Because people with diabetes have to be especially careful in order to prevent foot injuries, shoes need a little extra consideration. But that doesn’t mean you have to wear only one type of shoe or, for that matter, clunky, big, or ugly shoes. If you are not experiencing any loss of sensation in your feet, just be sure to wear proper-fitting and well-constructed shoes and have your feet measured before you buy new shoes; our feet tend to change in both size and shape as we get older. Joy Pape, foot care nurse and certified diabetes educator, says lifestyle changes may include some fashion changes, but if you know how to choose proper-fitting shoes, there are many good-looking options to protect your tootsies.
Here’s what to look for in a shoe :
- 3/8–1/2 inch of space between the end of your longest toe and the shoe. That’s room enough for your finger to fit in the back of your shoe. Also see that you can wiggle your toes in your shoe.
- Shoes should be comfortable when you put them on—don’t expect them to break in and stretch to fit your foot.
- Try to find shoes that have leather upper material and cushioned, comfortable insoles and soles.
- Avoid pointy-toe styles because they’ll squeeze your toes.
- Shoes should be firm in the back to cradle and support your heels, yet not skin tight over the ball of your foot.
- If you want to wear heels, know that for every inch of height, the ball of your foot will endure 25 percent more pressure.
Many people, without realizing it, actually wear shoes that are too small for their feet. This usually happens either when you are not aware that your shoe size has changed or when you can’t feel your feet and thus don’t know your shoes are too tight. See whether there’s a shoe store in your area that employs a pedorthist, a professional trained in the design, fit, and function of shoes and orthotics (a foot pad or heel insert custom-made or bought at the pharmacy that helps improve the health and function of the foot or ankle). A pedorthist will measure your feet and help you find a shoe with the correct shape and structure for you. The right shoe can redistribute pressure across the soles of your feet and help you walk better. Pedorthists are not a substitute for podiatrists, but sometimes they can help you alleviate a minor foot problem.
If your podiatrist recommends special shoes because you have a foot problem, follow his or her advice. A recent study of patients with foot problems who were at high risk for amputation showed that those who wore protective footwear had, as a group, far fewer amputations.
Subject : Does stress does not affect diabetes ?
Stress is not healthy for anyone, but it has particular ramifications for people with diabetes. Whether physical (illness or injury) or mental (feeling under the gun at work, fretting over a sick child, etc.), stress increases your heart rate and raises your blood pressure, which can put you at greater risk for heart disease. It also stimulates appetite, interferes with sleep, causes triggers anxiety, depression, and fatigue. All of this takes its toll on your body and your diabetes management. Chronic stress can even suppress your immunity and cause bone loss.
Relaxation techniques can lower stress, and blood sugar
Imagine that you could protect yourself from going into fight-orflight mode, that is from having a surge of stress hormones elevate your blood sugar. Dr. Surwit’s quarter-century of research on the mind–body connection, along with numerous studies conducted by universities around the world, proposes exactly this. Just as our brain can set off the fight-or-flight response, it can also reverse the effect; the body’s parasympathetic nervous system can slow heart rate, decrease blood pressure, and increase insulin secretion. “We now know,” says Surwit, “that we can use the power of our mind to influence our body, including normalizing blood sugar levels.” In a Surwit study, 108 patients with type 2 diabetes learned a relaxation technique to help them cope with stress. After one year, those who continued the relaxation technique had a 0.5 percent improvement in their A1C (average blood glucose over the past two or three months). Although that seems a small improvement, Surwit says it’s enough to reduce the risk for diabetes-related complications such as eye and kidney disease, and nearly a third of the people in the study experienced improvements in their A1C of 1 percent or more. Most compelling, says Surwit, the technique worked for everyone, including those who initially didn’t report that stress was a major factor in their lives.
How to recognize when you’re stressed
Unfortunately, stress has virtually become a way of life today, and many of us have grown so used to feeling anxious, with muscles tensed, that we’re not even aware we’re stressed. One way to notice that you’re stressed is to log your blood sugars and see whether, when they are high, there’s a stressful event going on in your life. The American Diabetes Association suggests that before testing your blood sugar, you rate how stressed you feel by assigning a number between 1 and 10 to your stress level. Then test your blood sugar and write down your blood sugar level next to your mental stress number. After a week or two, look at your numbers and see whether you notice any pattern. Do you notice that when you wrote down a high stress level, you had a high glucose level? If so, it’s safe to assume that at least some of your high blood sugars were stress-induced. Remember, stress is not necessarily due to negative events. It can also be caused by something positive, such as excitement about your wedding, a trip you’re looking forward to, or a job promotion. The first time I addressed a group of patients, I tested my blood sugar immediately afterward. I expected it to be low both before and after my talk because I hadn’t had time to eat lunch beforehand. To my surprise, my blood sugar was 100 points higher than before my talk! When it happened a second time, I realized that my stress hormones had kicked in because of my nervous excitement and raised my blood sugar!
Stress makes it harder to manage your diabetes
Short- and long-term stress and strain also take a toll on your diabetes management. Many diabetes care tasks tend to go by the wayside when you’re stressed, and if you ignore your diabetes management, you put yourself at greater risk for developing diabetes complications. If one or more of the following phrases describe your recent behavior, try to take one small action to decrease and better manage your stress.
- Frequently forgetting to check your blood sugar levels
- Forgetting to schedule doctor appointments
- Not making time to shop for or plan healthful meals
- Eating on the run or reaching for unhealthful snacks
- Losing your appetite completely
- Cutting off social ties that provide support