Living With Diabetes

A Mediaplanet Guide to Detecting and Managing Diabetes

Living With Diabetes

Dr. Joshua J. Joseph The endocrinologist talks about the health inequity of diabetes

Discover EcoSox: the hiking socks made specifically for diabetics Lakanto shares the ultimate sugar-free chocolate chip cookie recipe

JUNE 2021 | FUTUREOFPERSONALHEALTH.COM

An Independent Supplement by Mediaplanet to USA Today

Why People With Diabetes Need Yearly Kidney Checks People living with diabetes know how to take ownership of their health, but many may not realize the potential impact of kidney disease on their condition.

In fact, approximately 1 in 3 people living with diabetes also has kidney disease, according to data from the Centers for Disease Control and Prevention.

People who have been living with diabetes for many years may have developed chronic kidney disease (CKD) without realizing it, as symptoms often go unnoticed. But kidney disease affects more than just the kidneys.

There is a “triangle of risk” involving type 2 diabetes, chronic kidney disease, and cardiovascular disease.

Research shows people living with both type 2 diabetes and chronic kidney disease are three times more likely to die from a heart attack or stroke than people with type 2 diabetes alone and no kidney disease.

Fortunately, regular testing of kidney function can help identify problems before they become serious.

Most people living with diabetes undergo yearly kidney checks in the form of blood tests for estimated glomerular filtration rate. However, a simple urine test, called the urine albumin to creatinine ratio (UACR), can identify CKD at an early stage, and help prevent the development of severe disease and the possible need for kidney dialysis.

For more information about the connections between diabetes, chronic kidney disease, and cardiovascular disease, and tips for staying healthy, visit KnowDiabetesbyHeart.org.

Know Diabetes by Heart

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Move More and Sit Less to Make Strides Toward Better Health

Did you know only 1 in 5 adults and teens gets enough exercise?

If you need motivation to move more, here are some tips: Science has linked being inactive and sitting too much with higher risk of heart disease, type 2 diabetes, colon and lung cancers, and early death.

It’s clear that being more active benefits everyone and helps us live longer, healthier lives.

If you’re not as active as you’d like to be, it’s OK. Getting started doesn’t have to be hard. Any

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amount of movement is better than none!

Get moving Start by spending less time sitting. Even light-intensity activity (like walking, climbing stairs, and stretching) can offset some of the risks of being sedentary.

Aim for 150 minutes of moderate activity per week (or 75 minutes of vigorous aerobic activity), and try to spread out that activity throughout the week. Also, increase the amount and intensity of activity gradually over time.

An easy way to get more active is to include the whole family. Kids need to move more, too, so it’s important to set a good example for your children or grandchildren by encouraging healthy habits while they are young.

Before exercising, be sure to warm up for several minutes to get your muscles ready, and then stretch slowly for at least 5 minutes before you begin.

Ready to go If you have a chronic condition or disability, talk with your health-

care provider about what types and amounts of physical activity are right for you before making too many changes.

If you have diabetes, the American Diabetes Association suggests that you become familiar with how your blood sugar responds to exercise. Checking your blood sugar level more often before and after exercise can help you see the benefits of activity.

So what are you waiting for? Get ready, get set, get moving! n American Heart Association

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PLEASE RECYCLE

Publisher Caroline Dranow, Isabel Carretero Business Developer Katie Konfino Managing Director Luciana Olson Lead Designer Tiffany Pryor Designer Tiffany Jackson Lead Editor Mina Fanous Copy Editor Dustin Brennan Partnership and Distribution Manager Jordan Hernandez Director of Product Faye Godfrey Cover Photo Dr. Joshua J. Joseph All photos are credited to Getty Images unless otherwise specified. This section was created by Mediaplanet and did not involve USA Today.

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The Dangers of Diabetic Foot and How You Can Avoid Them Dr. Irina Saretzky, a practicing clinician, dermatologist, and wound-healing specialist at the Hospital de Clínicas of the University of Buenos Aires, breaks down some of the dangers that pose a risk to people living with diabetes, as well as the importance of quality care and treatments.

As the prevalence of diabetes rises across the nation, so does the risk of developing serious complications like diabetic foot syndrome (DFS). People living with diabetes have a 25 percent lifetime risk of experiencing high-risk chronic wounds and 15 percent lifetime risk of experiencing foot ulcers.

Despite these staggering statistics, DFS is often overlooked and patients are rarely provided with effective preventive options.

Most of the foot problems people with diabetes face arise from two main complications: nerve damage and poor circulation. Chronic nerve damage can cause dry, cracked skin, creating an entry point for bacteria and infection. Reduced blood flow in lower extremities, feet in particular, frequently causes loss of sensitivity or leg numbness, which allows small blisters to be ignored and progress to serious infections in a matter of days.

The skin on our feet is more delicate than we commonly believe. Heels and ankles have thinner skin, which is susceptible to injury from shoes, socks, and stockings. While the soles of the feet have thicker skin, they tend to develop calluses or helomas due to excessive friction, weight support, and dryness, making it necessary to moisturize these areas daily.

Keeping it natural Ointments based on natural components are ideal for diabetic skin care. The combination of cod liver oil, sunflower oil, and beeswax can be found in the products I’m pioneering at Curefini. These natural ingredients act synergistically, improving skin barriers by preventing the water loss, cracking, and irritation that often comes with diabetic wound infections.

Curefini’s cream and ointment solutions stand out for providing a quick and effective response in protecting the skin and promoting the natural healing process, including in cases of diabetic foot. To learn more about Curefini, Dr. Saretzky, and the future of skin care, check out www.curefini.com.

Dr. Irina Saretzky, M.D., Professor of Dermatology, University of Buenos Aires; and Medical Advisor, Curefini

This has been paid for by Curefini.

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What Really Matters When Deciding How to Manage Diabetes It is vital to ask the right questions when choosing the best blood glucose monitor for your lifestyle.

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or most people with diabetes, checking your blood sugar to keep it in a healthy range is just a part of life. That’s why choosing the right method that works for you matters.

The two main types are standard blood glucose meters that use a drop of blood to check what your levels are at that moment, and continuous glucose monitors (CGMs) that check your blood glucose regularly day and night.

What really matters Within these two options, there are more choices than ever, from basic designs to more advanced models that have all the bells and whistles. And fancier isn’t necessarily better.

Start by considering ease of use. Some meters are made for simpler operation, whether it’s larger buttons, illuminated screens or audio capabilities.

Another consideration is how much it costs and what your insurance will cover.

Meters vary in price and some

insurers limit coverage to specific models and the test strips that are used with them. Start by checking with your insurer to find out what they’ll cover.

Next, consider how the meter will retrieve your information, and whether you can download the data to a computer or mobile device to make it easier to share with your diabetes care team.

Flexibility is perhaps the largest advancement in diabetes care and management.

If you’re using a blood glucose meter and are tired of finger pricks, there’s an alternative site monitor (CGMs) that allows you to draw blood samples from your arm, thigh, or the palm of your hand.

What are CGMs? CGMs report your blood glucose levels in real time (e.g., every five minutes throughout the day), alert you when your glucose hits a high or low limit, and provide insight into glucose trends.

CGMs work by using a sensor placed on your skin. They

transmit readings to a small recording device. Whether you manage your diabetes with a pump, daily injections, or oral medications, a CGM can help you manage your blood glucose.

Many people with type 1 and type 2 diabetes can benefit from using a CGM. Those who would benefit the most are people that have trouble reaching and maintaining target blood sugar. CGMs are particularly useful if you often have lows and are unaware of when they happen.

Even if you have a good handle on your diabetes management, you still may want to consider using a CGM because it’s convenient and eliminates the need for finger pricks.

However, you’ll want to keep in mind that if you are managing your diabetes well without the use of a CGM, your insurance may not cover it; they might consider it a non-necessity. n Dr. Robert Gabbay, Chief Scientific and Medical Officer, American Diabetes Association

How Insulet Is Making Insulin Use Easier Than Ever For the millions of people living with diabetes worldwide, insulin is a daily lifeline. For Shacey Petrovic, president and CEO of Insulet, the maker of Omnipod®, insulin is a daily lifeline for her father as well.

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n college, Petrovic double majored in biology and comparative literature — the latter now manifests as voracious reading. She’s spent her entire career in service of science, pivoting from pharmaceutical sales to research and development work to running a small women’s healthcare company, but tech and innovation have always been what fueled her.

When the opportunity arose to join Insulet, it seemed like the next step in her journey.

“It felt like a natural progression,” Petrovic said.

“When I was in sales, I very quickly wanted to get into marketing. I wanted to get upstream in terms of a strategy, not just the execution.”

After a foray in marketing leadership and general man-

agement, she was ultimately recruited and primed for this CEO role, moving her family from Utah to Boston.

“What was attractive to me was the opportunity to build something. I wasn’t aiming to be a CEO,” Petrovic recalled. “Of course I loved it! It was probably one of the best decisions I’ve made in my career.” That was six years ago.

Improving lives Today, the mission of Omnipod® is to improve the lives of people with diabetes through an affordable, easyto-use, wearable solution that provides up to three days of continuous insulin delivery in a tubeless, waterproof pod (the pod has a waterproof IP28 rating for up to 25 feet for 60 minutes — the PDM is not waterproof)

that you wear anywhere on your body that you’d give yourself an injection.

Like many, Petrovic’s father took some convincing to wear an insulin delivery device to treat his type 1 diabetes.

“People with diabetes are making 300 decisions a day,” Petrovic said. “If you have a little bit of control, you don’t want to give that up. There’s a lot of inertia around technology use, so we have to focus on three areas: making the technology as simple to use as possible; bringing broad, affordable access to our users; and building awareness.

“Our ultimate goal is to simplify life with diabetes and improve outcomes for people across the globe.” n Insulet

This has been paid for by Insulet.

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When Perry Antelman studied his father’s research into special classes of minerals and saw their therapeutic results, he was compelled to bring this technology to the world. He launched Aidance Scientific, a research, development, and topical compounding facility, and set forth a healing revolution.

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ince the early days with its original Terrasil® Therapeutic Skincare formula, Aidance has pushed ahead in innovation to provide quality healing solutions grounded in science that harness the power of natural ingredients for wound care and other skin conditions.

In 2012, Aidance wanted to deliver more for its customers. Aidance developed a specialized family of Terrasil® products with specific

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OTC active ingredients for optimal results.

Always prioritizing the needs and feedback of its core customer base, the new line of products was tremendously successful. Sales continued to grow, with the diverse product line appealing to new groups of customers via Amazon, Walgreens, and CVS. Despite the growth, those direct relationships, now with thousands of repeat customers, have remained a core Aidance value. “Our customer

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support team has customers who ask for them by name — where else do you find that nowadays?” said Aidance co-founder Andrew Warren.

Solutions for diabetics With recent statistics putting diabetics at a 25 percent lifetime risk of experiencing chronic wounds and a 15 percent risk of experiencing foot ulcers, Aidance stands perfectly poised to offer topical therapeutic care solutions to diabetic and prediabetic populations.

Aidance combines a mission-driven business with family-centered culture, a track record of high customer satisfaction, and successful studies and reviews from leading wound care and health professionals, making its products a clear favorite among the vulnerable diabetic community and beyond.

Now in 2021, Aidance continues to refine formulations and processes to improve its existing products and launch new ones. Aidance recently

launched its Diabetic’s Ulcer & Sore Relief ointment in an easy-to-use jar container.

Check out www.terrasil healing.com to learn more about how you can incorporate its trailblazing treatments into your daily routine, and see why so many people are turning to Aidance to help them manage their diabetes with optimal skin health and wellness. n Aidance

This has been paid for by Aidance.

PHOTO: AIDANCE SKINCARE

How a Medicinal Skincare Company Is Serving the Diabetic Community

Why It’s Critical to Know the Signs of Diabetes There are specific health symptoms that may signal a need to visit your doctor. Early detection and treatment of diabetes can decrease the risk of developing complications.

Testing for diabetes requires a simple blood test administered by your doctor.

If you have been experiencing any of the following symptoms, it is crucial that you have a conversation with your doctor.

Diabetes is a manageable condition that can be treated with lifestyle changes and medication in order to prevent or manage many complications. Give yourself the chance to thrive while living with diabetes by knowing the signs: • Frequent urination and/or an increased feeling of thirst can be signs of diabetes.

If you are noticing that you are more thirsty than normal, that could be a sign that your body has excessive blood sugar levels and is attempting to rid itself of those sugars through urine.

• Feelings of increased or insatiable hunger can mean that your body is having trouble drawing glucose into your blood cells, something your body naturally does during the digestive process.

• It can be difficult to determine the root cause of feeling exhausted or drowsy, but these could both be signs of diabetes

as well. Make sure to monitor these feelings and report them to your doctor.

• Blurred vision may also occur when changing fluid levels cause swelling in your lenses, which prevents your eyes from focusing correctly.

• Sudden numbness or pain in your legs, feet, or other extremities is a reason to talk to your doctor. Feelings of numbness, tingling, or pain in your feet could be caused by nerve damage due to high blood sugar levels for an extended period of time. Untreated diabetes may be the cause of these feelings of pain or numbness, and should be addressed immediately.

• Sudden or rapid weight gain or loss is something that could signal possible diabetes.

• Yeast infections can become more prevalent as your blood sugar increases for both men and women.

If you have experienced any of these symptoms, ask your doctor for a diabetes test. Early detection is the key to managing the condition and avoiding life-altering complications. n Dr. Robert Gabbay, Chief Scientific and Medical Officer, American Diabetes Association

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The Ultimate Sugar-Free Chocolate Chip Cookies Following a diabetic diet doesn’t mean you have to give up your favorite sweet treats. Here is a recipe that will help you make the perfect batch of sugar-free chocolate chip cookies.

Why Diabetes Disproportionately Affects Minority Populations

Why is it so important for diabetics to get vaccinated against COVID-19?

Lakanto

This has been paid for by Lakanto.

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PHOTO: DR. JOSHUA J. JOSEPH

Ingredients (for 24 cookies): • 1 cup butter, softened (do not over-soften) • 1 cup Lakanto Classic Sweetener or Lakanto Baking Sweetener • 1/2 cup Lakanto Golden Sweetener • 1 tbsp vanilla extract • 2 large eggs, cold • 2 3/4 cups all-purpose flour (or glutenfree flour blend) • 1 tsp baking soda • 1 tsp sea salt • 1 cup or 8 oz Lakanto Chocolate Chips Instructions: 1. P reheat oven to 375 degrees.

2. In a large bowl, mix the butter with an electric hand mixer for about 1 minute or until butter is creamy. Add in the Lakanto sweeteners and vanilla extract. Mix well until combined.

3. Add in the egg and mix just until it is barely incorporated.

4. S crape all ingredients down the sides and along the bottom with a rubber spatula, ensuring everything is incorporated together.

5. Add in the flour, baking soda, and salt, and mix until dough forms. Gently stir in the chocolate chips with a spatula.

Using a cookie scoop, drop the 6. mixture onto a baking sheet lined with parchment paper.

7. F latten the scoops slightly with the palm of your hand.

8. B ake for 10-12 minutes until cookies are slightly golden. Be careful to not over-bake.

9. L et cookies cool on the baking sheet for 3 minutes before transferring to a cooling rack. Enjoy! Best served warm out of the oven.

non-medical, health-related social needs, which influence downstream health outcomes. Health equity to me is creating equity more broadly in our society by addressing the upstream and midstream determinants that are causing poor downstream outcomes.

We talked to Dr. Joshua J. Joseph, an endocrinologist specializing in diabetes and metabolism at The Ohio State University Wexner Medical Center, about the ethnic disparities seen in diabetes, and how we can overcome racial, social, and economic barriers to better health.

Can you explain the ethnic and racial disparities in diabetes?

In general, BIPOC (Black, Indigenous, and people of color) populations in the United States have more individuals developing type 2 diabetes and an excess of individuals with type 2 diabetes compared to white populations. Even more concerning is that BIPOC communities are seeing an explosion of type 2 diabetes diagnoses in kids and adolescents. The disparities unfortunately do not end there, and include disparities in diabetes control, com-

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plications both macrovascular and microvascular, and mortality.

What does health equity mean to you?

The CDC describes health equity as when “each person has the chance to reach his or her full health potential,” without facing obstacles from “social position or other socially determined circumstances.” If you think of health inequities as a river cascading down a mountain, the furthest upstream determinants are poverty, racism, and discrimination.

We have to address those, but they are also the most difficult to address, because they require policy, cultural change, and investment. Policy and cultural change can both be arduous. In the middle, we have the mid-stream determinants: housing, the built environment, education inequities, economic inequality, and food insecurity, referred to as

COVID-19 vaccination is critical for individuals with type 2 diabetes. U.S. data shows that while diabetes does not increase the risk of contracting COVID-19, it does increase the risk of worse outcomes, including hospitalization and mortality. COVID-19 has shown that if we are going to achieve diabetes equity, our diabetes care can’t end within the four walls of our clinic, but must extend into the communities we serve.

How can we increase awareness and help promote cardiovascular health for underserved communities?

We must meet people where they are and advocate for policies, practices, and procedures that increase awareness and promote cardiovascular health in all communities, like the Know Diabetes

by Heart Program. We know people who take control of their type 2 diabetes and heart disease have the opportunity to live longer, healthier lives. The key to achieving these goals lies in community-engaged efforts, by partnering with community members, stakeholders, and organizations with the shared goal of increasing health and well-being by utilizing both healthcare and community resources to realize that vision. n

The 5 Numbers to Know If You Have Diabetes Taking ownership of your heart health by monitoring some basic health numbers can contribute to a longer, healthier life.

Paying attention to blood pressure, cholesterol, and weight are important for everyone, but especially for individuals living with diabetes, who are twice as likely to develop and die from heart disease, strokes, or heart failure.

Type 2 diabetes is also a risk factor for severe complications from COVID19, so it is more important than ever for people living with diabetes to be aware of critical numbers and keep their diabetes well-managed.

Diabetes management is especially essential for Hispanic/Latino Americans, who have a 50 percent chance of developing type 2 diabetes and suffering devastating complications from it, according to the Centers for Disease Control and Prevention.

“My message for others living with diabetes is that we have control and choices,” said Lupe Barraza, who has type 2 diabetes and is a spokesperson for Know Diabetes by Heart, an initiative of the American Heart Association and the American Diabetes Association.

Key numbers There are five key numbers all people liv-

ing with diabetes should measure regularly. The first is body mass index, or BMI. Your BMI is an estimate of body size based on height and weight that is used to help determine if you’re overweight or obese.

The next is blood pressure, which is a measure of how strongly blood pumps through your body when your heart beats, and is a sign of heart health. A healthy blood pressure for most people is less than 120/80.

Another key number is your A1C, which is a measure of your average blood glucose levels for the past 2-3 months. A healthy A1C for someone with diabetes is 7 percent or less.

It’s also important to keep track of

your cholesterol, which is a waxy substance in the blood. If your cholesterol levels are too high, they can cause fatty deposits in blood vessels that can lead to a heart attack or stroke.

Finally there’s kidney function. Early detection of chronic kidney disease can make a huge difference. An often overlooked and simple test is the UACR (urine albumin to creatinine ratio), which can detect early signs of trouble.

Know Diabetes by Heart

For more information about monitoring your numbers, visit DiabetesdeCorazon.org.

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The Sock That Could Save Your Feet Wearing the right pair of socks is one of the best ways to care for your feet, especially for people with diabetes.

One of the key things to look for when choosing socks is the right material.

While cotton is a great and versatile material for many garments, it’s less than ideal for socks.

“Moisture and bacteria are the enemy of diabetics in terms of foot care,” said Jay Robinson, senior vice president and general manager of the Performance Division for Renfro Brands, which includes Dr. Scholl’s Socks. “So, cotton is not a good sock fiber for a diabetic because it retains the moisture next to the skin.”

Excess moisture invites opportunities for blisters and other wounds to occur and slows the healing process.

Therefore, having socks that efficiently wick away moisture from the foot is key to foot health. Polyester socks are ideal because polyester fibers naturally wick away moisture, pulling moisture away from the skin and to the outside of the sock, expediting evaporation.

“The great thing about polyester is that it wicks away moisture so much better than other fibers,” said Bailey Stinson, a type 1 diabetic and brand manager for Dr. Scholl’s Socks. “That is why all Dr. Scholl’s Socks are made with polyester fibers.”

Stinson adds that “it is also important to choose socks that have little or no toe

seam, as that can cause irritation, hot spots, and blisters.” She further states that people should really avoid socks that are binding and tight on the leg. If your socks leave marks on your legs, that means the socks are too tight and doing more harm than good.

Cushioning is another essential feature to look for when selecting socks for everyday wear. To fulfill this need for diabetic consumers, Dr. Scholl’s Socks have zoned cushioning and extended cushioning in the heel and toe for increased comfort and protection.

Graduated Compression can also be a key component of a great pair of socks.

“Graduated Compression is a great tech-

nology that is constructed with greater tension at the ankle that lessens as it goes up the leg to promote circulation throughout the body,” Stinson said. “It’s really great for people who have tired, achy feet and legs after standing or sitting for long periods of time.” n Dustin Brennan

Explore Dr. Scholl’s full line of socks today at loopsandwales.com/ collections/brand-dr-scholls and see how they can improve the way you care for your feet.

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How Hyperbaric Oxygen Therapy Can Help Treat Diabetic Foot Ulcers For people living with diabetes, we can’t stress enough the importance of checking your feet regularly for sores or ulcerations.

Diabetic foot ulcers are a growing problem in our aging population in the United States.

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ver 34 million people in the United States have diabetes, and 25 percent will develop a foot ulcer. As infection sets in, this may lead to amputation. Hyperbaric oxygen therapy, commonly used in treating diabetic ulcers of lower extremities and chronic refractory osteo-

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myelitis, provides necessary oxygenation, which is critical in limb preservation.

Diabetic foot wounds are particularly challenging to heal because of the multitude of problems diabetic patients face. Diabetic patients develop sensorimotor and autonomic neuropathy, which leads to loss of sensation and plantar foot deformities.

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When there is an abnormally low oxygen level in the blood, that leads to poor angiogenesis, decreased growth factor synthesis, and inhibition of stem cell mobilization, all of which lead to poor wound healing.

Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurized environment.

Hyperbaric oxygen increases the dissolved oxygen and increases the amount of oxygenated plasma dissolved in tissue.

The use of hyperbaric oxygen in treating patients has reduced the risk of major amputation.

If you or a loved one is struggling with a non-healing wound, don’t delay

care. Early intervention and care will improve your healing outcomes. Visit HyperbaricAware.com to learn more about hyperbaric oxygen therapy, the benefits, and finding care. n CūtisCare

This has been paid for by CūtisCare.

The Link Between Type 2 Diabetes and Kidney Disease If you have type 2 diabetes, you are more likely to develop kidney disease.

In the United States, 37 million adults are estimated to have kidney disease but only about 10 percent are diagnosed. That means millions of adults are walking around with kidney disease but don’t know it. One in every three adults in the country is at risk of developing kidney disease.

Type 2 diabetes is a leading cause of kidney failure, and if your kidneys fail, you will need dialysis or a kidney transplant to survive. People with kidney disease and type 2 diabetes are three

times more likely to die from a heart attack or stroke than patients with type 2 diabetes alone. The fact is that kidney disease is a dangerous comorbidity of type 2 diabetes.

The earlier you discover kidney disease, the better your chances of receiving the best prognosis. Early diagnosis and intervention are critical for slowing the progression of the disease.

Steps to take If you have type 2 diabetes, talk to your doctor about kidney disease; you should be tested for kidney disease every year. It’s also important to home monitor your blood glucose

levels, control your blood pressure, and adhere to your special diet.

The earliest sign of diabetic kidney disease is an increased excretion of the protein albumin in urine. This will happen long before the usual tests done in your doctor’s office show evidence of kidney disease.

Other signs of kidney disease include: weight gain, ankle swelling, and leg cramps; frequent bathroom visits at night; high blood pressure; high levels of blood urea nitrogen and serum creatinine; less need for insulin or antidiabetic medications; morning sickness, nausea, and vomiting; weakness, paleness, and anemia; and itching.

How’s your bladder?

Diabetes can injure small blood vessels. When the vessels in kidneys are injured, the organs cannot clean blood properly. The body will retain more water and salt than it should, and waste materials will build up in your blood.

Diabetes can also cause nerve damage that can sometimes make it difficult to empty your bladder. The pressure resulting from a full bladder can injure kidneys or cause infection.

If you have type 2 diabetes, speak with your healthcare professional about having your blood, urine, and blood pressure checked at least once a year. Controlling your diabetes can lower your risk of developing severe kidney disease. n Joseph Vassalotti, M.D., Chief Medical Officer, National Kidney Foundation

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Challenge the Status Quo for Diabetic Foot Care

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iabetes can cause a loss of sensation in the body’s extremities, making it common for people with diabetes to develop chronic wounds on their feet, referred to as diabetic foot ulcers.

To keep these wounds from becoming infected — and even requiring amputation — they require immediate attention to expedite healing.

For patients looking to treat chronic wounds — especially those with diabetic foot ulcers, advances in treat-

ment options are providing patients with a new sense of optimism.

“The longer you have a wound, the harder it is for your body to heal it,” said Mandy Spitzer, a medical education manager for Smith+Nephew and credentialed as a wound care nurse. “Science supports that it is important to heal a wound as quickly as possible to keep it from becoming infected or chronic.”

Routinely, doctors and their patients have used bandages such as gauze to heal wounds. The Smith+Nephew

PICO™ System is an example of how proprietary technology is being used to improve upon traditional methods of treating wounds. By using suction delivered to a dressing (with AIRLOCK™ Technology) covering the wound, via a pocket-sized battery powered pump, the PICO System can assist the body to create new tissue and close the wound.

The dressing can stay on a wound for up to seven days, is showerproof*, and is designed with portability in mind.

“The PICO System can be easier for

the patient,” Spitzer said. “It’s small, lightweight, and the belt clip makes it easy to carry with you, allowing for discreet therapy and the ability for you to continue with daily activities.” *The PICO dressing should not be exposed to a direct spray or submerged in water. n Dustin Brennan

If you have diabetes and suffer from chronic foot ulcers or other wounds, ask your doctor if the PICO System is right for you. See how the PICO System has changed the life of others living with diabetic foot ulcers by visiting www.possiblewithpico.com.

Important Safety Information Smith+Nephew does not provide medical advice. The information in this article is not intended to serve as medical advice. The PICO pumps contain a MAGNET. Keep the PICO pumps at least 4 inches (10 cm) away from other medical devices at all times. As with all electrical medical equipment, failure to maintain appropriate distance may disrupt the operation of nearby medical devices. For full product and safety information, please see the Instructions for Use.

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Meet the Mom on a Mission to Change Blood Sugar Management

As a mother raising children with diabetes, what does blood sugar management mean to you?

As a mom who has raised two young daughters with diabetes, I’ve personally witnessed the incessant battle my children are fighting to survive 24/7, 365 days a year, year after year.

Diabetes is an incurable disease and takes no vacations. Management of the disease is expensive and time-consuming: Every 3 months there are visits to the endocrinologist, optometrist, reordering expensive meds and supplies, blood work, and more. I am gravely aware that uncontrolled or mismanaged blood sugar levels can result in complications, such as heart disease, stroke, blindness, amputation, kidney failure, and death. Diabetes

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PHOTO: GLUCOSE SOS LIFE CORPORATION

When entrepreneur, inventor, and supermom Pamela Heyward faced the challenge of raising two daughters with type 1 diabetes, she became driven to change the future of blood sugar management.

We asked her about the work she’s been doing. never sleeps, and I’m part of a full-time, ongoing battle.

What inspired you to start Glucose SOS? My two daughters, Tayler and Emmi, are diabetics and are prone to serious blood sugar crashes. During a particularly horrible episode, I remember seeing the terrified expression on my girl’s face as she looked up at the medics pouring into our home, and couldn’t take it any more.

I knew there was a better way to raise low blood sugar quickly without spiking.

Not satisfied with existing glucose products, I became a mom on a mission to develop an effective and appealing form of glucose to quickly and safely elevate low blood sugar.

I made sure each packet of Glucose SOS™ provides the 15 grams of glucose that is recommended by the American

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Diabetes Association guidelines for a controlled, metered approach to low blood sugar management.

What’s Next for Glucose SOS? Recognizing that diabetes is one of the fastest-growing health challenges of the 21st century, I believe the future of Glucose SOS is bright and more important than ever. I am proud to announce our latest product in development: a new Glucose-Melt

with revolutionary new technology to quickly melt in your mouth. The fourth product extension is now in R&D with a global company aiming to launch in new territories across the world.

SOS Life Sciences Corp also has a pet product, which is currently being rebranded. It’s estimated that 1 in every 300 dogs and 1 in 230 cats will develop diabetes during their lifetime — and those statistics keep rising. The 2016 State of Pet Health Report shows an

upward trend in the prevalence of the disease, rising nearly 80 percent in dogs and 18 percent in cats over a 10-year period.

The mission of SOS Life Sciences will always be to provide the best rapid solution to treat a diabetes-induced low, and to prevent blood sugar spiking. Come join us on our journey and learn more at www.glucosesos.com. n This has been paid for by Glucose SOS.

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Why You Need to Consider Diabetic Footwear Living with diabetes means living with circulation-related foot problems. Choosing the right footwear can help prevent and address those complications.

Diabetic footwear In diabetics, high blood sugar leads to poor circulation, which in turn can lead to neuropathy (nerve damage) in the feet. This numbness can mask cuts and other wounds, leading to infections and slower healing.

Diabetics have higher incidences of open sores on their toes or the bottom of their feet, as well as hammertoe (a deformation of the toe joints), calluses, bunions, corns, fungal infections, and even gangrene.

The right shoes can make a difference. “If someone with diabetes develops a wound from going barefoot or due to

PHOTO: RILEY WHITE

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iabetes is officially the 7th-leading cause of death in the United States. One of the most common problems caused by diabetes is limited blood flow to the legs and toes, which can lead to nerve damage — and worse.

“The No. 1 leading cause of lower-limb amputations in the United States is diabetes,” says Brian Lane, director of education at Dr. Comfort, a leading provider of diabetic footwear.

“Diabetic footwear helps to reduce those complications.”

some horrible shoes they’re wearing, we can help,” says Lane. Dr. Comfort offers a wide range of shoes specifically designed for people living with diabetes. “The shoes come with extra depth in the toe box and elsewhere to allow for deformities and swelling to occur,” he explains, “and a seamless interior lining to help prevent rubbing and sores, as well as a protective insert. It protects the bottom, top, and sides of the foot.”

When choosing a diabetic shoe, Lane suggests looking for Lycra or another stretchable fabric that can accommodate swelling. He also encourages everyone to have athletic shoes.

“Especially talking about type 2 diabetes and the elderly diabetic population — they tend to be overweight,” he says. “So, getting an athletic shoe will hopefully increase their activity level.” In addition to their range of shoes, Dr. Comfort also creates custom orthotic inserts specifically designed to prevent and manage the health issues associated with diabetes.

Finding the right fit Finding the right diabetic shoe starts with a footwear professional — typically a podiatrist or other doctor who gives the customer a prescription. “The shoes aren’t magic,” Lane notes. “It’s about the practi-

tioner — the podiatrist, orthotist, prosthetist — helping us select the most appropriate shoes in the correct size. It’s about proper fitting, proper footwear, and a little bit of education.” Dr. Comfort has a tool that helps customers locate a qualified footwear professional near them based on their zip code.

Diabetic footwear is typically covered by most insurance. “Medicare covers 80 percent of the cost because it’s durable medical equipment,” Lane explains. “So, the patient would be responsible for 20 percent of that cost. A lot of people have secondary insurance, Medicaid and so forth,

so that typically covers 100 percent if they have diabetes and one of six qualifying conditions — a previous amputation, history of an ulcer, history of a callus, diabetic neuropathy with evidence of callus formation, a foot deformity, or poor circulation.”

For Lane, matching diabetics with the right shoe and orthotic is more than good business — it’s lifesaving.

“Patients with one of those six risk factors are the highest risk. If they’ve had an ulcer, if they’ve had an amputation, they present the greatest risk to re-ulcerate, to get more callus formation. With people who have had one amputation, many will have a second amputation or die within five years. So, it’s not just about quality of life. Getting a pair of shoes and properly fitting some of these patients could potentially save their life.” n Jeff Somers

To learn more about diabetic footwear options, visit drcomfort.com/usatoday

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In today’s busy, digital-filled world, it is increasingly important to be able to pursue physical activity and balance in life. For people living with diabetes, physical activity is also a tool for managing the disease.

Leslie Cook, Vice President, EcoSox

This has been paid for by EcoSox.

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There are a ton of clothing products that enable outdoor enthusiasts to enjoy their activities, from shoes and underwear, to backpacks and parkas. People with diabetes have to be concerned with foot health, and avoid blistering and ulcers, which can lead to foot amputation in some cases.

As consumers, people with diabetes make choices based on what offers the greatest foot health solution. In the past, they likely found it necessary to compromise when it came to socks and outdoor gear.

Today, that compromise is no longer necessary. EcoSox has created diabetic hiking socks that combine the qualities needed in a diabetic sock with the comfort and cushioning required of a hiking sock. EcoSox uses cellulose-derived yarn that has inherent silk-like softness to reduce rubbing and blistering.

The yarn is also six times more absorbent than cotton, which helps keep feet dry.

A dry foot is important to diabetics because moisture provides an environment for microbes to grow.

When it comes to socks, diabetics no longer have to compromise with their outdoor gear.

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AI

Using Artificial Intelligence to Better Manage Diabetes

The Sock That’s Helping Diabetics Enjoy the Outdoors

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New technology is giving us deeper insights into our own health than ever before. Noosheen Hashemi, founder of January AI, talks about how her company is using health information to help people living with diabetes manage the disease.

What led you to create January AI? After a few experiences with family members and friends, I became passionate about prevention and whole-person health. Continuous monitoring devices like Apple Watch and Fitbit that measure heart rate, and Abbott FreeStyle Libre and Dexcom that measure blood glucose provide opportunities to look at trends over time and, with the help of artificial intelligence, dial lifestyle to optimize it to the best of our abilities.

Figuring out what to eat, when and how much to exercise, and how to get the most restful sleep are vital to healthspan, especially for those with diabetes and prediabetes.

Can you discuss the importance of nutritional support for people living with diabetes and the prediabetic community?

Studies show that people can have a wide range of responses to many foods and this is due to a variety of factors

READ MORE AT FUTUREOFPERSONALHEALTH.COM

unique to every person. January AI helps consumers stay in control of their health by offering a personalized roadmap. By using predictive machine learning capabilities, we provide helpful nutritional information before people with prediabetes and diabetes select what foods to eat.

The January AI Season of Me program gives users personalized insights on how diet, exercise, and sleep affect their blood sugar in real time, allowing people to incorporate these new findings in a way that is meaningful to them.

January AI is the first precision health company that accurately predicts users’ blood sugar response to over 16 million foods — including groceries, recipes, and restaurant menus.

Why stress the body and use it to figure out what and how much you should eat, when you can use AI to tell you the same thing?

With rates of diabetes rising nationwide, what can people do to better understand their glycemic responses in order to manage and even prevent the development of diabetes?

It’s estimated that 34 million people have diabetes and 88 million have prediabetes in the United States today.

With half of the U.S. population having metabolic disease or being on their way to developing it, we need to realize that one-size-fits-all solutions are not working.

The Diabetes Prevention Program, or DPP, was created in 2002, well before popular continuous glucose monitors, smart phones, and watches hit the market. The best DPP programs, and

there are at least 1,800 out there, can help half of the participants lose 5 percent of their weight.

We can dramatically improve outcomes with personalized solutions. We can help people make small changes in their daily lives that make the biggest impact. With machine learning, we build models for each person and we can learn across populations.

How does metabolic health relate to diabetes? What should our readers know about the “diabetic spectrum?”

In the United States, unhealthy food is all around us, and we’re in an epidemic of metabolic disease. Metabolic health factors, such as blood sugar, triglycerides, high-density lipoprotein, cholesterol, blood pressure, and waist circumference directly relate to a person’s risk for heart disease, stroke, and diabetes. Metabolic syndrome and type 2 diabetes, impair the body’s ability to metabolize glucose.

So knowing the impact of food on blood glucose level before you eat — critical information that January AI provides with precision medicine and AI — is key. That information allows you to know exactly what foods can and will impact your blood glucose level. January AI helps people across the metabolic health spectrum build better habits.

The Diabetic spectrum includes type 1, type 2, gestational diabetes, and prediabetes. No matter where you fall on the spectrum, actively understanding how diet and activity affect your glucose levels can positively affect your health. n This has been paid for by January AI.

prevent amputations. These revascularization procedures can help restore blood flow to the lower extremities and improve wound care, which is particularly important for people with diabetes.

Unfortunately, for many Americans, including many with diabetes, these screenings are often not taking place.

Proper foot care is an essential component of diabetes management, though it is often an overlooked aspect, particularly as patients go in for their regular visits with their health providers.

How to Prevent Unnecessary Diabetes-Related Amputations

Every four minutes, an American loses a limb due to diabetes. This doesn’t have to be the case.

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here are a l m o s t 200,000 amputations that take place in America each year, meaning that an American loses a limb every four minutes due to diabetes. This problem is particularly pronounced among minority populations.

In fact, Black Americans face rates of amputation that are more than twice as high as white Americans.

Research shows that as

much as 60 percent of these procedures are preventable through screening, diagnostic testing, earlier interventions, and proper diabetes management.

People with diabetes are at an increased risk for developing complications that can sometimes lead to amputations. Many of these complications include peripheral arterial disease, lower limb neuropathy, or wounds or ulcers that are slow to heal.

It’s important that people with neuropathy know that, because of the neuropathy, they may not experience normal sensation in their feet. This becomes critically important, especially if they have poor fitting shoes or step on something while barefoot. Normally, we would have pain from these things, but people with neuropathy may feel nothing at all. This can lead to the formation of a foot ulcer, which, if infected, can be

quite serious and potentially lead to amputations.

Preventing amputations Fortunately, medical science has advanced a great deal in a very short amount of time.

Screenings for such conditions are widely available and have been demonstrated to be highly effective at preventing unnecessary amputations.

Additionally, minimally invasive surgical procedures are now available to these patients, which can also help

Early detection As with most conditions, earlier interventions are better.

The best thing people can do is check their feet, specifically the bottoms, every day. If they have neuropathy, they might even need to use a mirror to see the bottoms of their feet and make sure they have no cuts or ulcerations.

If they have neuropathy, they should probably be seeing a podiatrist to prevent calluses and ulcers, and focus on good blood sugar control, as that is the most important key to prevention. One does this through appropriate diet and exercise, medication and monitoring, and ensuring they see their healthcare provider on a regular basis.

Together, we can reduce the number of amputations that take place every year and even save lives. n

Dr. Robert Gabbay, Chief Scientific and Medical Officer, American Diabetes Association

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