FOOT CARE ADVICE FOR PEOPLE WITH DIABETES

If you have diabetes, it's important to pay special attention to your feet. Diabetes can lead to nerve damage in the feet (peripheral neuropathy), which, in turn, can reduce your ability to feel sensations, like cold, heat or pain. Also, diabetes can impair circulation and wound healing by hardening and narrowing the arteries that supply blood to the legs (peripheral arterial disease, PAD).

A wound on your foot that doesn't heal can turn into an ulcer that may become infected. And if you have severe peripheral neuropathy, you may not even know it's there. Left untreated, or if treatment is unsuccessful, amputation may be required in severe cases.

What should you do? People with diabetes should follow the self-care measures described below:

·         Inspect your feet each day - Contact your doctor promptly if you notice any infected toenails, swelling, sores, cuts, bruises, blisters or red spots that do not heal after a day. Also, call your doctor if you experience tingling, numbness or pain in your feet.

·         Wear shoes and socks - Always wear footwear even when you're indoors. If you walk barefoot, it's easy to injure your feet without realizing it. Avoid wearing tight socks or garters or elastic bands to hold up socks because they can cut off circulation to your feet.

·         Wash your feet daily - Use a gentle soap and warm water. If you have nerve damage and the water is so hot it scalds your skin, you may not notice it. 

·         Treat calluses and corns gently - If recommended by your doctor, gently file calluses and corns after bathing, using an emery board or pumice stone. Do not use chemicals, razor blades or other harsh methods to remove corns or calluses. 

·         Dry your feet thoroughly after bathing - Use a nonabrasive towel to gently blot dry your skin. And don't forget to dry the spaces in between your toes.

·         Moisturize your feet - Apply a thin layer of skin cream to the top and bottom of each foot after drying your feet. Avoid putting lotion between your toes, where excess moisture can contribute to infection. 

·         Cut your toenails once a week - Cut the nails straight across without curving in at the edges. Cutting into the corners of the nails can lead to ingrown toenails.  Also, avoid cutting your nails too short. 

·         Carefully wash any cuts or blisters - For cuts, use a mild antiseptic like Bactine and cover the cut with a dry, sterile dressing and paper tape. If you develop a blister, rub an antibiotic cream on it a few times daily until it heals. Never pop a blister.

·         Avoid heat and cold - Feet can be damaged easily by cold surfaces or frostbite. Be sure to protect your feet from the cold during winter by wearing extra-warm socks and shoes or boots. Although most people never think of it, sun can be damaging to your feet as well. To avoid a sunburn if you're wearing sandals, apply sunscreen to your feet and keep them out of direct sunlight.

(Source:  John Hopkins Health Alert, Posted Diabetes on 27 June 2013)

AMYLIN DEPOSITS IN THE BRAIN MAY LINK DEMENTIA AND DIABETES

Deposits of a hormone called amylin in the brain may indicate risk for developing dementia and type 2 diabetes, according to a study published online in the Annals of Neurology. The analysis by researchers at the NIA-funded Alzheimer’s Disease Center at the University of California, Davis, is the first to identify amylin deposits in post-mortem brain tissue from older people who had been diagnosed with Alzheimer’s disease or vascular dementia and diabetes. The findings also indicated that amylin may play a similar role in the Alzheimer’s disease process as amyloid protein, a hallmark of the disorder.

Amylin (also known as islet amyloid polypeptide) is a hormone expressed and secreted with insulin. It influences blood sugar levels; when too much is secreted, risk for developing diabetes increases. These new findings show that amylin deposits can also build up and form plaques in the brain, similar to amyloid plaques found in Alzheimer’s disease.

The researchers examined post-mortem brain tissue from three groups of volunteers older than 70 years: those who had diabetes and dementia (vascular dementia or Alzheimer’s), those who had Alzheimer’s but no diabetes, and those free of these disorders. Investigators found significant amylin deposits in the brain tissue of people with both dementia and diabetes. Surprisingly, they also found amylin in people with Alzheimer’s but without diabetes—perhaps because these individuals had undiagnosed insulin resistance. The healthy controls had few amylin deposits.

The study, led by Dr. Florin Despa, may explain why people with diabetes are at risk for dementia. Like amyloid, amylin circulates in the blood and, during the disease process, is overproduced and not cleared normally, building up in the brain. Over time, both proteins lead to the loss of brain cells and brain damage. Amylin buildup in the brain’s blood vessels may also play a role in amyloid buildup and contribute to risk for Alzheimer’s, the study found.

(Source:  National Institute On Aging, 30 July 2013)

IS INSULIN A KEY TO ALZHEIMER’S DISEASE?

Doctors have known for some time that the production of too little insulin by the pancreas and the inability of the cells throughout the body to respond to insulin (insulin resistance) are the hallmarks of type 1 and type 2 diabetes, respectively.

While the relationship between insulin and diabetes is well known, a more recent discovery is the role it plays in regulating brain functions such as the ability to learn and make new memories and to store and recall events. Scientists have also discovered that people with Alzheimer's disease have fewer insulin receptors than healthy patients.

Another intriguing finding: Insulin affects the brain's ability to clear away beta-amyloid-42 (Aß42), the toxic protein that builds up into plaques in the brain. These plaques, along with tangles of another protein called tau, located within cells, are telltale signs of Alzheimer's disease.

The suggestive evidence linking insulin to Alzheimer's disease may help explain why people with diabetes have a greater risk of experiencing cognitive decline and future dementia than individuals who don't have diabetes.

A gateway to the brain. Some researchers now believe that just as insulin is an effective treatment for diabetes, it might also be a useful therapy for Alzheimer's disease. The challenge: getting it to the brain without affecting blood glucose levels, as insulin injections would do. One potential answer: a nasal spray that is inhaled, allowing it to reach the brain within a few minutes, with minimal absorption into the bloodstream.

While recent studies suggest that intranasal insulin therapy may be safe and effective, there are important considerations to keep in mind. First, most studies have been small and have focused on short-term use. Consequently, the safety and effectiveness of intranasal insulin use over an extended period are unknown.

Second, intranasal insulin doesn't work for everyone, but it's not clear why. Some evidence suggests that genetics may play a role. For example, a small 2008 study in the Journal of Alzheimer's Disease found that memory improved after insulin treatment in study participants who did not carry the APOE-ε4 gene -- a known risk factor for late-onset Alzheimer's disease. In those with the APOE-ε4 gene, however, memory deteriorated. Findings from this study raise another potentially troubling concern. Intranasal insulin increased blood levels of Aß42 -- the toxin implicated in the development of late-onset Alzheimer's disease. This may indicate that the insulin was working by removing the protein from the brain and having it removed by the bloodstream, but other reasons are possible.

(Source:  John Hopkins Health Alert, posted in Diabetes on 13 March 2013) 

SAT/27APR13 2.00pm - Talk "Managing Diabetes in Patients with Dementia" Organized by National Caregivers Network

Dear Caregivers/Members, 

We are pleased to announce that Dr Lee Fatt Soon, Consultant Physician and Geriatrician, Head of Geriatrics, Hospital Kuala Lumpur, will be giving a talk on “Managing Diabetes in Patients with Dementia” for Caregivers and members of the ADFM National Caregivers Network.

Day / Date : Saturday, 27 April 2013

Venue : ADFM PJ Daycare Centre, No. 6, Lorong 11/8E, Seksyen 11, 46200 Petaling Jaya.

PROGRAM:

2:00pm     Registration of Attendance

2.30pm     “Managing Diabetes in Patients with Dementia”

3.15pm     Q & A Session

3.40pm     Sharing Session - Sandie Lahra will be giving an account of her family caring their       Alzheimer’s Mom from the early stages, progression of her condition, and now.

4.00pm     Light Refreshments/End

Who Should Attend?

·      Caregivers & families of PWD (Persons with Dementia).

·      Persons with diabetes but not dementia.

·      Anyone who wants to find out more about diabetes.

COMPULSORY PRE-REGISTRATION :  First-Come-First-Served Basis:

1. Email Registration Form to jenny@adfm.org.my or Fax to 03 7960 8482.

2. SMS 016 608 2513 with full name and contacts if you do not have email access.

3. Closing Date 22 April 2013.

Call 016 608 2513 / 03 7956 2008 (Jenny) for further enquiries. 

Please be punctual :)  Thanks.

JOIN ADFM NATIONAL CAREGIVERS NETWORK

The National Platform for The Caregivers Community

SIGN UP at  “http://admalaysia.ning.com/main/authorization/signUp”