Archive for Diabetes Prevention

Do You Recognize These 11 Early Warning Signs of Borderline Diabetes?

What You Need To Know- Borderline Diabetes

  • Diabetes does not just develop overnight.
  • Borderline diabetes may have no symptoms at all, or you may experience 1 or more of the symptoms described below.
  • You can prevent diabetes if you identify borderline diabetes early.

What You Need To Do- Borderline Diabetes

  • If you have any of the symptoms described below then get checked out by your health care provider.
  • If you are in a high risk group than you also should be screen for prediabetes, even if you do not have symptoms.

I was stopped at a local function recently and the person I was speaking to told me she was recently diagnosed with borderline diabetes. My acquaintance was very concerned because she read and heard about many of the complications of diabetes; and she wanted to know what this meant for her.

She asked me things like “do I need to check my blood sugar all the time now,” “do I need to eat differently,” and “am I going to have to start taking medications?” While I discuss the answers to many of these particular questions in a previous post, I am always struck, in this day of the news coverage of obesity and the diabetes epidemic, how many people have not heard of borderline diabetes and its complications.

What Is Borderline Diabetes?

Actually, there is no medical diagnosis called “borderline diabetes.” Rather, borderline diabetes refers to a medical condition called prediabetes. This is when your blood glucose levels are higher than normal but not yet high enough to be diagnosed with type II diabetes. People with borderline diabetes or prediabetes are more likely to develop type II diabetes and may already have some of the signs or symptoms of diabetes.

Many times patients with borderline diabetes (prediabetes) will not have any signs or symptoms. The following signs and symptoms indicate you may have borderline diabetes (prediabetes) that you should get checked out:

1. Increased urination and  thirst. As your blood sugar rises your kidneys become overwhelmed and you begin to pass sugar in your urine. Your body takes fluid from normal tissues to help excrete the blood sugar from the body. This causes you to urinate more frequently and can lead to dehydration, and subsequently make you thirsty. As you drink more fluid you then subsequently will urinate more.

2. Hunger. With borderline diabetes (prediabetes) your body begins to become resistant to insulin. You become more hungry because sugar is not able to enter cells. This can also lead to hunger even after just eating.

 3. Dry mouth. This results primarily because increased urination and dehydration that result from elevated blood sugar levels as described above.

4. Tiredness. Fatigue in borderline diabetes (prediabetes) can be from a number of different causes. When your blood sugar is elevated your body is just not working properly. You do not use sugar appropriately, and a constant state of dehydration both contribute to the tiredness many borderline diabetics feal.

 5. Visual changes. Elevated blood sugar causes changes in the eye that can make it more difficult to see. In general, the lenses of the eye can become distorted and stiff- making it more difficult to focus. Over the long term there are a number of different complications to the high if diabetes is not well controlled.

 6. Itching. Dry itchy skin is not uncommon in patients with elevated blood sugars. Additionally, itching is common in the genital areas and lower legs. This is often due to dry skin that results from the previously mentioned dehydrated state that occurs in borderline diabetes (prediabetes).

 7. Weight changes. Significant weight changes are more common in type I compared to type II diabetics. However, if you have lost weight or if you feel hungry all the time you should let your doctor know and get tested for borderline diabetes (prediabetes).

 8. Rash. Acanthosis nigricans is a brown to black hyper pigmentation of the skin. This is a benign condition that is commonly seen in obese patients that have insulin resistance. When your blood sugar gets under better control the rash may improve.

 9. Numbness in the hands and feet. High blood sugar levels over long periods of time can damage your nervous system. This can result in decrease in sensation and feelings of numbness and tingling in the hands and feet. This is also known as neuropathy. Decreased sensation in the feet can also contribute to frequent injury and development of diabetic foot ulcers.

10. Poor healing. A number of different factors contribute to poor wound healing in patients with elevated blood sugars. These range from decreased immune response to decreased function of the actual cells that heal the body. If you frequently have wounds that scene to take a long time to heal you need to be checked for borderline diabetes (prediabetes).

11. Sexual dysfunction. While some sexual dysfunction is common in increases as you get older, sexual dysfunction is more common with elevated blood sugars. This is generally not a symptom of borderline diabetes (prediabetes) because the high blood sugar sugar levels leading to nervous and cardiovascular changes generally take many years to develop. However, elevated blood sugar levels can lead to dryness in the genital area making sex uncomfortable.

What Do I Do If I Have Symptoms of Borderline Diabetes (Prediabetes)?

If you’re experiencing any of the signs of borderline diabetes (prediabetes), let your healthcare provider know.

 There are many things that you can do if you have borderline diabetes so that you can prevent diabetes in the long-term.


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Diabetic Foot Care- 11 Tips To Improve Your Diabetic Foot Care

Incorporating These Diabetic Foot Care Tips Will Prevent Complications

Diabetic foot care is very important because you are more likely to have foot problems because you have diabetes. Diabetes damages the nerves and makes it less likely that you will feel pain. As a result, you are more likely to injure your foot or not notice a problem until the foot has been damaged.When your doctor does a foot evaluation as part of your diabetic foot care they will look for signs of:

  • poor circulation
  • nerve damage (decreased sensation of the foot)
  • skin changes
  • deformities of the foot and toes


Specific Diabetic Foot Care Tips

These 11 tips will help you improve your diabetic foot care:

Piede diabetico1. Check Your Feet Daily. Because diabetes decreases sensitivity in your feet, you may not realize that you have an ulcer or abrasion. Make sure you examine all aspects of your foot-  start on top and then look at the  sides, soles, heels, and between the toes. Make checking your feet part of your daily diabetic foot care plan.

2. Don’t Go Barefoot. One of the easiest diabetic foot care tips is to avoid going barefoot, even indoors. Because you may have poor vision and decreased sensation in your feet, you are at greater risk of injury. It is very easy to stub your toe or step on something and cut your foot.

Wearing shoes all the time will protect your feet from developing a diabetic foot problem. Make sure your shoes do not have any rough edges that could cause irritation and also wear socks for extra protection. Wear comfortable fitting shoes that are not tight on your feet. Make sure you choose shoes that are made of a breathable material such as leather or canvas. Finally, changing shoes or taking them off after several hours decrease pressure and chances of developing an ulcer.

3. Watch For Calluses. If you have calluses or corns, talk with your doctor about appropriate diabetic foot care. Do not just take a file or treat the corn yourself.

Diabetic Foot Care- Calluses

Diabetic Foot Care- Calluses

4. Wash Your Feet Daily. Using a mild soap and lukewarm water, you should wash your feet daily. Hot water and strong soaps can damage your foot. Drying your feet is also an important part of your routine diabetic foot care. If you don not dry well, you may develop infections in moist areas like between your toes. If your feet are dry and cracked, use lotion to moisturize your feet, but avoid any areas of cracked skin.

5. Get An Annual Foot Exam. The final piece of your diabetic foot care plan is to get a yearly exam by your doctor. During this exam your doctor will test to see if you have lost any sensation and look for any problems.

6. Quit Smoking. Smoking increases your risk of heart attack and stroke as well as lead to vascular problems that result in decreased blood flow.

7. Ask For Foot Exams. Your foot exam is am important part of your diabetic plan. This exam should be part of your regular healthcare visits, but can sometimes get left out, especially if you have a number of medical problems. You should have a diabetic foot care visit at least once per year- more often if you have any complaints or problems with your feet.

Diabetic Foot Care- Wear Shoes

Diabetic Foot Care- Wear Shoes

8. Choose Shoes and Socks Wisely. Shoes should be comfortable, not too tight or too loose, and broken in slowly to prevent blisters. Your diabetic foot care plan should always include socks- cotton and loose fitting. Certain patients may also benefit from specialized, custom shoes. Patients with abnormally shaped feet or those with ulcers are most likely to benefit. Additionally, special insoles can decrease pressure on the soles and bottom of the feet.

9. Protect Your Feet From Temperature Extremes. Never walk barefoot- whether at the beach or in the mountains. Before putting your feet in water make sure you test the temperature, much like you would do when bathing a baby. Do not use heating pads, electric blankets, or hot water bottles as you can quickly burn your feet.

10. Keep Your Circulation Going. Wiggling your toes increases blood flow to the feet. Doing this several times per day while flexing your ankle back and forth keeps blood flowing to your foot/ ankle area. You can also sit with your legs straight and make circles with your feet to promote blood flow in the foot/ ankle area. Ask your significant other for or treat yourself to a foot massage- his also increases blood flow to your feet. Additionally you want to avoid crossing your legs as this decrease blood flow to the heart.

11. Use Foot Cream. This will help keep your feet soft and smooth. Cracks on the skin increase your risk for infection. If you have a cut or skin damage, make sure you get treatment right away.


NIDDK. Prevent diabetes problems: Keep your feet and skin healthy. Accessed January 30, 2013.

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Diabetes Dental Problems

Oral Health and Diabetes: Everything You Need To Know To Protect Your Teeth

Diabetes dental problems are extremely common, but not as well know as complications related to:
• Eyes
• Heart
• Kidneys

Diabetics are at increased risk for periodontal disease or an infection in the gums. If not addressed diabetes dental problems can not only make it more difficult to control your diabetes, but also can lead to an infection in the bone.

Plaque Makes Diabetes Dental Problems Worse
Diabetics are not the only people that have plaque problems, but elevated blood sugar makes it harder to get control of your diabetes oral health. Plaque uses sugar to produce bacteria and acid that eventually leads to a cavity. Because you have higher sugar levels, you run a greater risk of developing a cavity.

Dry Mouth Is Also A Diabetes Oral Health Problem
The elevated blood sugars that you have when you develop diabetes can also lead to a dry mouth. Additionally, it is thought that changes in the parotid gland in diabetics may contribute to this. While this may be mildly irritating to you on a day to day basis, it is actually a risk for diabetes dental problems. Normally, your saliva helps wash away plaque and bacteria from your teeth. When you have dry mouth, you have less saliva to help improve your diabetes oral health. As a result you are at increase risk of cavities. If it becomes sever enough, dry mouth can lead to irritation of your gums.

Fungal Infections and Your Diabetes Oral Health
Your elevated blood sugar also increases your risk for a fungal infection called candidiasis. This diabetic dental problem is also referred to as thrush. You may see white or red spots in the mouth. If you have diabetes you are twice as likely to find Candida in the mouth.

How Can I Improve My Diabetes Oral Health

The most important step in preventing diabetes dental problems and improving your diabetes oral health, is to keep your blood sugar under control. After that the recommendations are similar to those for everyone:

• Brush daily- even better after each meal. Gently brush the gums to keep them healthy.
• Floss daily using a sawing motion between the teeth. This will help remove plaque.
• Get regular dental checkups
• Tell your diabetes oral health provider (dentist or dental hygienist) if your gums hurt or have been irritated
• Quit Smoking

How Do I Know If I Am Developing Diabetes Dental Problems
If you develop any of the following symptoms you need to call or see your diabetes oral health provider:
• Red, swollen painful gums
• Bleeding gums
• Poorly fitting dentures
• Loose teeth
• Sensitive teeth
• Halitosis or bad breath
• Your teeth begin to look longer or you think your gums are receding

Bartholomew GA, Rodu B, Bell DS. Accessed December 27, 2012. Oral Candidiasis in Patients With Diabetes Mellitus: A Thorough Analysis.

Loe H, Genco RJ. Oral Complications in Diabetes. In Diabetes In America 2nd Edition.

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Preventing Blindness When You Have Diabetes and Glaucoma


Diabetes and Glaucoma: What You Need Know If You Have Diabetes and Glaucoma

Blindness can be one of the most worrisome complications of diabetes. While many diabetic patients are familiar with retinopathy as a complication of diabetes, many diabetic patients are not as familiar with glaucoma. While this is not a sudden cause of blindness in diabetic patients, this condition can lead to blindness over time.

Glaucoma and Diabetes

Glaucoma in diabetes is like hypertension of the eye. With diabetes and glaucoma, the pressure in the eye builds up because fluid gets trapped. The increased pressure may lead to decreased blood flow to the parts of the eye that help you see, the retina and optic nerve. Damage to the retina and optic nerve lead to decreased vision and potentially blindness. This is a progressive disease, which means that without treatment it will get worse. The longer you have had diabetes the more likely you are to develop diabetes and glaucoma together.

Research reported by the University of Michigan Kellogg Eye Center has shown that having high cholesterol or hyperlipidemia may lower the risk of glaucoma when you have diabetes. It is unclear whether it is the hyperlipidemia or the drugs that are used to treat hyperlipidemia, statins, that lead to the decreased risk of glaucoma.

According to the American Diabetes Association, people with diabetes are 40% more likely to develop glaucoma than people who do not have diabetes. This risk of glaucoma with diabetes increases as you get older or if you have other complications of diabetes like diabetic retinopathy.
How Would I Know I have Glaucoma If I Have Diabetes?

Diabetes and Glaucoma: Symptoms

Most patients with diabetes do not have symptoms of glaucoma. If your diabetes and glaucoma is beginning to lead to vision loss, you would expect to see things at the center of your eye without any differences, while things on the periphery or off to the side may be blurry or not seen as well. Glaucoma generally does not cause eye pain or redness. If you have these symptoms, blurry vision, nausea or other problems with your eyesight, call your eye professional for an appointment.
Preventing Complications Of Diabetes and Glaucoma

Every diabetic patient needs to see an eye professional every year. Your eye professional will screen you for glaucoma as part of your regular diabetes eye checkup. If you have an elevated eye pressure or other abnormality, you may need to see your eye professional more frequently.

When you see your eye care professional they will look into the back of your eye to see if there is any damage to the retina and optic nerve. They will also use special tools to measure the pressure and determine if it is elevated. They may also test both your central and peripherla vision to see if there are any problems. Unfortunately, taking vitamins does not prevent glaucoma when you have diabetes as it does for some other eye conditions like age related macular degeneration.
Treatments with you You Have Glaucoma and Diabetes

Diabetes and Glaucoma: Treatment

There are 2 main types of eye drops used in the treatment glaucoma when you have diabetes. The drugs lower the pressure in the eye. The classes are:

Beta Blockers

There are 2 other types of treatments that may lower the pressure of glaucoma when you have diabetes. The 2 treatments are laser therapy and surgery. Both of these treatments improve drainage of fluid from the eye and decrease the pressure. In general, your doctor will likely recommend surgery only after the eye drops have not successfully lowered the eye pressure when you have diabetes and glaucoma.

[box] What You Need To Know When You Have Diabetes and Glaucoma

You are at higher risk for glaucoma if you have diabetes.

What You Need To Do When You Have Diabetes and Glaucoma

You need to see your eye professional every year or if you develop eye symptoms.



American Diabetes Association. Eye Complications. Accessed January 14, 2013.