One in four people in the U.S. over age 60 are living with diabetes. Controlling diabetes is hard work. It takes a lot of effort and care to manage your blood sugar and insulin levels. It can literally take a team of people to keep your diabetes under control – a primary care physician, a dietitian, an endocrinologist, an eye doctor and a podiatrist, just to name a few.

In 2012, with nearly 47 million Americans lacking health insurance, limited access to affordable health care made seeing a doctor regularly difficult for many. Thanks to the Affordable Care Act, regular visits to the doctor are now a viable financial option for most people.

What the Affordable Care Act Does

According to information on the Joslin Diabetes Center website, the ACA not only prevents health insurance companies from denying you health care due to pre-existing conditions such as diabetes, but it also “requires essential health benefits that are of particular value to people with diabetes, such as coverage for outpatient care, mental health care, lab tests and prescription medications.” And if you can’t afford health insurance, check to see if you are eligible for one of the new exchanges. Make sure to consider the pointers on the Joslin Diabetes Center’s Advocacy and Government Affairs page.

If you have access to health care and still opt out of managing your diabetes, the consequences can be grave. Affecting nearly every organ in the body, diabetes can cause:

• Heart disease and vascular problems: Adults with diabetes have heart disease death rates about two to four times higher than adults without diabetes. The risk for stroke is two to four times higher.
• Eye disorders and blindness: Studies show that regular eye exams and timely treatment of diabetes-related eye problems could prevent up to 90% of diabetes-related blindness.
• Kidney disease: Diabetes is the leading cause of kidney failure in adults in the U.S., accounting for 44% of new cases in 2008.
• Nerve damage: Approximately 60-70% of people with diabetes have some form of nerve damage, which can cause pain in the legs, arms and hands.
• Gum disease
• Loss of limbs: About 15% of people with diabetes who have a foot ulcer will need an amputation.

Reducing Amputation Risk

The American Podiatric Medical Association reports that more than 65,000 lower limbs are amputated every year due to complications from diabetes. They also say that once a limb has been amputated there is a 50% chance that the other one will be amputated within 3 to 5 years of the initial surgery. The site suggests that including a podiatrist in your diabetes care “can reduce the risk of lower limb amputation up to 85% and lowers the risk of hospitalization by 24%.”

Dr. Elliot Diamond is a podiatrist in Philadelphia and has seen firsthand what happens when you get lazy about caring for diabetes. What’s the most important thing to focus on? “Prevention, prevention and even more prevention,” says Dr. Diamond.

For individuals with diabetes, prevention and prompt care of foot problems such as ulcers, blisters, ingrown nails and cuts is essential before they become more serious and could lead to an amputation. According to Dr. Diamond, it is estimated that 85% of diabetic amputations could be avoided “if the individual completed daily foot checks and notified their podiatrist or general practitioner at the first sign of a potential problem. Be your own first line of defense.”

What You Can Do

Dr. Diamond gave us a few pointers about the ideal ways in which you can care for you feet.

  1. Screen your feet every day. Check for redness, cracks, blisters, ingrowing nails, callouses, corns and cuts. Use a mirror if need be to see the bottom of your feet. Remember that many diabetics experience partial or total loss of sensitivity, so pain is not always present with these warning signs.
  2. Use your common sense in choosing shoes. Pick shoes that are best for your individual foot type. They need to have a wide toe box, provide good support and not apply too much pressure on your toes, heel bottom or the back of your heel. Never wear hand-me-down shoes as they will not fit you properly and could lead to problems.
  3. Visit a podiatrist every two to three months. And make sure to visit them right away if there is any change in your perceived foot health.
  4. Walk and exercise on a daily basis. Make sure to wear comfortable shoes when you do.
  5. Remember: prevention, prevention and even more prevention.

To learn more about this topic:
Type 1 Diabetes: Complications
Type 2 Diabetes: Complications
Avoiding Diabetes Complications

Hilary Young is the Communications Manager for Medical Guardian. She helps to keep baby boomers and their loved ones educated about their health and wellbeing. She is also a regular contributor to the Medical Guardian Blog, the Huffington Post, and