What patients with diabetes need to know
While blood sugar is of great concern for patients with diabetes, foot health is something that needs boosted awareness, according to Northwest Community Healthcare (NCH) Certified Diabetes Educator Melissa Ptak, R.N., MSN. As the NCH Diabetes Services Program Coordinator, Melissa spends her days working with patients in an outpatient setting, offering comprehensive diabetes education.
“It's all about managing diabetes with the foods that they eat, incorporating activity, medications and setting them up for success,” Melissa says.
So why are the feet so important?
Because blood sugar control affects the feet and puts patients with diabetes at increased risk for developing foot complications such as diabetic neuropathy (nerve damage), it's important to monitor foot health. She recommends checking the bottoms of your feet at the same time every day, such as after a shower or before bed.
“A lot of people who have diabetes are not aware of the importance of monitoring and caring for their feet,” Melissa says. “Even those people who have good control over their diabetes need to be diligent to make sure they're checking their feet on a regular basis.”
Uncontrolled diabetes can result in damaged nerves that prevent a patient from feeling heat, cold or pain in their feet. That means a cut or sore might get worse or become infected, which is why it's important to check the feet regularly.”
“Sometimes, patients might feel numbness or tingling in their feet that comes and goes, and generally it's in both of their feet,” Melissa says. “The American Diabetes Association notes that up to 50 percent of people with diabetes develop peripheral neuropathy and they may not even have any symptoms. That means that the high blood sugars are already starting to cause damage to their nerves and they haven't even developed the numbness or pain yet.”
Eating the right foods while controlling blood sugar can help improve foot health. “It’s more about monitoring your healthy fats intake and eating less carbohydrates because the more carbs we eat, the higher our blood sugar is,” she says. “Having a good balance of healthier foods helps patients to control blood sugars a little better to prevent these foot complications.”
Good blood sugar control can prevent or even delay the progression of diabetic peripheral neuropathy. “Prevention is the big key,” she says.
Some issues that can develop from diabetic neuropathy:
- Lower quality of life
- Isolation as patients in pain tend to stay at home
- Increased risk of depression
In addition to diet, Melissa recommends:
- Checking blood sugar daily through a finger prick
- Staying active by exercising regularly
- Taking medications on a regular basis
While there are other blood sugar monitoring devices on the market, Melissa says the “old-fashioned finger stick is still the best way to keep track of blood sugars.”
Melissa says every person who has diabetes is at risk for peripheral neuropathy and foot problems, but development is based on how well their blood sugar is controlled.
Increased risk factors include:
- Poor control of blood sugar
- Foot deformities such as calluses, corns or previous foot ulcers
- Diabetic kidney disease
NCH offers a Diabetes Education and Support Group on the second Tuesday of each month at the Arlington Heights Senior Center. The group is for those who have diabetes or pre-diabetes, or are trying to prevent developing them. No registration is needed and walk-ins are welcome. For more information about NCH Diabetes Services, call 847-618-4475.
From NCH’s Sodexo
Try this low-carbohydrate, low-saturated fat recipe, perfect for patients with diabetes.
Green Tea Poached Salmon with Asian Slaw
Prep Time: 10 minutes
Cook Time: 23 to 25 minutes
Yield: 4 servings
Nutrition Facts: Calories 340; Carbs 9g; Protein 35g; Fat 18g; Sat. fat 2g; Cholesterol 95mg; Sodium 220mg; Fiber 3g; Sugar 4g.
For the slaw
- 3 tablespoons plain rice wine vinegar
- 2 tbsp canola oil
- 1 tsp honey
- 1 tbsp fresh lime juice
- 1/4 tsp kosher salt
- 1/2 tsp chili garlic sauce, such as Sriracha (optional)
- 1/4 head napa cabbage, thinly sliced (about 4 cups)
- 1/2 small daikon radish, peeled and sliced into ribbons using a vegetable peeler or shredded using a box grater
- 1 medium carrot (scrubbed well), sliced into ribbons using a vegetable peeler or shredded using a box grater
- 1/4 small red onion, very thinly sliced
For the fish
- 2 cloves garlic, thinly sliced
- One 2-inch piece peeled fresh ginger root, minced (1 tbsp)
- 2 scallions, thinly sliced on the diagonal, white- and light-green parts kept separate from the dark-green parts
- 5 cups water
- 5 green tea bags
- 2 tbsp fresh lime juice
- Four 6-ounce center-cut, skin-on salmon fillets*
- 1/8 tsp kosher salt
- Freshly ground black pepper
For the slaw:
1. Whisk together the vinegar, oil, honey, lime juice, salt and the Sriracha, if using, at the bottom of a bowl large enough to hold all the slaw ingredients.
2. Add the cabbage, radish, carrot and red onion, which should total 7 to 8 cups of vegetables. Toss to incorporate the dressing. Let the slaw sit while you prepare the salmon.
For the fish:
1. Combine the garlic, ginger, the white and light-green scallion parts and water in a large, deep skillet or saute pan. Bring to a boil over high heat, then reduce the heat to low; cook for 10 minutes, then remove from the heat. Add the tea bags and let steep for 5 minutes.
2. Discard the tea bags, then add the lime juice and place over low heat.
3. Arrange the salmon fillets in the skillet, skin side down. Add water as needed to make sure the fish is completely submerged. Cover and cook for 8 minutes or until the fillets are opaque and firm. Use two spatulas to gently transfer the fillets to a plate or cutting board; discard the skin.
4. Season the salmon with the salt and few grinds of pepper. Serve warm or chilled over a mound of the slaw, garnished with the sliced scallion greens.
*Make ahead: The salmon can be poached, cooled and refrigerated in an airtight container up to two days in advance.