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How often do you worry about diabetes complications?

May 24th, 2012
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I've always been used to humidity. I may not appreciate what it does to my curly, frizz-prone hair, but I'm used to it. Sixty to seventy percent humidity was fairly common growing up. I just never realized how much my skin appreciated the high humidity of my area.

 

My mom always said to like it since people in high humidity areas wrinkle less. I didn't make the connection until I moved and started experiencing the irritation of dry skin. Moving, just four hours away, sent me into a completely different climate where the air is typically dry and a lot colder than what I'm used to (except in summers when it's so much hotter than what I'm used to but without that humidity it's actually tolerable at 115 degrees).

 

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Fair warning: if you’re the teeniest bit squeemish or gross out easily don’t read this post because I will be talking about feet and the skin on feet and what happens when the skin on my feet gets dry.
 

So, I’m no stranger to dry feet. I’ve had them forever. Midwestern winters can do a number on tootsies and the constant lack of humidity in the desert can do the same. I know it’s a big diabetic no-no, but I prefer not to wear shoes. If I’m planning to walk on hot coals, I’ll wear shoes, but for the most part at home (and sometimes at my desk at the office) I choose to go shoeless.
 

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OK so it's not such a popular, appetizing topic, but as people with diabetes we need to be on top of our foot care.

 

I'm a picker: literal and figurative, but the figurative is not the focus of this post. Pimples, scabs, dry skin, dead skin, toe nails (though not my finger nails, interestingly), hang nails... you get the picture. Pretty much nothing is safe.

 

I'm actually pretty good about taking care of my feet. I do like to walk around without shoes on and I like to wear sandals and flip flops, so I have a fair amount of dry, dead skin and calouses. But I lotion those puppies up every night and once or twice a week I'll use the foot scrubber to get all the dead skin off or smooth out any big calouses.

 

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I'm six weeks into my Accutane treatment. My first month I had a 45% improvement from my starting point. The second month seems about the same, but we'll see in the next two weeks. I've had quite a few side effects. Dry lips being the worst. I'm only recently starting to experience extensive dry skin, leaving me with tiny red rashes much like eczema. I've had back pain, some joint pain, and a few headaches.

 

The worst side effect has been the effect it had on my blood sugars...forcing me to raise my Lantus and lower my insulin to carb ratios due to intense insulin resistance. Luckily, I've managed to get that into much better control. And I'm looking forward to it resolving once I'm done with this treatment.

 

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Call me a glutton for punishment, but I like to buy my shoes for their cute factor rather than their comfort. I have way too many pairs of shoes and boots to count. By majority, they are high heels, trendy, and semi-insane.

 

Usually, my feet don't really give me issues. I've heard and read plenty of things about how diabetics really have to watch for foot problems. I'm well aware that my feet do need a little extra care and attention.

 

But that doesn't usually stop me from wearing four inch heels or strappy sandals with absolutely no support. Because usually, nothing happens. I get a blister every now and then but they heal and I get over it. Who doesn't get blisters in four inch heels?

 

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Thursday morning, I woke up at 51 mg/dl. Friday morning, I was 50. Saturday, I woke up at 210 after a chocolate shake the night before and not enough insulin (210 was lower than I should have been). Sunday, 94. And this morning, a 65 mg/dl.

 

I've also been getting lower numbers from my morning Lantus peak (about 6 to 8pm since I take it between 10am and noon). Nothing too difficult, but a 64 there and an 88 there. Lows none the less.

 

I lowered my evening Lantus on Friday, after the two 50s. And Sunday, I lowered the morning Lantus as well. I still saw a low in the afternoon, but I think it was a mix of activity and a misjudged bolus. I held steady in the 110 to 120 range for almost twelve hours...something I haven't seen all that often lately.

 

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Dating has a lot to do with how comfortable you feel in your own skin and especially around that other person. Diabetes, PCOS, and any other health condition really can make comfort an extremely troubling thing. It's something that I've become very familiar with over the past few years.

 

Diabetes can make feeling "okay" or "right" a distant thing, a rare thing. Each range of numbers can throw your moods into tailspins. Lows make you weak, anxious. Highs make you irritable, crabby. Just knowing the number, even without the biological effects, can upset a perfectly even keel.

 

There are the bruises and bumps from years of insulin injections. The calluses on fingertips. Those things don't make you feel comfortable, sexy in your own skin. They remind you, they remind your lover that you aren't whole.

 

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It's my last day of Accutane. I've officially finished five grueling months of the "miracle drug." I cannot say that I'll miss it.

 

The first two months weren't unbearable. Increasingly dry skin, headaches, and off and on joint pain. Easy enough to handle. Even with the rising insulin resistance that started within two days of starting the drug.

 

Month three was a hurdle. A big one. Rashes on my arms, migraines, constant back pain, and the fatigue. Oh, the fatigue. Month four and five have been difficult as well. Muscle cramps, unquenchable thirst, insomnia, and all sorts of dryness. On top of that extensive fatigue.

 

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Three days, or until the insulin is all used up - that is how long an OmniPod is to be worn for. Before pumping, I was unsure if the scheduled three day replacement interval was going to be a nuisance. I even pondered the idea of trying to sneak in an extra day on the pods- so long as there was enough insulin stowed away in them. Well, that notion, along with a little of my patience, consistently scurries away when I near the end of a pod cycle, and the three day itch sets in. (READ MORE)


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It was easy to ignore diabetes when the effects of poor blood sugar management were intangible. When I don't feel sick, when I feel normal despite eating carb-laden foods and not countering with exercise or insulin, I felt like if I had complications they were so far down the road that I would just deal with it then.
And then, something happened. Something that could have been a result of poor diabetes care or just a fluke or just something that happens to me.
Most winters the heel of my right foot cracks badly enough-despite daily lotion therapy and foot scrubs in the shower at least once a week-that it's painful to walk. Most winters that crack gets bad enough that I pick at it until it opens up and I can peel off the dead skin. There's no blood, nothing unmanageable. It's then that I can walk normally. This is winter time, when dry, cracked feet are normal for me. (READ MORE)


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Michelle Kowalski
Michelle KowalskiMichelle Kowalski, a writer, editor and photography hobbiest living in Phoenix, was diagnosed with Type 2 diabetes in February 2005. In January 2008, as part of her quest to start on an insulin pump, Michelle learned that she actually has type 1 diabetes. (Read More)
Lindsey Guerin
Lindsey GuerinLindsey is a typical, yet unique, Texas girl who loves shopping, movies and reading. She loves to travel and take risks. She dreams of diabetes cures, never-ending cheesecake and her own airplane. The rest you can discover in her blog! (Read More)
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