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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  • ‘Noisy’ autistic brains seem better at certain tasks. Here’s why neuroaffirmative research matters

    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.

    Pratik Raul, University of Canberra; Jeroen van Boxtel, University of Canberra, and Jovana Acevska, University of Canberra

    Autism is a neurodevelopmental difference associated with specific experiences and characteristics.

    For decades, autism research has focused on behavioural, cognitive, social and communication difficulties. These studies highlighted how autistic people face issues with everyday tasks that allistic (meaning non-autistic) people do not. Some difficulties may include recognising emotions or social cues.

    But some research, including our own study, has explored specific advantages in autism. Studies have shown that in some cognitive tasks, autistic people perform better than allistic people. Autistic people may have greater success in identifying a simple shape embedded within a more complex design, arranging blocks of different shapes and colours, or spotting an object within a cluttered visual environment (similar to Where’s Wally?). Such enhanced performance has been recorded in babies as young as nine months who show emerging signs of autism.

    How and why do autistic individuals do so well on these tasks? The answer may be surprising: more “neural noise”.

    What is neural noise?

    Generally, when you think of noise, you probably think of auditory noise, the ups and downs in the amplitude of sound frequencies we hear.

    A similar thing happens in the brain with random fluctuations in neural activity. This is called neural noise.

    This noise is always present, and comes on top of any brain activity caused by things we see, hear, smell and touch. This means that in the brain, an identical stimulus that is presented multiple times won’t cause exactly the same activity. Sometimes the brain is more active, sometimes less. In fact, even the response to a single stimulus or event will fluctuate continuously.

    Neural noise in autism

    There are many sources of neural noise in the brain. These include how the neurons become excited and calm again, changes in attention and arousal levels, and biochemical processes at the cellular level, among others. An allistic brain has mechanisms to manage and use this noise. For instance, cells in the hippocampus (the brain’s memory system) can make use of neural noise to enhance memory encoding and recall.

    Evidence for high neural noise in autism can be seen in electroencephalography (EEG) recordings, where increased levels of neural fluctuations were observed in autistic children. This means their neural activity is less predictable, showing a wider range of activity (higher ups and downs) in response to the same stimulus.

    In simple terms, if we imagine the EEG responses like a sound wave, we would expect to see small ups and downs (amplitude) in allistic brains each time they encounter a stimulus. But autistic brains seem to show bigger ups and downs, demonstrating greater amplitude of neural noise.

    Many studies have linked this noisy autistic brain with cognitive, social and behavioural difficulties.

    But could noise be a bonus?

    The diagnosis of autism has a long clinical history. A shift from the medical to a more social model has also seen advocacy for it to be reframed as a difference, rather than a disorder or deficit. This change has also entered autism research. Neuroaffirming research can examine the uniqueness and strengths of neurodivergence.

    Psychology and perception researcher David Simmons and colleagues at the University of Glasgow were the first to suggest that while high neural noise is generally a disadvantage in autism, it can sometimes provide benefits due to a phenomenon called stochastic resonance. This is where optimal amounts of noise can enhance performance. In line with this theory, high neural noise in the autistic brain might enhance performance for some cognitive tasks.

    Our 2023 research explores this idea. We recruited participants from the general population and investigated their performance on letter-detection tasks. At the same time, we measured their level of autistic traits.

    We performed two letter-detection experiments (one in a lab and one online) where participants had to identify a letter when displayed among background visual static of various intensities.

    By using the static, we added additional visual noise to the neural noise already present in our participants’ brains. We hypothesised the visual noise would push participants with low internal brain noise (or low autistic traits) to perform better (as suggested by previous research on stochastic resonance). The more interesting prediction was that noise would not help individuals who already had a lot of brain noise (that is, those with high autistic traits), because their own neural noise already ensured optimal performance.

    Indeed, one of our experiments showed people with high neural noise (high autistic traits) did not benefit from additional noise. Moreover, they showed superior performance (greater accuracy) relative to people with low neural noise when the added visual static was low. This suggests their own neural noise already caused a natural stochastic resonance effect, resulting in better performance.

    It is important to note we did not include clinically diagnosed autistic participants, but overall, we showed the theory of enhanced performance due to stochastic resonance in autism has merits.

    Why this is important?

    Autistic people face ignorance, prejudice and discrimination that can harm wellbeing. Poor mental and physical health, reduced social connections and increased “camouflaging” of autistic traits are some of the negative impacts that autistic people face.

    So, research underlining and investigating the strengths inherent in autism can help reduce stigma, allow autistic people to be themselves and acknowledge autistic people do not require “fixing”.

    The autistic brain is different. It comes with limitations, but it also has its strengths.

    Pratik Raul, PhD candidiate, University of Canberra; Jeroen van Boxtel, Associate professor, University of Canberra, and Jovana Acevska, Honours Graduate Student, University of Canberra

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

    The Conversation

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  • Marathons in Mid- and Later-Life

    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.

    It’s Q&A Day at 10almonds!

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

    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

    We had several requests pertaining to veganism, meatless mondays, and substitutions in recipes—so we’re going to cover those on a different day!

    As for questions we’re answering today…

    Q: Is there any data on immediate and long term effects of running marathons in one’s forties?

    An interesting and very specific question! We didn’t find an overabundance of studies specifically for the short- and long-term effects of marathon-running in one’s 40s, but we did find a couple of relevant ones:

    The first looked at marathon-runners of various ages, and found that…

    • there are virtually no relevant running time differences (p<0.01) per age in marathon finishers from 20 to 55 years
    • the majority of middle-aged and elderly athletes have training histories of less than seven years of running

    From which they concluded:

    ❝The present findings strengthen the concept that considers aging as a biological process that can be considerably speeded up or slowed down by multiple lifestyle related factors.❞

    See the study: Performance, training and lifestyle parameters of marathon runners aged 20–80 years: results of the PACE-study

    The other looked specifically at the impact of running on cartilage, controlled for age (45 and under vs 46 and older) and activity level (marathon-runners vs sedentary people).

    The study had the people, of various ages and habitual activity levels, run for 30 minutes, and measured their knee cartilage thickness (using MRI) before and after running.

    They found that regardless of age or habitual activity level, running compressed the cartilage tissue to a similar extent. From this, it can be concluded that neither age nor marathon-running result in long-term changes to cartilage response to running.

    Or in lay terms: there’s no reason that marathon-running at 40 should ruin your knees (unless you are doing something wrong).

    That may or may not have been a concern you have, but it’s what the study looked at, so hey, it’s information.

    Here’s the study: Functional cartilage MRI T2 mapping: evaluating the effect of age and training on knee cartilage response to running

    Q: Information on [e-word] dysfunction for those who have negative reactions to [the most common medications]?

    When it comes to that particular issue, one or more of these three factors are often involved:

    • Hormones
    • Circulation
    • Psychology

    The most common drugs (that we can’t name here) work on the circulation side of things—specifically, by increasing the localized blood pressure. The exact mechanism of this drug action is interesting, albeit beyond the scope of a quick answer here today. On the other hand, the way that they work can cause adverse blood-pressure-related side effects for some people; perhaps you’re one of them.

    To take matters into your own hands, so to speak, you can address each of those three things we just mentioned:

    Hormones

    Ask your doctor (or a reputable phlebotomy service) for a hormone test. If your free/serum testosterone levels are low (which becomes increasingly common in men over the age of 45), they may prescribe something—such as testosterone shots—specifically for that.

    This way, it treats the underlying cause, rather than offering a workaround like those common pills whose names we can’t mention here.

    Circulation

    Look after your heart health; eat for your heart health, and exercise regularly!

    Cold showers/baths also work wonders for vascular tone—which is precisely what you need in this matter. By rapidly changing temperatures (such as by turning off the hot water for the last couple of minutes of your shower, or by plunging into a cold bath), your blood vessels will get practice at constricting and maintaining that constriction as necessary.

    Psychology

    [E-word] dysfunction can also have a psychological basis. Unfortunately, this can also then be self-reinforcing, if recalling previous difficulties causes you to get distracted/insecure and lose the moment. One of the best things you can do to get out of this catch-22 situation is to not worry about it in the moment. Depending on what you and your partner(s) like to do in bed, there are plenty of other equally respectable options, so just switch track!

    Having a conversation about this in advance will probably be helpful, so that everyone’s on the same page of the script in that eventuality, and it becomes “no big deal”. Without that conversation, misunderstandings and insecurities could arise for your partner(s) as well as yourself (“aren’t I desirable enough?” etc).

    So, to recap, we recommend:

    • Have your hormones checked
    • Look after your circulation
    • Make the decision to have fun!

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  • 53 Studies Later: The Best Way to Improve VO2 Max

    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.

    VO2 max measures maximum oxygen usage during intense exercise and reflects overall health and performance. To have a high VO2 max, efficient functioning of lungs, heart, red blood cells, muscles, and mitochondria is crucial. So, how to get those?

    Let’s HIIT it!

    High-Intensity Interval Training (HIIT) outperforms moderate-intensity exercise, by a long way. Further, based on the data from the 53 studies mentioned in the title, we can know which of the protocols tested work best, and they are:

    1. 15×15 Interval Training: 15 seconds sprint (90–95% max heart rate) + 15 seconds active rest (70% max heart rate), repeated 47 times.
    2. 4×4 Interval Training: 4 minutes sprint (90–95% max heart rate) + 3 minutes active rest (70% max heart rate), repeated 4 times.

    Whichever you choose, it is best to then do that 3x per week.

    Note that “sprint” can mean any maximum-effort cardio exercise; it doesn’t have to be running specifically. Cycling or swimming, for example, are fine options too, as is jumping rope.

    For more on each of these, plus how the science got there, enjoy:

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

    Want to learn more?

    You might also like to read:

    How To Do HIIT (Without Wrecking Your Body)

    Take care!

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  • Acorns vs Chestnuts – 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 acorns to chestnuts, we picked the acorns.

    Why?

    In terms of macros, chestnuts are mostly water, so it’s not surprising that acorns have a lot more carbs, fat, protein, and fiber. Thus, unless you have personal reasons for any of those to be a problem, acorns are the better choice, offering a lot more nutritional value.

    In the category of vitamins, acorns lead with a lot more of vitamins A, B2, B3, B5, B6, and B9, while chestnuts have more of vitamins B1 and C. However, that vitamin C is useless to us, because it is destroyed in the cooking process (by boiling or roasting), and both of these nuts can be harmful if consumed raw, so that cooking does need to be done. That leaves acorns with a 6:1 lead.

    When it comes to minerals, things are more even; acorns have more copper, magnesium, manganese, and zinc, while chestnuts have more calcium, iron, phosphorus, and potassium. Thus, a 4:4 tie (and yes, the margins of difference are approximately equal too).

    We mentioned “both of these nuts can be harmful if consumed raw”, so a note on that: it’s because, while both contain an assortment of beneficial phytochemicals, they also both contain tannins that, if consumed raw, chelate with iron, essentially taking it out of our diet and potentially creating an iron deficiency. Cooking tannins stops this from being an issue, and the same cooking process renders the tannins actively beneficial to the health, for their antioxidant powers.

    You may have heard that acorns are poisonous; that’s not strictly speaking true, except insofar as anything could be deemed poisonous in excess (including such things as water, and oxygen). Rather, it’s simply the above-described matter of the uncooked tannins and iron chelation. Even then, you’re unlikely to suffer ill effects unless you consume them raw in a fair quantity. While acorns have fallen from popular favor sufficient that one doesn’t see them in supermarkets, the fact is they’ve been enjoyed as an important traditional part of the diet by various indigenous peoples of N. America for centuries*, and provided they are cooked first, they are a good healthy food for most people.

    *(going so far as to cultivate natural oak savannah areas, by burning out young oaks to leave the old ones to flourish without competition, to maximize acorn production, and then store dried acorns in bulk sufficient to cover the next year or so in case of a bad harvest later—so these was not just an incidental food, but very important “our life may depend on this” food. Much like grain in many places—and yes, acorns can be ground into flour and used to make bread etc too)

    Do note: they are both still tree nuts though, so if you have a tree nut allergy, these ones aren’t for you.

    Otherwise, enjoy both; just cook them first!

    Want to learn more?

    You might like to read:

    Why You Should Diversify Your Nuts

    Take care!

    Don’t Forget…

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  • Peace Is Every Step – by Thích Nhất Hạnh

    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.

    Mindfulness is one of the few practices to make its way from religion (in this case, Buddhism) into hard science. We’ve written before about its many evidence-based benefits, and many national health information outlets recommend it. So, what does this book have to add?

    Thích Nhất Hạnh spent most of his 95 years devoted to the practice and teaching of mindfulness and compassion. In this book, the focus is on bringing mindfulness off the meditation mat and into general life.

    After all, what if we could extend that “unflappability” into situations that pressure and antagonize us? That would be some superpower!

    The author offers techniques to do just that, simple exercises to transform negative emotions, and to make us more likely to remember to do so.

    After all, “in the heat of the moment” is rarely when many of us are at our best, this book gives way to allow those moments themselves to serve as immediate triggers to be our best.

    The title “Peace Is Every Step” is not a random collection of words; the goal of this book is to enable to reader to indeed carry peace with us as we go.

    Not just “peace is always available to us”, but if we do it right: “we have now arranged for our own peace to automatically step in and help us when we need it most”.

    Bottom line: if you’d like to practice mindfulness, or practice it more consistently, this book offers some powerful tools.

    Click here to check out Peace Is Every Step, and carry yours with you!

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  • Feel-Good Productivity – by Dr. Ali Abdaal

    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.

    “Rise and grind” is not a sustainable way to live. Yet for most of us, there are things we do have to do every day that we don’t necessarily do for fun. So, how to be productive with those things, and not feel like we are constantly compromising and sacrificing our time on this earth for some intrinsically trivial but extrinsically required activity that’ll be forgotten tomorrow?

    And most of us do also have dreams and ambitions (and if you don’t, then what were they before life snatched them away from you?), things to work towards. So there is “carrot” for us as well as “stick”. But how to break the cycle and get more carrot and less stick, while being more productive than before?

    Dr. Abdaal frames this principally in terms of neurology first, psychology next.

    That when we are bored, we simply do not have the neurochemicals required to work well anyway, so addressing that first needs to be a priority. He lays out many ways of doing this, gives lots of practical tips, and brings attention to the ways it’s easy to go wrong (and how to fix those too).

    The writing style isdeceptively relaxed and casual, leading the reader smoothly into understanding of each topic before moving on.

    Bottom line: if you want to get more done while feeling better about it (not a tired wreck), then this is the book for you!

    Click here to check out Feel-Good Productivity, and thrive!

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