Type 2 Diabetic Foot Problems

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It’s Q&A Day!

Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

So, no question/request too big or small

Q: I’d like to know more about type 2 diabetic foot problems

You probably know that the “foot problems” thing has less to do with the feet and more to do with blood and nerves. So, why the feet?

The reason feet often get something like the worst of it, is because they are extremities, and in the case of blood sugars being too high for too long too often, they’re getting more damage as blood has to fight its way back up your body. Diabetic neuropathy happens when nerves are malnourished because the blood that should be keeping them healthy, is instead syrupy and sluggish.

We’ll definitely do a main feature sometime soon on keeping blood sugars healthy, for both types of diabetes plus pre-diabetes and just general advice for all.

In the meantime, here’s some very good advice on keeping your feet healthy in the context of diabetes. This one’s focussed on Type 1 Diabetes, but the advice goes for both:

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  • Curious Kids: what are the main factors in forming someone’s personality?

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    “What are the main factors in forming someone’s personality?” – Emma, age 10, from Shanghai

    Hello Emma, and thank you for this very interesting question!

    Let’s start by exploring what we mean by personality. Have you noticed no two people are completely alike? We all see, experience, and understand the world in different ways.

    For example, some people love spending time with friends and being the centre of attention, whereas other people are more shy and enjoy having time to themselves.

    Your unique personality is shaped by your genes as well as various influences in your environment. And your personality plays an important role in how you interact with the world.

    The big five

    Did you know there are scientists who spend time researching personality? Their research is concerned with describing the ways people differ from each other, and understanding how these differences could be important for other parts of life such as our health and how well we do in school or at work.

    There are many different perspectives on personality. A widely accepted viewpoint based on a lot of research is called the five factor model or the “big five”. According to this theory, a great deal of a person’s personality can be summarised in terms of where they sit on five dimensions, called traits:

    1. the introversion-extraversion trait refers to how much someone is outgoing and social (extroverted) or prefers being with smaller groups of friends or focusing on their own thoughts (introverted)
    2. agreeableness captures how much someone tends to be cooperative and helps others
    3. openness to experience refers to how much a person is creative and enjoys experiencing new things
    4. neuroticism describes a person’s tendency to experience negative feelings, like worrying about things that could go wrong
    5. conscientiousness encompasses how much a person is organised, responsible, and dedicated to things that are important to them, like schoolwork or training for a sports team.

    A person can have high, low, or moderate levels of each of these traits. And understanding whether someone has higher or lower levels of the big five can tell us a lot about how we might expect them to behave in different situations.

    So what shapes our personalities?

    A number of factors shape our personalities, including our genes and social environment.

    Our bodies are made up of many very small structures called cells. Within these cells are genes. We inherit genes from our parents, and they carry the information needed to make our bodies and personalities. So, your personality may be a bit like your parents’ personalities. For example, if you’re an outgoing sort of person who loves to meet new people, perhaps one or both of your parents are very social too.

    A mother getting her son ready, fastening his backpack.
    Our personalities are influenced by the genes we get from our parents.
    KieferPix/Shutterstock

    Personalities are also affected by our environment, such as our experiences and our relationships with family and friends. For example, some research has shown our relationships with our parents can influence our personality. If we have loving and warm relationships, we may be more agreeable and open. But if our relationships are hurtful or stressful, this may increase our neuroticism.

    Another study showed that, over time, young children who were more physically active were less introverted (less shy) and less likely to get very upset when things don’t go their way, compared to children who were less physically active. Although we don’t know why this is for sure, one possible explanation is that playing sport leads to reduced shyness because it introduces children to different people.

    While we’re learning more about personality development all the time, research in this area presents quite a few challenges. Many different biological, cultural and environmental influences shape our development, and these factors can interact with each other in complex ways.

    Is our personality fixed once we become adults?

    Although we develop most of our personality when we are young, and people’s personalities tend to become more stable as they get older, it is possible for aspects of a person’s personality to change, even when they are fully grown.

    A good example of this can be seen among people who seek treatment for conditions like anxiety or depression. People who respond well to working with a psychologist can show decreases in neuroticism, indicating they become less likely to worry a lot or feel strong negative feelings when something stressful happens.

    Hello, Curious Kids! Do you have a question you’d like an expert to answer? Ask an adult to send your question to mailto:curiouskids@theconversation.edu.auThe Conversation

    Tim Windsor, Professor, Director, Generations Research Initiative, College of Education, Psychology and Social Work, Flinders University and Natalie Goulter, Lecturer, College of Education, Psychology and Social Work, Flinders University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • 10 Tips To Reduce Morning Pain & Stiffness With Arthritis

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    Physiotherapist and osteoarthritis specialist Dr. Alyssa Kuhn has professional advice:

    Just the tips

    We’ll not keep them a mystery; they are:

    1. Perform movements that target the range of motion in stiff joints, especially in knees and hips, to prevent them from being stuck in limited positions overnight.
    2. Use relaxation techniques like a hot shower, heating pad, or light reading before bed to reduce muscle tension and stiffness upon waking.
    3. Manage joint swelling during the day through gentle movement, compression sleeves, and self-massage .
    4. Maintain a balanced level of activity throughout the day to avoid excessive stiffness from either overactivity or, on the flipside, prolonged inactivity.
    5. Use pillows to support joints, such as placing one between your knees for hip and knee arthritis, and ensure you have a comfortable pillow for neck support.
    6. Eat anti-inflammatory foods prioritizing fruits and vegetables to reduce joint stiffness, and avoid foods high in added sugar, trans-fats, and saturated fats.
    7. Perform simple morning exercises targeting stiff areas to quickly relieve stiffness and ease into your daily routine.
    8. Engage in strength training exercises 2–3 times per week to build stronger muscles around the joints, which can reduce stiffness and pain.
    9. Ensure you get 7–8 hours of restful sleep, as poor sleep can increase stiffness and pain sensitivity the next day. 10almonds note: we realize there’s a degree of “catch 22” here, but we’re simply reporting her advice. Of course, do what you can to prioritize being able to get the best quality sleep you can.
    10. Perform gentle movements or stretches before bed to keep joints limber, focusing on exercises that feel comfortable and soothing.

    For more on each of these plus some visual demonstrations, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Take care!

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  • Get Fitter As You Go

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    Dr. Jaime Seeman: Hard To Kill?

    This is Dr. Jaime Seeman. She’s a board-certified obstetrician-gynecologist with a background in nutrition, exercise, and health science. She’s also a Fellow in Integrative Medicine, and a board-certified nutrition specialist.

    However, her biggest focus is preventative medicine.

    What does she want us to know?

    The Five Pillars of being “Hard to Kill”!

    As an athlete when she was younger, she got away with poor nutrition habits with good exercise, but pregnancy (thrice) brought her poor thyroid function, other hormonal imbalances, and pre-diabetes.

    So, she set about getting better—not something the general medical establishment focuses on a lot! Doctors are pressured to manage symptoms, but are under no expectation to actually help people get better.

    So, what are her five pillars?

    Nutrition

    Dr. Seeman unsurprisingly recommends a whole-foods diet with lots of plants, but unlike many plant-enjoyers, she is also an enjoyer of the ketogenic diet.

    While keto-enthusiasts say “carbs are bad” and vegans say “meat is bad”, the reality is: both of those things can be bad, and in both cases, avoiding the most harmful varieties is a very good first step:

    Movement

    This is in two parts:

    • get your 150 minutes of moderate exercise per week
    • keep your body mobile!

    See also:

    Sleep

    This one’s quite straightforward, and Dr. Seeman uncontroversially recommends getting 7–9 hours per night; yes, even you:

    Mindset

    This is key to Dr. Seeman’s approach, and it is about not settling for average, because the average is undernourished, overmedicated, sedentary, and suffering.

    She encourages us all to keep working for better health, wherever we’re at. To not “go gentle into that good night”, to get stronger whatever our age, to showcase increasingly robust vitality as we go.

    To believe we can, and then to do it.

    Environment

    That previous item usually won’t last beyond a 10-day health-kick without the correct environment.

    As for how to make sure we have that? Check out:

    Our “food environments” affect what we eat. Here’s how you can change yours to support healthier eating

    Want more?

    She does offer coaching:

    Hard To Kill Academy: Master The Mindset To Maximize Your Years

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  • Mythbusting The Big O

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    “Early To Bed…”

    In yesterday’s newsletter, we asked you for your (health-related) views on orgasms.

    But what does the science say?

    Orgasms are essential to good health: True or False?

    False, in the most literal sense. One certainly won’t die without them. Anorgasmia (the inability to orgasm) is a condition that affects many postmenopausal women, some younger women, and some men. And importantly, it isn’t fatal—just generally considered unfortunate:

    Anorgasmia Might Explain Why You’re Not Orgasming When You Want To

    That article focuses on women; here’s a paper focusing on men:

    Delayed Orgasm and Anorgasmia

    Orgasms are good for the health, but marginally: True or False?

    True! They have a wide array of benefits, depending on various factors (including, of course, one’s own sex). That said, the benefits are so marginal that we don’t have a flock of studies to cite, and are reduced to pop-science sources that verbally cite studies that are, alas, nowhere to be found, for example:

    Doubtlessly the studies do exist, but are sparse enough that finding them is a nightmare as the keywords for them will bring up a lot of studies about orgasms and health that aren’t answering the above question (usually: health’s affect on orgasms, rather than the other way around).

    There is some good science for post-menopausal women, though! Here it is:

    Misconceptions About Sexual Health in Older Women

    (if you have the time to read this, this also covers many very avoidable things that can disrupt sexual function, in ways that people will errantly chalk up to old age, not knowing that they are missing out needlessly)

    Orgasms are good or bad, depending on being male or female: True or False

    False, broadly. The health benefits are extant and marginal for almost everyone, as indicated above.

    What’s that “almost” about, then?

    There are a very few* people (usually men) for whom it doesn’t go well. In such cases, they have a chronic and lifelong problem whereby orgasm is followed by 2–7 days of flu-like and allergic symptoms. Little is known about it, but it appears to be some sort of autoimmune disorder.

    Read more: Post-orgasmic illness syndrome: history and current perspectives

    *It’s hard to say for sure how few though, as it is surely under-reported and thus under-diagnosed; likely even misdiagnosed if the patient doesn’t realize that orgasms are the trigger for such episodes, and the doctor doesn’t think to ask. Instead, they will be busy trying to eliminate foods from the diet, things like that, while missing this cause.

    Orgasms are better avoided for optimal health: True or False?

    Aside from the above, False. There is a common myth for men of health benefits of “semen retention”, but it is not based in science, just tradition. You can read a little about it here:

    The short version is: do it if you want; don’t if you don’t; the body will compensate either way so it won’t make a meaningful difference to anything for most people, healthwise.

    Small counterpoint: while withholding orgasm (and ejaculation) is not harmful to health, what does physiologically need draining sometimes is prostate fluid. But that can also be achieved mechanically through prostate milking, or left to fend for itself (as it will in nocturnal emissions, popularly called wet dreams). However, if you have problems with an enlarged prostate, it may not be a bad idea to take matters into your own hands, so to speak. As ever, do check with your doctor if you have (or think you may have) a condition that might affect this.

    One final word…

    We’re done with mythbusting for today, but we wanted to share this study that we came across (so to speak) while researching, as it’s very interesting:

    Clitorally Stimulated Orgasms Are Associated With Better Control of Sexual Desire, and Not Associated With Depression or Anxiety, Compared With Vaginally Stimulated Orgasms

    On which note: if you haven’t already, consider getting a “magic wand” style vibe; you can thank us later (this writer’s opinion: everyone should have one!).

    Top tip: do get the kind that plugs into the wall, not rechargeable. The plug-into-the-wall kind are more powerful, and last much longer (both “in the moment”, and in terms of how long the device itself lasts).

    Enjoy!

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  • Pistachios vs Pecans – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing pistachios to pecans, we picked the pistachios.

    Why?

    Firstly, the macronutrients: pistachios have twice as much protein and fiber. Pecans have more fat, though in both of these nuts the fats are healthy.

    The category of vitamins is an easy win for pistachios, with a lot more of vitamins A, B1, B2, B3, B6, B9, C, and E. Especially the 8x vitamin A, 7x vitamin B6, 4x vitamin C, and 2x vitamin E, and as the percentages are good too, these aren’t small differences. Pecans, meanwhile, boast only a little more vitamin B5 (pantothenic acid, the one whose name means “it’s everywhere”, because that’s how easy it is to get it).

    In terms of minerals, pistachios have more calcium, iron, phosphorus, potassium, and selenium, while pecans have more manganese and zinc. So, a fair win for pistachios on this one.

    Adding up the three different kinds of win for pistachios means that *drumroll* pistachios win overall, and it’s not close.

    As ever, do enjoy both though, because diversity is healthy!

    Want to learn more?

    You might like to read:

    Take care!

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  • Magic mushrooms may one day treat anorexia, but not just yet

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Anorexia nervosa is a severe mental health disorder where people fear weight gain. Those with the disorder have distorted body image and hold rigid beliefs their body is too big. They typically manage this through restricted eating, leading to the serious medical consequences of malnutrition.

    Anorexia has one of the highest death rates of any mental illness. Yet there are currently no effective drug treatments and the outcomes of psychotherapy (talk therapy) are poor. So we’re desperately in need of new and improved treatments.

    Psilocybin, commonly known as magic mushrooms, is one such novel treatment. But while it shows early promise, you won’t see it used in clinical practice just yet – more research is needed to test if it’s safe and effective.

    Ground Picture/Shutterstock

    What does treatment involve?

    The treatment involves the patient taking a dose of psilocybin in a safe environment, which is usually a specifically set up clinic. The patient undergoes preparation therapy before the dosing session and integration therapy after.

    Psilocybin, extracted from mushrooms, is a psychedelic, which means it can produce altered thinking, sense of time and emotions, and can often result in hallucinations. It also has the potential to shift patients out of their rigid thinking patterns.

    Psilocybin is not administered alone but instead with combined structured psychotherapy sessions to help the patient make sense of their experiences and the changes to their thinking. This is an important part of the treatment.

    What does the research show?

    Research has shown improved effects of psilocybin-assisted psychotherapy after one or two dosing sessions, a couple of weeks apart. Most research to date has targeted depression.

    Psilocybin has been found to increase cognitive flexibility – our ability to adjust our thinking patterns according to changing environments or demands. This is one of the ways researchers believe psilocybin might improve symptoms for conditions such as depression and alcohol use disorder, which are marked by rigid thinking styles.

    People with anorexia similarly struggle with rigid thinking patterns. So researchers and clinicians have recently turned their attention to anorexia.

    In 2023, a small pilot study of ten women with anorexia was published in the journal Nature Medicine. It showed psilocybin-assisted psychotherapy (with 25mg of psilocybin) was safe and acceptable. There were no significant side effects and participants reported having valuable experiences.

    Although the trial was not a formal efficacy trial, 40% of the patients did have significant drops in their eating disorder behaviour.

    However, the trial only had one dosing session and no long-term follow up, so further research is needed.

    Lab technician holds mushroom with tweezer
    Researchers are still working out dosages and frequency. 24K-Production/Shutterstock

    A recent animal study using rats examined whether rigid thinking could be improved in rats when given psilocybin. After the psilocybin, rats gained weight and had more flexible thinking (using a reversal learning task).

    These positive changes were related to the serotonin neurotransmitter system, which regulates mood, behaviour and satiety (feeling full).

    Brain imaging studies in humans show serotonin disturbances in people with anorexia. Psilocybin-assisted psychotherapy is showing promise at modifying the serotonin disturbances and cognitive inflexibility that have been shown to be problematic in anorexia.

    Research with animals can provide unique insights into the brain which can sometimes not be investigated in living humans. But animal models can never truly mimic human behaviour and the complex nature of chronic mental health conditions.

    What’s next for research?

    Further clinical trials in humans are very much needed – and are underway from a research team at the University of Sydney and ours at Swinburne.

    Our trial will involve an initial 5mg dose followed by two subsequent doses of 25mg, several weeks apart. An initial low dose aims to help participants prepare for what is likely to be a new and somewhat unpredictable experience.

    Our trial will examine the usefulness of providing psychotherapy that directly addresses body image disturbance. We are also investigating if including a family member or close friend in the treatment increases support for their loved one.

    Drazen Zigic/Shutterstock
    We’re investigating whether including a family member or close friend in treatment could help. Shutterstock

    Data from other mental health conditions has suggested that not everyone sees benefits, with some people having bad trips and a deterioration in their mental health. So this treatment won’t be for everyone. It’s important to work out who is most likely to respond and under what conditions.

    New trials and those underway will be critical in understanding whether psilocybin-assisted psychotherapy is a safe and effective treatment for anorexia, and the optimal conditions to improve the patient’s response. But we are some way off from seeing this treatment in the clinic. One of the big issues being the cost of this intervention and how this will be funded.

    Susan Rossell, Director Clinical Trials and Professor Cognitive Neuropsychiatry Centre for Mental Health and Brain Sciences, Swinburne University of Technology and Claire Finkelstein, Clinical Psychologist and PhD candidate, Swinburne University of Technology

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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