Diabetes mellitus is a disease that affects 21 million people in the US, with 1 million new cases diagnosed each year. Poor diet and obesity are the primary causes of type 2 diabetes. Diabetes is treated through diet, exercise, oral medications, and insulin injections to control blood glucose levels. Uncontrolled diabetes can lead to serious side effects by damaging tissues and blood vessels over time like retinopathy, nephropathy, and cardiovascular disease. Proper foot care and glucose management can help prevent complications.

1. •What is Diabetes
•How is it treated
•Side effects and prevention
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2. •There are 21 million
people in the U.S.
with Diabetes Mellitus
•This represents 6%
of the population
•1 million new cases
are diagnosed each
year
•5 million are
undiagnosed
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3. •Although there are
genetic factors, the
number one cause of
diabetes mellitus is
poor diet, leading to
obesity which is why
exercise and diet
control is so important
in the management of
the disease
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4. A fasting glucose test is good, but
complicated by epinephrine:
-blocks insulin secretion
-stimulates glucagon release
-activates glycogen breakdown
-impairs insulin action via
increased hepatic glucose
production
Also complicated in the face of:
-illness
-diet
-decreased physical exercise
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5. •Poor glucose control
•Glycation of tissues
causing change in cells,
with basement
membrane thickening
and small vessel disease
•Neurologic,
immunologic and
vascular compromise
results
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6. The changes that happen
to the tissues causes more
than loss of sensation
Changes lead to:
• retinopathy
• nephropathy
• coronary arterial disease
and stroke
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7. Neuropathy
–Autonomic
-Dry skin which is easily injured
because it is thick, rough, non-
pliable
–Motor
–Atrophy of muscles with
contractures of digits
–Sensory
-Loss of sensation leads to injured
skin which is unrecognized
-Wound extending to bone
means amputation
-One amputation usually
leads to another
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8. Secondary:Pancreatic (β-cell mass loss)
Primary: Type I Diabetes Mellitus
-autoimmune -Hormonal (pheochromocytosis,
acromegaly, Cushing's, steroids)
Type II Diabetes Mellitus
-Drug or chemical induced
-non-obese
-Insulin receptor abnormalities
-obese
-Genetic syndromes
-maturity onset of the young
(lipodystrophy, myotonic
dystrophy, ataxia/telangiectasias)
-Other
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9. Type I (<40 years of age) Type II (>40 years of age)
-genetically susceptible -abnormal insulin secretion
(HLAD region)
-resistance to insulin @ target
-environmental event (virus) tissues
-both β and α cell mass is intact,
-insulinitis (action of T-
but α mass is increased
lymphocytes)
-autoimmunity -insulin levels are normal to high
-β-cell attack (islet cell Ab) -rare ketoacidosis, usually lactic
acid HHNK (hyperglycemic,
-DM (>90% of β-cells)
hyperosmolar, non-ketoacidosis) induced
coma
Ketoacidosis follows decreased insulin
and increased glucagon, leading to
osmotic diuresis and dehydration
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10. Most oral diabetes
medications act to either
increase the production
of insulin to match
caloric intake or increase
the effectiveness of the
insulin at the target cell
via up regulation of
receptors
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13. •Never ignore a red mark, a
bruise or blister
•Never ignore an ingrown
nail or local trauma
•A ‘little thing’ can become a
big thing—with unfortunate
results!
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14. Look for:
Insect or animal bites
High Pressure Points
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15. Look for hot spots
Good shoes Not good shoes
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16. Final Points………
•Check feet daily
• Wear shoes at all times
• Shake out shoes before wearing
• Wear proper fitting shoes
• Don’t use hot water on your feet
• Check glucose levels every day
• Visit primary care doctor regularly
• Visit foot care specialist regularly
• Attend diabetic classes
• Avoid complications by living right,
eating right, exercising and staying under
control
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17. Thank you!
Office: 5350 South Stapes Street, Suite 100 (New York Life Building),
Corpus Christi, TX 78411
Phone: 361 888 8878
Fax: 361 888 8815
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