Diabetic foot prevention care

Written by Li Hui Zhi
Endocrinology
Updated on September 23, 2024
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First of all, it's important to keep blood sugar under control. It's recommended that people with diabetes check their glycated hemoglobin every three months to see if their blood sugar levels meet the standards. Second, many patients suffer from diabetic foot due to severe diabetic peripheral neuropathy. Injuries such as stepping on a nail or accidental bumps may lead to infections. Therefore, it's suggested that patients with diabetes check their feet daily for any small wounds or ulcers, and if found, they should seek timely treatment from an endocrinology specialist. Third, using warm water for foot baths and treatments like local infrared lamp therapy are advised. It's important to ensure that the temperature is not too high, generally around 40 degrees Celsius, to avoid burning the skin.

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Gestational diabetes symptoms

During pregnancy, there are two scenarios concerning diabetes: one is where diabetes is diagnosed before pregnancy, referred to as pregestational diabetes combined with pregnancy. The other scenario is where the sugar metabolism is normal before pregnancy, or there is an underlying reduced glucose tolerance, and diabetes appears or is diagnosed during pregnancy, also known as gestational diabetes. Over 80% of diabetic pregnant women have gestational diabetes. Typically, gestational diabetes doesn't show clear symptoms of the classic "three polys and one less" - excessive drinking, eating, urination, and weight loss. Some women with gestational diabetes may experience itching of the vulva, caused by repeated infections with Candida albicans. Additionally, gestational diabetes may lead to conditions like fetal macrosomia and polyhydramnios during pregnancy, and pregnant women with gestational diabetes are more prone to infections.

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Gestational diabetes indicators

Gestational diabetes refers to the absence of a diabetes history before pregnancy, but during pregnancy screening (Tang screening), blood sugar abnormalities are discovered. At this point, the diagnosis of gestational diabetes is made. The criteria for diagnosing gestational diabetes are based on a diabetes screening test conducted at 24-28 weeks. If the fasting blood glucose is ≥5.1, one-hour blood glucose is ≥10.0, or two-hour blood glucose is ≥8.5, meeting any one of these criteria is sufficient for a gestational diabetes diagnosis.

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Gestational diabetes symptoms

Gestational diabetes shows several symptoms, the most typical being the "three more one less" syndrome, namely increased thirst, increased appetite, urination, and weight loss. The second common manifestation is fatigue, which is due to glucose not being utilized effectively in the body and being broken down too quickly, leading to insufficient energy replenishment. The third is unexplained frequent fungal infections, such as recurring candidal infections of the vulva and vagina, at which point blood sugar screening should be considered. The fourth symptom is pregnancy accompanied by excessive amniotic fluid or a large fetus. The fifth is glucose positivity in urine from two fasting morning samples.

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How long does prediabetes take to turn into diabetes?

How long it takes for prediabetes to progress into diabetes varies, with no definitive answer, as it differs from person to person. Whether prediabetes will develop into diabetes largely depends on blood sugar control. Clinical experience shows that some individuals never progress to diabetes after adjusting their diet and exercise routines. However, if a patient does not take their condition seriously and fails to change their lifestyle, it might take as little as 2-3 years or as long as 5-10 years to develop into diabetes. Therefore, it is crucial to manage lifestyle promptly upon prediabetes diagnosis, paying attention to blood sugar monitoring and pancreatic function tests.

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Gestational diabetes standards

Before addressing this question, let's first clarify another concept: if diabetes is diagnosed before pregnancy, this is referred to as pre-existing diabetes in pregnancy, which is different from gestational diabetes. Gestational diabetes refers to cases where there is no pre-existing diabetes diagnosis before pregnancy, but abnormal blood glucose levels are detected after becoming pregnant. Generally, a glucose screening test is conducted between the 24th and 28th weeks of pregnancy. Currently in China, there are two approaches: the one-step and the two-step methods. The one-step method involves a direct 75-gram oral glucose tolerance test. However, most of China uses the two-step method, which starts with a 50-gram glucose challenge test. If the blood glucose level one hour after eating is greater than or equal to 7.8 mmol/L, a 75-gram oral glucose tolerance test is recommended. For the 75-gram glucose test, the fasting blood glucose level should generally be less than or equal to 5.6 mmol/L, one hour post-glucose intake should be 10.3 mmol/L, two hours post-glucose should be 8.6 mmol/L, and three hours post-glucose should be 6.7 mmol/L. If two or more of these values exceed the diagnostic criteria, gestational diabetes can be diagnosed. If only one value is abnormal, impaired glucose tolerance can be diagnosed. It is recommended that anyone who experiences abnormal blood glucose levels during pregnancy undergo another 75-gram oral glucose tolerance test six months post-pregnancy to determine if blood glucose levels are still abnormal and whether treatment should continue.