If you smoke quit

Mike is a migrant farm worker with type 2 diabetes and high blood pressure. Mike, 47, is married, and he and his wife have three children. The family is often on the move, depending on where the work is. Mike has his blood pressure and kidneys checked at clinics in migrant worker camps. Some of the clinics also offer diabetes classes. Whenever they can, Mike and his wife attend these classes. They especially like the cooking classes because they learn how to prepare low-cost, healthy meals for the whole family.

Over time, high blood glucose can harm the nerves in your body. Nerve damage can cause you to lose the feeling in your feet or to have painful, burning feet. It can also cause pain in your legs, arms, or hands or cause problems with digesting food, going to the bathroom, or having sex.

Nerve damage can happen slowly. You may not even realize you have nerve problems. Your doctor should check your nerves at least once a year. Part of this exam should include tests to check your sense of feeling and the pulses in your feet.

Tell the doctor about any problems with your feet, legs, hands, or arms. Also, tell the doctor if you have trouble digesting food, going to the bathroom, or having sex, or if you feel dizzy sometimes.

Nerve damage to the feet can lead to amputations. You may not feel pain from injuries or sore spots on your feet. If you have poor circulation because of blood vessel problems in your legs, the sores on your feet can't heal and might become infected. If the infection isn't treated, it could lead to amputation.

Ask your doctor whether you already have nerve damage in your feet. If you do, it is especially important to take good care of your feet. To help prevent complications from nerve damage, check your feet every day (see Foot Care Tips on page 46).

Here are some ways to take care of your nerves:

• Keep your blood glucose and blood pressure as close to normal as possible.

• Limit the amount of alcohol you drink.

• Check your feet every day.

Joe is a 65-year-old retired letter carrier with type 2 diabetes. Every time he visits his doctor, he takes his shoes and socks off so the doctor can check his feet for sores, ulcers, and wounds. The doctor also checks the sense of feeling in Joe's feet. Joe and his doctor talk about ways to prevent foot and nerve problems. Since Joe has lost some feeling in his toes, the doctor also talks to him about the importance of good foot care and keeping his blood glucose in a good range.

Foot Care Tips

You can do a lot to prevent problems with your feet. Keeping your blood glucose in your target range and taking care of your feet can help protect them.

• Check your bare feet every day. Look for cuts, sores, bumps, or red spots. Use a mirror or ask a family member for help if you have trouble seeing the bottoms of your feet.

• Wash your feet in warm—not hot—water every day, but don't soak them. Use mild soap. Dry your feet with a soft towel, and dry carefully between your toes.

• After washing your feet, cover them with lotion before putting your shoes and socks on. Don't put lotion or cream between your toes.

• File your toenails straight across with an emery board. Don't leave sharp edges that could cut the next toe.

• Don't try to cut calluses or corns off with a razor blade or knife, and don't use wart removers on your feet. If you have warts or painful corns or calluses, see a podiatrist, a doctor who treats foot problems.

• Wear thick, soft socks. Don't wear mended stockings or stockings with holes or seams that might rub against your feet.

• Check your shoes before you put them on to be sure they have no sharp edges or objects in them.

• Wear shoes that fit well and let your toes move. Break new shoes in slowly. Don't wear flipflops, shoes with pointed toes, or plastic shoes. Never go barefoot.

• Wear socks if your feet get cold at night. Don't use heating pads or hot water bottles on your feet.

• Have your doctor check your feet at every visit. Take your shoes and socks off when you go into the examining room. This will remind the doctor to check your feet.

• See a podiatrist for help if you can't take care of your feet yourself.

Diabetes can lead to infections in your gums and the bones that hold your teeth in place. Like all infections, gum infections can cause blood glucose to rise. Without treatment, teeth may become loose and fall out.

Help prevent damage to your gums and teeth by doing the following:

• See your dentist twice a year. Tell your dentist that you have diabetes.

• Brush and floss your teeth at least twice a day.

Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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