Diabetes is a disorder of metabolism, in which the body is unable to regulate its blood glucose levels appropriately. Glucose, a simple sugar, comes from the carbohydrates that you eat. Your body synthesizes and stores glucose, which it then uses as a major source of energy. For glucose to get into cells, insulin, a hormone produced in the pancreas, must be present. In people with diabetes, the pancreas either produces little or no insulin, or the body cells do not respond to the insulin that it produces. As a result, glucose can't get into the cells of the body and glucose levels in the blood become elevated. Over time the high blood sugar levels damage many organs of the body.

Certain factors can increase the risk of developing diabetes. People who have close family members with diabetes and people who are overweight have a greater chance of developing diabetes. Also, the risk of diabetes is increased in some ethnic groups including people who are African-American, Latino American or Native American. Other factors that may increase the risk of diabetes include high blood pressure and hyperlipidemia (elevated cholesterol).

Symptoms of high blood sugar include increased thirst and urination, blurred vision, fatigue, and weight loss. In some individuals the elevated blood sugar may lead to recurrent infections such as urinary tract infection, vaginal yeast infection, or infections of the skin. However, many individuals with diabetes may go for many years without symptoms. For that reason, it is recommended that all adults age 45 and above should be tested for diabetes every three years.

Individuals with diabetes are at risk for complications that may affect the eyes, kidneys, nerves and circulatory system. Managing diabetes requires that each patient establish goals of therapy that include target blood sugar range, weight management, and dietary and lifestyle changes. Comprehensive treatment of diabetes requires a team approach involving the patient as well as health care providers comprising an endocrinologist, the diabetes educator, nutritionist, ophthalmologist, and podiatrist.

A common and costly complication of diabetes, foot ulcers, can easily be prevented through self-examination and proper foot care. When left untreated, however, foot ulcers can lead to infection, gangrene and lower limb amputation. Most often the result is minor foot trauma and wound-healing failure. Diabetes related amputation accounts for 51% of all amputations in the United States. Because of poor circulation and nerve damage to the feet, people with diabetes are more likely to develop infections even from a minor foot injury. For this reason, people with diabetes should treat their feet with special care. By following some simple foot care tips, people with diabetes can dramatically reduce their risk of amputation and lead healthy, active lives.

Patients with diabetes should follow these steps to prevent foot ulcers:

Every day

• Check your feet for cuts, sores, blisters, or areas of irritation. If you have any concerns, see your podiatrist or internist.
• Wash and dry your feet, particularly between your toes.
• Protect your feet from extreme hot and cold temperatures.
• Avoid walking barefoot.

When your toenails need trimming

• Trim your nails straight across, and only if you can see well.
• If you cannot see well or if your toenails are thick or yellowed, have a podiatrist trim them.
• Do not cut into the corners of your toes.
• Do not cut corns or calluses.

When you visit your doctor, ask him/her to:

• Look at your bare feet at each visit. As a reminder, remove your shoes and socks.
• Check your feet for sense of feeling and your pulse at least once a year.
• Show you how to take care of your feet.