Sandal Wearing Guidelines for People with Diabetes
If you have diabetes and are wondering if you should not wear sandals, there is definitely something you must first do before you take to wearing sandals.
And that is to see a doctor.
“If a diabetic has neuropathy and/or peripheral vascular disease, then sandals and open toed shoes are to be avoided,” says Peter D. Highlander, DPM, Reconstructive Foot & Ankle Surgeon, Director, Wound Reconstruction Center, The Bellevue Hospital, Bellevue OH.
This includes sandals and open toed footwear that are flat.
“If a person is unsure if they have neuropathy or PVD, then they should make an appointment with their local podiatrist [foot doctor],” advises Dr. Highlander.
Neuropathy from Diabetes
Many diabetics have or will develop peripheral neuropathy.
This condition is characterized by the inability to feel pain from a foot sore or injury such as a cut or laceration.
Wearing sandals means an increased risk of foot or toe injury – for obvious reasons.
What might be an innocuous scratch to a nondiabetic can turn out to be a nightmare for the person with diabetes — either type 1 or type 2.
And people who don’t have diabetic neuropathy or any other issues with their sensory nerves will immediately know when there is an injury or skin tear – and treat it.
If they don’t treat it and it becomes infected, they will surely feel this and then treat it.
The diabetic may miss this opportunity that’s triggered by sensory nerves.
Left untreated (because neuropathy blunts pain), a sore or cut can become infected, then become gangrenous and require amputation of part of the foot or even the leg.
PVD
Peripheral vascular disease is hardening of the arteries in the legs/feet. PVD can cause many symptoms including painful walking, for which sandals would not be a smart idea for obvious reasons.
However, PVD can also result in sores in the feet or toes that won’t heal.
In summary, if your feet are at risk for sustaining unhealed wounds or injuries, you just should not wear sandals – even on the hottest days.
Dr. Highlander provides advanced treatment and prevention options for lower extremity wounds with a special interest in deformity correction and soft tissue coverage for non-healing wounds.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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How Many Elderly Have Undiagnosed Sleep Apnea?
Sleep apnea is one of the most under- and misdiagnosed conditions in the elderly; the estimated number who have it is alarmingly high, and this includes non-overweight as well as female older people.
Symptoms of sleep apnea in the elderly can easily mimic signs of other conditions such as “old age” and “age-related” fatigue, loss of energy, issues with concentration and falling asleep in front of the TV or while doing something else passive such as reading or crocheting.
“Sleep apnea is very common in the elderly, and some studies have shown a prevalence between 20 and 40%, and this prevalence steadily increases with advancing age,” says Daniel Rifkin, MD, a sleep medicine expert at the Sleep Medicine Centers of Western New York.
“This is almost double the prevalence in the younger adult populations!
“Because untreated obstructive sleep apnea is associated with heart disease and strokes, among many other medical conditions, and worsens quality of life, we should focus our efforts on treating our older patients.
“Instead of laughing at grandma falling asleep at the kitchen table during lunch or dinner, we should take it seriously and urge her to get her sleep evaluated.”
Excessive Daytime Sleepiness Is NOT Normal in the Elderly
It’s likely due to obstructive sleep apnea.
This is what University of Michigan researchers have found.
According to their study, 56% of people over 65 have a high risk of obstructive sleep apnea.
How was the study done?
1,052 Medicare recipients completed a sleep questionnaire plus other surveys as part of the National Health and Aging Trends Study.
The study found that 94% of those at risk turned out to actually have OSA.
Though OSA is common, it’s one of the most misdiagnosed conditions.
One reason is that its symptoms mimic what seems to be the inevitable signs of advancing age.
Falling asleep in the middle of the day, during supper or having difficulty concentrating are signs that wouldn’t be as alarming in an elderly person as they would be in a 45-year-old. Thus, a diagnostic workup wouldn’t as likely be pursued.
The second reason is that it can’t be diagnosed with a simple blood test, biopsy sample or X-ray.
Rather, it requires a sleep study, and many people just do not want to get hooked up to wires overnight.
A third reason for the massive under-diagnosis of OSA in the elderly (and younger) is because many people anticipate being told they’ll need to “sleep with a mask” if they’re diagnosed. So they deny they might have OSA.
The study appears in the April 2018 Journal of the American Geriatrics Society.
Dr. Rifkin is board certified in both neurology and sleep medicine. He also treats insomnia, RLS and narcolepsy.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Source: newswise.com/articles/view/694298/?sc=mwhn underdiagnosed elderly, obstructive sleep apnea
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