Tools of a diabetic

Here are objetcs that a diabetic always has with him (I mean at home at least):

. Insulin (Lantus, Novorapid...) :

.Glycemia meter :

.Needles: .Specific Rubbish bin:

.Glucagon:

Diabetic retinopathy

The main cause of blindness in France and many other countries is retinopathy, generally called diabetic retinopathy because it affects more than 80% of 15-year diabetic patients. This disease is another consequence of badly-controlled diabetes, with lots of hyperglycemia. It affects blood vessels which form at the back of the eye, and when there is hyperglycemia, it creates some small vesicles leading to aneurysms that can explode at any time, bleeding in the retina. These bleedings are responsable for an inflation of the retina: these are the first symptoms of retinopathy. There are two levels of retinopathy :

. Non proliferating retinopathy : deterioration of the eyesight but generally undetectable.

. Proliferating retinopathy : to repair deteriorated vessels, the retina makes new ones but more fragile. They can bleed and then affect a part of the eye leading to badly blurred vision. And if the retina heals itself, it can cause blindness.

(pictures from wikipedia)

There are some treatments to counter retinopathy, but generally it is too late when it is detected. The best option is to be treated by an opthalmologist. I have a check-up each year.

"Diabetic Foot"

20% of diabetics may present lesions leading to amputation.

There are 3 000 to 5000 amputations a year due to Diabetes.
Risk of amputation is 15 times bigger for a diabetic than a non-diabetic.
55% of diabetics don't know risks that their feet may have
(as a consequence, they don't take care of them).
42% of diabetics (generally old people with type 2 diabetes) can't wash their feet alone.
(http://jvalla.club.fr/piediabintro.html)

A lot of diabetics may have complications with their feet. In effect, the foot is a complex but a highly important structure of the body. With a lot of muscles and tendons, and at least 26 bones, the foot has a well defined architecture in order to respond to its fonction which is to support the body, from its weight to its different movements. Complex structures are fragile, and diabetes is responsable for lots of problems with feet.

Each hyperglycemia leads to a thin coating of sugar on the body's nerves, preventing them from working well. In this case, the foot can't detect injuries anymore, and many infections may appear. Moreover, it affects the immune system of the patient. That is why a diabetic foot may develop some skin deseases like Vitiligo (a skin condition that causes loss of pigment). Last but not least, diabetes attacks arteries and blood vessels.

The consesquences of these three main complications are that the diabetic feels no more pain in his foot, its architecture is changed and the foot can't function anymore. Any infection can affect the body and the life of the patient will be in danger.

Insulin pump therapy

The regulation of blood glucose level is not that easy. Even though you take care of it, there are always some unpredictable variations just by eating a simple sweet. Moreover, it is much harder for young people, I mean those who are 8, 10 or 13 years old, and for those who already have another handicap. And as said before, if glycemia is not well regulated, it leads to big complications, illness and death. That is why doctors and researchers developed a method based on an Insulin pump. They are an answer to these kinds of problems. This involves an external pump, working with a battery, and delivering rapid insulin continually, under the skin with the help of a catheter. It injects insulin automatically without any variations, permitting diabetics to live a bit more "normally", avoiding hyperglycemia or hypoglycemia. The pump is checked every day, and you can inject more insulin, if you want to eat more, by pressing a button.

However, this therapy is not allowed for everybody. There are specific requirements :
. patients who have difficulties to keep the objectives of good glycemia: too much hypo or hyperglycemia (generally young people or those who already have a handicap)
. patients who want to increase their traitement to have a better control
. people who need smoothness for their meal, and who have problems with the mix of different types of insulin (slow and rapid)
. very active people
. pregnancy
. and other people with medical prescriptions