There are three main types of diabetes: type 1 where the body does not produce insulin; type 2 where there is resistance to insulin; and gestational diabetes during pregnancy. Diabetes is caused by high blood sugar levels and symptoms include increased thirst and urination. It is diagnosed through blood tests and managed through lifestyle changes like diet, exercise, and sometimes medication or insulin depending on the type. Complications can affect the feet, eyes, kidneys, heart and nerves if blood sugar levels are not well controlled. Proper foot care and blood glucose monitoring are important for diabetes management and prevention of complications.

1. Diabetes mellitus is a disease caused by deficiency or
diminished effectiveness of internal insulin.
MAIN TYPES:
a) Type 1(10%): Body fails to produce sufficient
insulin
b) Type 2 (90%): Resistance to the insulin
c) Gestational diabetes: Diabetes developed only
during pregnancy
HYPERGLYCEMIA ( BLOOD SUGAR LEVELS)
WARNING SIGNS
 Increased thirst/ hunger
 Weight loss
 Frequent urination
 Numbness/ Tingling of
hands/ feet
 Tiredness, loss of energy
 Frequent Fungal infection
 Slow healing of wounds
 Blurred vision
 Dry mouth & itchy skin
 Family History
 Alcohol, Smoking, Stress
 Over weight (wrong
eating habits)
 History of high BP
 History of gestational
Diabetes
 Autoimmune Disease
 Abnormal blood
cholesterol level
 Old age
DIAGNOSIS
TREATMENT OPTIONS
 Type 1: Insulin
 Type 2: Oral tablets, Insulin or both
 Gestational: Insulin
GLYCEMIC TREATMENT GOAL
TESTS
OUT- PATIENT
NON PREGNANT PREGNANT
FBS <110 -
Pre prandial - ≤95
Post prandial <140
After 1 hr ≤140
After 2hr ≤120
HbA1C ≤6.5% -
HYPOGLYCEMIA ( BLOOD SUGAR LEVELS)
RISK FACTORS
 Sweating
 Shaking
 Immediate hunger
 light-headed/ confusion
 Lack of coordination
 Blurred vision
 Irritability
 Euphoria
 Unconsciousness
 Missing a meal or snack
 Poor nutrition intake
 Strenuous physical
activity
 Too much Insulin/ Oral
anti-diabetic agents
 Advanced age
MANAGEMENT
 Always carry sugar candy
 3 teaspoon of glucose powder in 1 glass of water
 2-3 sugary candies
 3 teaspoon of honey or jam
A. FOOD
 Small frequent meals
 Whole grains, oats, channa atta, millets and
other high fibre foods
 High fibre vegetables such as peas, beans, broccoli
and spinach /leafy vegetables
 Milk
 Pulses/ DAL.
 Good fats such as Omega-3 fatty acid.
 Fruits high in fibre such as papaya, apple, orange,
pear and guava should be consumed. Mangoes,
bananas, and grapes contain high sugar; therefore
should be consumed less/ avoided
B. PHYSICAL ACTIVITY
 150 mins (minimum) per week of moderate
intensity aerobic exercise for at least 2 or more
days per week
 Avoid exercising in extreme weather, empty
stomach and inadequately controlled blood
sugar levels
C. REDUCTION OF MODIFIABLE RISK FACTORS
 Achieve glucose, lipid and blood pressure goals
Blood Pressure <130/80mmHg
 Smoking cessation
 Weight reduction, if appropriate
D. DENTAL CARE: Yearly check-up
E. EYE CARE: Yearly check-up
LOW CARBO-
HYDRATE
VEGETABLES
GRAINS/
STARCHY
VEGETABLES
PROTEINS
PLATE- METHOD
FRUITS
DAIRY
TESTS NORMAL PREDIABETIC DIABETIC GESTATIONAL
FBS < 100 100- 125 ≥ 126 ≥ 92
RBS <140 - ≥ 200 -
OGTT - 140-199 > 200 After 1Hr: ≥ 180
After 2Hr: ≥ 153
HbA1C < 5.6% 5.7- 6.4% ≥ 6.5% -
WARNING SIGNS RISK FACTORS
WARNING SIGNS RISK FACTORS
MANAGEMENT
PREVENT DIABETES STAT- SCREEN/ TEST/ ACT TODAY
DIABETIC CARE

2. DIABETES COMPLICATIONS
MAINTAIN CHECK USING A GLUCOMETER
Step 1: Get a blood sample
Use your lancing device and a new lancet to get
a drop of blood from your fingertip
Step 2: Apply blood to strip
Apply the blood droplet to the test strip when
the blood droplet symbol
Step 3: Read the appeared result
Your meter will count down and display the
result of your blood glucose level
Step 4: Record the result
Complication
s
FOOT
DAMAGE
NERVE
DAMAGE
KIDNEY
DAMAGE
HEART
DAMAGE
BLOOD VESSEL
DAMAGE
EYE
DAMAGE
Wash your feet in warm
water every day
Dry your feet well especially
between toes
Keep skin soft with
moisturizing lotion, but do not
apply between toes
Inspect your feet every day for
bruises, swelling or cuts. Seek
medical attention if abnormality
+
Trim your toe nails carefully,
seek medical advise on trimming
Wear soft, clean and fitting
socks
Keep your feet warm and dry,
Always wear comfortable shoes
Never walk barefoot indoor
or outdoor
Examine your shoes every
day for pebbles, cracks
anything that could hurt
your feet
DIABETIC FOOT CARE
Prepared By:
Dr. Rachana Shetty (PharmD)
Dr. Anam Sohail (PharmD)
Dr. Beegum Sheena Karim
(PharmD)