blood glucose levels
(ii) Have regular medical check ups
With a blood glucose meter ,you can check your blood glucose level at any time of the day and see what affect the food you ate, or exercise you did, had on your on your blood glucose level. This helps you make decisions-what to eat, when to exercise or how much medications to take in order to control your blood glucose level. This knowledge can give you more flexibility in your day to day activities, also will help you to predict what your blood glucose level will do ,you can change your schedule around –eat at later time, exercise more than usual and still keep your blood glucose levels under control.

By using a blood glucose meter ,you don’t have to wait until you go to your health care provider to know how you are doing .Still your health care provider is important. Only your health care provider will check your over all health to assess how your treatments are working .Having a physical exam at least once a year gives your health care provider a better chance of finding any potential problems.

Untreated type 2 diabetes can lead to serious diseases of the heart, blood vessels ,nerves, kidneys, and eyes.
These diseases are called diabetes complications .You may have had diabetes for years and not even known about it. During that time, high blood glucose levels may have may have been damaging these parts of your body. that is why is important for you to take control of diabetes as soon as you are diagnosed. You can do something to prevent or postpone diabetes complications. Bringing your blood glucose levels closer to normal will stop or slow the damage to your eyes ,nerves, and kidneys

-eat health food
-Control your health
-Stay physically active.
-Take diabetes pills or insulin, if needed
-test your blood glucose
-Get regular checkups.

Because you have diabetes, your children, siblings,or parents may be at risk for developing it,too.There are ways to help protect them:
-Share your health eating plan with your family; prepare family meal that every one can enjoy.
-Involve your family in your education; encourage them to visit your diabetes care provider, dietitian, and other health care team members with you.
-Make sure your family member have regular checkups with a health care provider experienced in diabetes. There are tests that can detect markers for diabetes before it develops.
-Ask your family members to be your exercise partners. Set goals together, and help keep each other motivated.


At first, you will need sometime to absorb all the information your health care providers give you. You may feel overwhelmed by all you must do and remember. You may feel sad about the loss of your good heath. You may feel angry because you have to make changes to the way you live. You may feel afraid of having a low blood glucose reaction, having to give yourself shots, or the thought of future complications. These and other strong emotions are all parts of living with chronic diseases.
Knowing these emotions are part of the disease may help you recognize them more quickly when they appear. This may help you to accept your anger, your fear, or your resentment. Seeking support from your family, friends, or a mental health professional may help.
Hopefully, you will come to accept your diabetes. Just realize that even after you have accepted it, you wont always want to follow a healthy meal plan and exercise. Some days will be easier than others. But that is okay, just do the best you can at the moment, and start fresh each day


People with diabetes can get many kinds of foot problems, even minor ones can quickly turn into serious ones. This can lead to an amputation since the feet can develop a gangrene

Corns and Calluses
Calluses are areas of thick skin caused by regular or pronged pressure or friction
Corns are callus on a toe. Corns and calluses can develop on your feet when your body weight is borne unevenly. There are several things you can do to prevent calluses from forming.

Wear shoes that fits
Shoes that fits are comfortable when you buy them. Almost all new shoes are little stiff at the start and mold to your feet with wear, but this is different from buying the wrong size and trying to break them in. Make sure there is room for you to move your toes.

Wear shoes with low heels and thick soles.
Thick soles will cushion and protect your feet. Low heels distribute your weight more evenly.

Try padded socks
They not only cushion and protect feet but also reduce pressure. Be sure your shoe is large enough to fit this thicker sock. You may need extra –deep shoes.

Try shoes inserts
Ask your diabetes care provider or foot doctor about shoe inserts to better distribute your weight onto your feet.

If you get a callus or corn, have it trimmed by your diabetes care provider or foot doctor .Trying to cut corns or callus yourself can lead to infections .Trying to remove them with over-the counter chemicals can burn your skin .Untrimmed calluses can get very thick ,breakdown and turn into ulcers are not something you want.

Foot Ulcers
Foot ulcers are open sores or holes in the skin. Ulcers form most often over the ball of the foot or on the bottom of the big toe .Ulcers can be caused by a cut, callus or blister that is not taken care of .Ulcers on the sides of a foot are usually caused by shoes that don’t fit well. You can prevent ulcers by.

-Wearing shoes that fit.
-Wearing new shoes for just a few hours at a time.
-Throwing away worn-out shoes and sneakers.
-Wearing socks that fit
-Wearing socks without seams,holes,or bumpy areas in the
-Putting on clean socks each day
-Pulling or rolling your socks on gently
-Checking for pebbles or other objects before you put on your shoes.

An ulcer can be very painful. But if you have nerve damage you may not feel it. Even though you may not feel any pain from the ulcer, you need to get a medical attention right away. Walking on an ulcer can cause it to become larger and infected, an infected ulcer can lead to gangrene and amputation.

Poor Circulation
Poor circulation can make your feet feel cold and look blue or swollen .The best way to treat cold feet is to wear warm socks, even to bed .Do not use hot water bottles, heating pads, or electric blankets. They may burn your feet without you noticing .Keep your feet out of water that is too hot. Test it first with your elbow .If your feet are swollen, try lace-up shoes. You can tighten or loosen them to fit the shape of your feet.
To increase blood flow to your feet, start exercising (with your health provider’s approval). Avoid sitting with your legs crossed, which can interfere with blood flow .If you smoke, stop now, smoking limits blood flow to your feet.

Nerve Damage (Neuropathy)
Nerve damage can make your feet less able to feel pain, heat, and cold. If you have lost some of the feeling in your feet, don’t go barefoot. You could hurt your and not notice it. Check your shoes before you put them on. Make sure there are no stones, nailspaper clips,pins,or other sharp objects in them. Be sure the inside of the shoe is smooth and free of tears or rough edges.
Nerve damage can affect the nerves that cause sweating. As a result, your feet may become dry and scaly and the skin may peel and crack. If your feet have become dry and scaly, use a moisturizer twice a day. But don’t put the moisturizer between your toes, because the extra moisture can lead to infection. And don’t soak your feet, soaking dries out your skin..
Nerve damage can also deform your feet. Your toes may curl up, the ball of your foot may stick out more, and your arch may get higher. These changes can cause some parts of your feet to bear more weight. Those areas are then more likely to get calluses and corns. If the shape of your feet has changed, ask your diabetes care provider or foot doctor about shoe inserts or special shoes.

How to Care for your Feet
Check both of your feet each day. Look all over them. If you can not see well, have a friend or relative who can see well do it for you. Compare one foot to the other. Use a mirror to help see the bottom of your feet. Look for cuts, blisters, scratches, ingrown toenails, changes in color, changes in shape,punctures,anything that wasn’t there the day before.

Keep your feet clean,
Wash and dry them well, don’t forget to dry between your toes.

Keep your toenails trimmed
Trim your toenails to follow the curve of your toe. If you cant trim them yourself, have a member of your healthy care team to do it.

Have your feet checked regularly.
Take your shoes and socks off at every regular office visit to remind your health care provider to check your feet. Have your diabetes care provider check your feet for blood vessel, muscle, and nerve damage at least once a year.

Keep your blood glucose in control.
If blood glucose levels are high, you are more likely to get food problems

Keep you diabetes care provider informed
Call your provider if you have a foot problem, no matter how minor.


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