When we asked our community of South Africans with Diabetes if they had any questions for our diabetes experts, they did! So we asked them your diabetes questions… Here are the answers from our Panel of Experts.
Diabetes and feet questions
Why is diabetes affecting circulation, especially my feet? I try my best to keep my blood sugar levels down and I exercise twice a week?
We asked podiatrist Dr Anette Thompson for her input. She said:
“There are multiple pathways in diabetes that can lead to impaired blood circulation. The main one is when blood glucose levels are not controlled, even for short periods of time.”
Excess glucose in the blood sets off a chain reaction that affects the actual cell walls of blood vessels, causing them to become rough. Cell walls that are no longer smooth act as a trap for cholesterol traveling in the blood, leading to small areas of what is called plaque. Those small areas of trapped cholesterol that form plaque interact with the minerals in your blood to form calcification. As time progresses, these lead to narrowing of your arteries and a decrease in blood circulation.
Here is what Dr Anette Thompson recommends:
- Manage your blood sugar as well as you can.
- Get your cholesterol checked regularly.
- Wear comfortable and flexible shoes, and avoid heels higher than 25mm.
- Regular exercise is very helpful: half hour walks in super flexible shoes or 15 minutes heel raise exercises sitting on a chair (even while watching TV at night!) Heel raise exercises get your calf muscles to pump blood, and assist in keeping those blood vessels open.
- Do a kidney function test once a year.
- Never self medicate or fill a script for anti-inflammatories before you have a blood test done of your kidney function.
- Avoid alcohol and smoking.
My feet and fingers are so numb, what could be the cause?
“Numbness, also known as paresthesia, is a sign of peripheral neuropathy or nerve damage to the nerves in your extremities (hands and feet),” says podiatrist Dr Anette Thompson.
Lack of blood circulation, high cholesterol, low-grade inflammation caused by damage to blood vessels by high blood glucose levels and irregular levels of calcium all play a part in nerve damage in diabetes.
Dr Anette Thompson, Podiatrist
Doing your best to manage your blood glucose is essential for people living with diabetes. Keep your feet warm using socks, preferably mohair socks since warm blood travels better to reach nerves than cold blood does.
Here is what Dr Anette Thompson recommends:
- Improve blood circulation by going for regular walks.
- Do heal raise exercises for at least 15 minutes every day.
- Get a squeeze ball to exercise your hands and wear gloves at night to keep your hands warm so that blood circulates to the nerves.
- If you are vegetarian, you may need to have your vitamin B12 levels in your blood tested so that adequate vitamin B12 supplementation can be prescribed. Vitamin B12 is necessary for nerve function and may be missing in the diets of strict vegetarians.
Diabetes and health questions
I’m getting scaly sores on my legs, arms and stomach – round, red and scaly. Any idea what it could be?
Scaly sores could be a fungal infection or a Staph infection if they are itchy or sore.
Dr Claudine Lee, GP with a special interest in diabetes
What can I use for dry skin?
My best recommendation would be skinworx cream.
Dr Claudine Lee, GP with a special interest in diabetes
What makes my mouth so dry?
You are probably not well hydrated ? Drink more plain water, one of the easiest ways to stay hydrated is to keep a full water bottle with you at all times.
Dr Claudine Lee, GP with a special interest in diabetes
Why are my sugars so high in the morning and how can I change this?
If your fasting glucose is high, you may need to increase your dose of long acting insulin. Please check with your doctor to see if you’re on the right dose.
Dr Claudine Lee, GP with a special interest in diabetes
How long has anyone been in the honeymoon phase with a 2 year old?
The honeymoon phase is different for every child, it may last months or even years.
Dr Claudine Lee, GP with a special interest in diabetes
Does high blood sugar affect the effectiveness of contraceptives? Any advice for women considering contraceptives?
Most birth control is safe for people with Type 1 and Type 2 diabetes. The best contraception for people living with diabetes I think personally is a copper T.
Dr Claudine Lee, GP with a special interest in diabetes
Diabetes and eyes questions
My right eye is blurry… it looks like a ‘leak’ behind my eye as I see black lines moving up and down. What can that be?
We asked ophthalmologist Dr Dale Harrison and he said:
This is not normal: please see an ophthalmologist for a dilated eye examination.
Find out more about diabetes retinopathy here.
Diabetes and food questions
Why am I gaining so much weight while everyone is losing it?
We asked dietician Louise Ferreira, and she said:
This is such a great question! It shows you’re really thinking about things and ready to get the bottom of the problem. I don’t have an answer for you, but I have some things that you could think about to find your answer:
1. Are you exercising enough? Exercise is such a great way to make our bodies more sensitive to insulin which will put us on a good trajectory for weight loss.
2. Are you mindful of what you are fuelling your body with? Are you eating foods you didn’t realise have a lot of calories?
3. Is there something else going on medically and is your medication optimised?
Having a deeper look into your moving, eating and medical management is the first step to finding out exactly what could be causing your weight gain.
Louise Ferreira, Registered Dietician
Does eating very slowly have an effect on glucose levels?
The speed of eating hasn’t been a major point of interest in Diabetes research. The major things that affect glucose levels from food are glycaemic index and glycaemic load. Glycaemic index (GI) refers to the speed at which glucose is released into the bloodstream. Lower GI foods release their glucose more slowly and help to prevent a glucose spike. Glycaemic load (GL) refers to the amount of carbohydrate in the food eaten. A lower GL will cause less of a change to blood glucose. Eating incredibly slowly could, perhaps, spread the ‘load’ (the GL) and theoretically have some sort of effect on blood sugar, but I’m not convinced that this will be significant enough to warrant hours at the dinner table.
Louise Ferreira, Registered Dietician
Do you have any other questions for our experts?
What to read next?
Making the right diabetic food choices: Aim to fill half your plate with vegetables or salad. Look out for vegetable skewers, veggie sides, crudités (chopped raw veg), soup or salads.
What is normal blood sugar? An explanation of what the normal range of blood sugar is, and what people with diabetes can do to achieve those numbers.
Managing Type 2 diabetes: All you need to know to manage your condition, with terrific food and exercise tips.
Photos by Oswald Elsaboath , Nathan Dumlao, madison lavernon and Sweet Life Unsplash
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