By Kim Walter
FRONT ROYAL -- Barbara Faauaa was diagnosed as pre-diabetic before moving to Front Royal in 1990, but at the time she had no idea what that meant.
Now, the 73-year-old lives on her own, drives her own car and is proud today that she takes care of herself as a type 2 diabetic. Faauaa recently participated in a two-day diabetes education event at the Warren Memorial Hospital Outpatient Center for geriatric patients. Even through she's had the disease for about 18 years, she said there's always room to learn more.
"You know, I thought I was doing really good with my diabetes, but these talks have made me realize that I was going backwards with a few things," she said Wednesday morning. "We learned more about a little bit of everything, and it was very interesting."
The event touched on all aspects of the disease, with a particular focus on diet, exercise and foot care. Faauaa said a presentation on the amputations and infections that sometimes come from poorly managed diabetes scared her.
"Oh my goodness, it was horrible," she said. "If I learned anything, it's that you take care of your feet."
Yevgeny Kats, a podiatrist with Shenandoah Foot and Ankle Center, spoke to the group of participants about how to prevent such a gruesome outcome.
"I know you've all heard it before, but you have to mange your diabetes, your blood glucose levels," he said.
He explained that diabetics are more likely to develop problems with arteries and neuropathy. Unfortunately, diabetics specifically have issues with arteries in their lower legs.
Kats said damaged leg and foot arteries are harder to treat, which is why the outcomes are often more severe. The leading cause for non-traumatic amputations are diabetics, he added, which is a "significant problem."
"The biggest reason diabetics go to the hospital is because of foot infections," he said. "The thing that really gets me, though, is it can be avoided."
Diabetics should always work to keep their blood sugars from running high, and avoid smoking at all costs, Kats said. While they should also get checked for neuropathy, or damaged nerves, at least once a year by their doctor, diabetics can also conduct visual checks on their own every day.
It's important to be aware of calluses, blisters, cuts or any other skin breakage, Kats said. If anything like that shows up and doesn't heal normally, one should seek a doctor's attention immediately.
"If you let the loss of sensation in your feet go, it can impact so many other things," he said. "For instance, you lose the ability to feel if there's an object in your foot - and yes, I've seen it - and then it becomes infected, and then it's too late to do anything but amputate."
From there, a patient wouldn't be able to exercise as well or as often, so the initial nerve problem can impact heart health and life expectancy in the long run.
Kats suggested that diabetic men and women seek out comfortable running shoes for everyday use, instead of narrow, hard shoes that lend themselves more to fashion than anything else.
Diabetics should always try shoes on and take a few hours walking in them to make sure their toes or inside seams or laces aren't rubbing into skin. Socks should be worn as often as possible, but if sandals are the way to go, then Kats suggested using sunscreen on the tops of feet.
Faauaa said she recently found out that Medicare will supply her with a supportive pair of shoes for free each year, due to her diabetes. She hasn't had a problem with her feet yet, and plans to keep up that success as long as possible.
During the event, Mike Mitchell, a sports fitness instructor who often works with geriatrics at the outpatient center, also touched on the importance of exercise in diabetics. He said setting goals, big or small, will help patients feel better in the long run.
He explained that cardio is important, but patients shouldn't forget about resistance training.
"When you do the strength exercises, it actually pulls sugar from your blood for up to 72 hours," he said. "So it's not something you have to obsess over, you aren't expected to start lifting weights and bulk up, I'm just talking about maintaining the muscles you already have to prevent further injury and stay healthier, longer."
The center works with patients in the diabetes management program at the hospital, and Mitchell said he's seen a number of successes. Faauaa said she knows not to "sit and be a couch potato," and does a number of resistance exercises in the comfort of her home.
However, Faauaa admitted that she "falls off the wagon" from time to time. Sometimes she eats something high in sugar, and regrets it later. Other times she forgets her insulin shot or doesn't test her blood sugar as often as she should.
"It's all about willpower," she said.
Over the years, Faauaa has learned a number of dietary substitutions that allow her to keep her blood sugars at a more stable level. She might be tempted by friends who "load up their plates," but she's learned when to say no.
"When they told me I had this, I said, 'I am not ready to die,'" she said. "This is just part of my life now. I've got to be true to myself, have patience, bounce back from bad days ... but it could always be worse."
Contact staff writer Kim Walter at 540-465-5137 ext. 191, or firstname.lastname@example.org