There are four major potential complications of poorly controlled diabetes, eye damage (retinopathy), kidney damage (nephropathy), nerve damage (neuropathy), and heart disease. The control of glucose is vitally important for the prevention of diabetes related microvascular complications (retinopathy and nephropathy) as well as neuropathy. However, studies have now shown that in order to prevent heart disease, the leading cause of death in people with diabetes, treatment of hypertension (high blood pressure) and hyperlipidemia are as important or more important than glucose control.

The American Diabetes Association, the American Heart Association, the National Kidney Foundation, and the Joint National Committee on Prevention, Detection, and Treatment of High Blood Pressure all agree that people with diabetes need to maintain a blood pressure less than 130/80 millimeters of Mercury (mm Hg) in order to prevent not only kidney disease but also heart disease. These societies also recommend the use of one of two classes of antihypertensive medications, Ace Inhibitors or Angiotensin Receptor Blockers, as the first-line agent for blood pressure management. However, in my experience, most patients require two or three different medications for adequate blood pressure control (130/80 mm Hg).

Lipid management is also of crucial importance with regard to heart disease prevention and there are strict guidelines outlining HDL (good cholesterol), LDL (bad cholesterol), and Triglyceride treatment goals from the the National Cholesterol Education Program, the American Diabetes Association, and the American Heart Association. Triglycerides should be maintained less than 150 mg/dl, HDL more than 40 mg/dl in men and 50 mg/dl in woman, and LDL below 100 mg/dl. However, for individuals with multiple heart disease risk factors or known heart disease an LDL goal of less than 70 mg/dl is desirable.

Other conditions can contribute to hypertension and high blood glucoses. One condition in particular that is very common in people with diabetes is sleep apnea. I would advocate screening all people with diabetes for sleep apnea with at least a questionnaire as it is very common and once again effects both blood pressure and glucose control. We use the Epworth Sleepiness Scale as a screening tool at the Diabetes Care Center where I serve as the diabetologist and medical director. The Epworth Sleepiness Scale can be taken online at a number of different websites.

In order to prevent the potential long term complications associated with diabetes be sure you are not only achieving glucose control but also blood pressure and cholesterol control. Be advised that sleep apnea is common in people with diabetes and can lead to difficult to control glucoses and blood pressure as well as heart and lung disease if left untreated.

Getting on with Life with Feet Protection

Diabetes can strike anytime and the hardest hit are men because they are prone to feet problems linked to the disease. Each year, there are more than 82,000 amputations reported among people with diabetes and it all begins with a blister that develops into a deep wound. Can diabetic socks for men help?

The Scourge of Diabetes

Diabetes occurs when the body ignores the insulin in the body or when there is an abnormally high level of blood sugar in the system. The condition can be genetic or acquired.

Complications of the disease can range from cardiovascular disease, blindness, kidney failure, and impaired nerves. But amputation of the leg is a dreaded consequence of the disease; hence, diabetics should pay close attention to their feet.

Because there is an absence of sensation in the feet, the diabetic cannot detect a blister forming on a heel or on any other part of the feet. Poor blood circulation adds to the problem because it delays the healing the blister or contributes to the festering of an infection.

When a person has the disease, the immune system is also suppressed, hindering the response of white blood cells to attack infections; other related complications are atherosclerosis or hardening of the arterial walls, high levels of cholesterol, and high blood pressure

Protection from Diabetic Socks

Men should double their efforts to pay careful attention to the health of their feet, as they are more prone to develop feet blisters compared to women. Part of their feet care is to wear properly fitting shoes and diabetic socks for men.

Diabetic socks for men provide the best protection, comfort. These are moisture-proofed to prevent the infections caused by bacteria and feet odor. These are padded to give added protection against blisters and lastly the tops of the socks are loose to allow for better blood circulation in the feet and legs.

The best fabrics for men’s socks are cotton and wool. Cotton is often combined with elastic fabrics and should be the main component because it is gentle on the skin and allows the skin to breathe. All diabetic socks are seamless to prevent abrasions on the feet.

Some diabetic socks for men are bolstered with colloidal silver particles woven into the sock’s insole. The silver draws away and absorbs the moisture that would have harmed the feet.

How to Choose Diabetic Socks for Men

Before shopping for the diabetic socks, ask the doctor’s recommendation. Other considerations should be:

Diabetic socks vary in sizes and lengths. The best socks should fit and lengths should be selected for their appropriateness for different sports or activities. If more support is needed for the calf, choose calf-length socks. There are more choices than over the calf or under, crew socks and quarter socks.

Cushioning and support socks should be comfortable and gentle on the feet. There are gel padded socks that absorbs shock and offer extra cushioning. Padded and cushioned socks are available for different needs.

Cuffs should be elastic free to prevent the pinching of the leg worsening poor circulation in the legs and feet.

With the protection of these socks, men can go on with their lives. They can still enjoy safe sports and fun activities with family and friends.

Overall control of cardiovascular (CV) risk factors has deteriorated over the last 35 years to a greater extent in diabetic individuals than in their nondiabetic counterparts, an analysis of Framingham Heart Study data suggests.

The finding is worrying given the higher cardiovascular morbidity and mortality faced by diabetics, and suggests that further, more aggressive efforts are needed to improve risk-factor control in this group.

For the study, Caroline Fox (National Heart, Lung, and Blood Institute, Framingham, Massachusetts, USA) and team examined trends in CV risk factors among Framingham participants between 1970 and 2005. The researchers compared risk-factor control in 4195 patients aged 50 years and 3495 patients aged 60 years with and without Type 2 diabetes mellitus.

Reporting their findings in Circulation, Fox et al say that those with diabetes experienced a greater increase in body mass index than those without diabetes at 2.52 vs 0.39 kg/m² per decade.

Encouragingly, diabetic participants also exhibited a greater decrease in low-density-lipoprotein (LDL) cholesterol than nondiabetics of 15.5 versus 7.43 mg/dl (0.40 vs 0.19 mmol/l). Reductions in systolic blood pressure and smoking prevalence were of a comparable magnitude in diabetics and nondiabetics.

Nevertheless, the overall control of both hypertension and LDL cholesterol remained suboptimal in both sets of patients. “Overall, individuals with diabetes have not experienced the necessary declines in CV risk factors to overcome their increased risk for CV disease,” remark Fox et al.

Noting that diabetic patients continue to have a 2??”3-fold increased risk for CV disease relative to those without diabetes, the researchers conclude: “To further reduce the differences in CV disease rates between those with and without diabetes, efforts must be intensified to achieve guideline targets for systolic blood pressure and cholesterol levels among those with diabetes.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

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