On a regular basis, I talk with diabetic individuals that are scared of lose of a foot or toe. They are often told of the worst case scenarios and just told they need to be careful. They hear about going blind, heart attacks, wounds that don't heal and even death from the "complications of diabetes". This scare tactic has been ineffective at reducing the complications or helping people prevent these complications.

I have always felt that better educated individuals will better limit the complications and problems. Therefore, I would like to provide the top 4 ways to limit complications based on current research:

1. The best way to limit complications of diabetes (all the complications) is strict blood sugar control. You should be monitoring your blood sugar and seeking to have a A1c of 6 or lower. Spikes in blood sugar are not recommended at any time, as this provides opportunity for the complications to start. As you talk with your doctor, you can get an aggressive program to keep blood sugars managed. The better the blood sugar control, the smaller chance you have for diabetic complications.

2. Exercise helps control blood sugar. Exercise in a diabetic is an important part of your self care. Recent studies have shown exercise improving diabetic symptoms (especially in type 2 diabetics) and may reduce the need for diabetic medications. This program should be under the direction of your physician and should include adjustments in medications as necessary, diet changes and carefully monitored exercise.

Some key points of an exercise program should include not exercising when blood sugars are highest, limiting exercise until 30 - 60 minutes after meals and addition of carbohydrates may be required to reduce hypoglycemia (low blood sugars).

Talk with your doctor and get an exercise program that will work for you.

3. Examine your feet twice a day. The American Diabetes Association recommends you examine your feet daily for new areas of redness, new calluses, blisters, or any skin changes. Since you are putting shoes on and taking them off, I recommend checking your feet twice a day. This evaluation will help you understand if a certain shoe or activity is causing any of these changes.

If changes are noted to the feet, your feet should be checked by a foot and ankle specialist to help improve the problem before it becomes a bigger problem. As you examine your feet, you are performing the most important exercise to reduce wounds, infections and amputations.

4. Play an active part in managing your disease. No matter how good your doctor is, you are the key to good diabetic control. Learn all you can and work to reduce your diabetic foot complications (as well as other complications).

Diabetic complications can be limited with an integrated approach to self management and a good health care team including your diabetic doctor, a podiatrist for foot care and a dietician to help you manage how you eat. With this team, you are the key to the best reductions in your risk of diabetic complications.

Copyright (c) 2009 Mountain West Foot & Ankle Institute