Health Secrets	UPDATED: Tuesday, January 17, 2006
Write a Comment on Story Print Email Story Add to Favorites

Head to Toe Diabetes Care-Focus on Eyes and Feet

Posted on Tuesday, November 01, 2005

By Wendy J. Meyeroff
THE ERICKSON TRIBUNE

Two of the most prevalent consequences of diabetes are eye disease and foot problems. Here is what you need to know to fight both.

Diabetic Retinopathy

The most prevalent eye disease for people with diabetes is diabetic retinopathy, which affects the eye’s retina.

“The retina is the part of the eye that records the images we see, like film in a camera. Those images are transmitted through the optic nerve to the brain,” says Connie McRill, M.D., a consulting ophthalmologist to Charlestown, a community in Maryland built and managed by Erickson.

“There are two forms of this disorder, non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). In NPDR, the more common form, fluid leakage causes vision problems. PDR is the more advanced form in which new blood vessels proliferate. They can bleed a lot and damage vision,” says McRill.

Diabetic retinopathy is the second leading cause of blindness in the U.S. Partly because it usually doesn’t show any symptoms, especially in the early stages, and when symptoms do develop—like spots floating in front of the eyes—they’re easily ignored.

“You must schedule and keep regular eye exams if you’ve been diagnosed with diabetes. Once a year is fine if your diabetes is controlled; if not, you should be seen as often as every six weeks. There are medicines and laser surgeries for both NPDR and PDR you can ask about,” says McRill.

“Keep close control of your blood sugars with diet and exercise. Sometimes I think exercise—stimulating blood flow and oxygen to the eyes—is even more important for people with diabetes. It doesn’t have to be aerobic; it can be chair exercises, tai chi, there’s always something—especially if you’re already in a community like those built and managed by Erickson.”

Moving on to Feet

Health Secrets

More Health Secrets

A different heart problem

Medicare Advantage 101

Brain breakthroughs

Health 411: Mental Health news

Read or Add a Comment?

Hope for children and families

The hidden costs behind 'Gifts of Life'

Whitening your teeth

electronic medical records

EMR-Thoughts? Comments?

Are researchers working fast enough?

Tools

Write a Comment on Story

Email Story

Add to Favorites

“People with diabetes should regularly inspect their feet for any cuts or openings; they can be a doorway for viruses and bacteria to enter. If you can’t do it yourself, have someone—a doctor or a loved one—do it,” says Terry Cooke, D.P.M., a full-time staff podiatrist who works at two communities built and managed by Erickson.

Improperly clipping toenails or ill-fitting shoes that rub or chafe, are two potential dangers. “Up to 15 percent of people with diabetes develop diabetic ulcers in their feet,” says Cooke.

Cooke notes that reduced sensitivity to pain is common in people with diabetes and often leads to major problems. “Don’t walk barefoot. You could step on something in the house like a nail and not even know it. You might not notice that chafing shoe until you’re hobbling.”

“You might have to abandon your soothing foot soak; because of reduced pain sensation, it’s easy to burn yourself with too-hot water. To test water temperature, use your elbow. It’s more likely to still have nerve sensations than your feet or fingertips,” Cooke says.

Minor Problems Can Turn Major

Seemingly minor foot problems can lead to major consequences if not treated in a timely and effective manner, so don’t ignore corns, ingrown nails, or anything else. “Nearly 25 percent of people with diabetes will have an amputation,” says Cooke, but adds, “Doctors can reduce that number with better education and treatment.”

“Unfortunately, most primary care doctors don’t have the time to do a foot exam. A podiatrist should definitely be a part of every older person’s health care team. We’re trained to look for diabetes-related foot problems and can sometimes spot diabetes before an internist by examining someone’s feet”, says Cooke.

If your sugar is controlled, twice a year visits are recommended. Otherwise, you should arrange appointments every other month,” she adds.

Ask your primary care physician for referrals today and make sure an ophthalmologist with experience in diabetes and a podiatrist become part of your health team.