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In 2019 the global prevalence for having diabetes was 463 million people. Approximately one in two people do not know they have diabetes. These are concerning statistics. Podiatric medicine allows the importance of foot and limb assessment to take place, in the presence of both Type 1 and Type 2 diabetes.  Our feet are crucially important for our locomotion during the day, making mobility a prime focus of our life and activity. Healthy foot function is critically important. And realizing we have more control over this than we think is especially important. Even if we are not walking or unable to walk on them, their health is vital. Why then is this the case?

 

Apart from not having any essential organs located in your feet, they are similar to tissue physiology anywhere else in your body. With over 100,000KM of blood vessels in your body, there is not one of your thirty trillion cells that is more than approximately 0.2 nanometers away from a blood vessel. This activity in the thirty trillion cells takes place every one billionth of a second in your body. To travel from one side of a cell to the other at increments of one billionth of a second is like an entire day to us, to travel from one side of the cell to the other. This requires good nutrition. Where from? The blood supply of course.

 

So, what is our responsibility to ourselves to achieve this, to levels of maximal health capability? As mentioned earlier, approximately half the people in Australia with type 2 diabetes have not even been diagnosed. Or even if they do not have diabetes, they may have metabolic syndrome or pre-diabetes, which may pose a serious risk of progressing to Diabetes. What can we do to lower the risk of damage or dysfunction to the nerves and blood vessels in our feet, eyes, macro vessels in our heart, kidneys, brains, and livers? A lot. That is the good news.

 

We can start by observing the recommended activity levels for the global population, which will allow us to live longer. It has been demonstrated by evidence,  that from the moment you start exercising, within minutes, days, and weeks you can start reversing the risk of developing chronic diseases, including but not limited to overweight and obesity, cardiovascular and cardiorespiratory disease, including hypertension, diabetes, hyperlipidemia, kidney disease, liver disease, visceral fat production (nasty fat). You should consult your family Doctor before making any exercise changes, based on your medical history. There is good evidence-based research demonstrating the improved management, and even remission of type 2 Diabetes when lifestyle medicine management is put in place. Sometimes medications may be able to be reduced, where improved management takes place, determined by your family doctor. This includes weight management, diet, exercise, sleep quality, stress reduction, management of stress and anxiety, cessation of smoking and excessive alcohol consumption and better social integration.

 

In our surgery we deal and manage with these principles as part of our scope of practice. Where further referral to specialist or Allied health practitioners is required, we can conduct this assessment. There are a vast number of examples of lowering the health risks associated with diabetes and the feet and lower limb. These include vascular, neurological, and dermatological assessment of your feet in our surgery. They may include biomechanical assessment of the foot and your whole body in relation to your locomotion to see if your walking needs adjustment, by orthotic support or musculoskeletal medicine intervention with advanced musculoskeletal adjustment practices, also done in our surgery. Additional examples include good adherence to the recommendations your GP make regarding your blood sugar levels. This is an important topic outside the boundaries of this article, but adherence to the recommendations is part of lowering the risk of further complications in relation to the presence of diabetes. Having a thorough assessment is vital, which can be done in a set of appointments in our surgery. Our health is a hugely important part of what makes us love our lives and allows us to care and love our family friends, society and have good levels of self-compassion. Do not underestimate the power of creating changes in your life that can change your anatomical and physiological function, every billionth of a second. Please contact our team if you would like to arrange further assessment. I am Dr Jeremy Hawke (Podiatrist) and look forward to assisting you to be in the driver’s seat of your healthier future.