Although Undefeeted is a global campaign it has from its conception realized the need for interaction with individuals such as yourself to truly make a difference in your life and so cumulatively an impact on the world. If you have diabetes, have a family member with diabetes, are caring for someone with diabetes or simply know someone with diabetes then undefeeted will be able to offer you something of value. The purpose of Undefeeted is to help people with diabetes (or their careers/ Parents/family) to understand and accept the risks that the condition poses to their lower limbs. It aims to give you the knowledge of how the disease can affect your feet, help you understand personally what already may be going wrong that you are currently unaware of and then crucially helps you form a personalised action plan which will enable you to live in what we call the diabetic sweet spot.
You as a person with diabetes will be empowered to change where necessary your lifestyle, improve your blood glucose management, take control of your condition and thus positively influence your destiny. Remember you have the power to directly impact how long you will be able to remain active doing the things you enjoy with those you love and ultimately how long you are likely to live.
The complications that people with diabetes can face with their feet can be considerable and you would be forgiven for feeling overwhelmed and even depressed about what the future may hold for you.
Yet by choosing to live in the Diabetic sweet spot you will be seating yourself well and truly in the drivers seat where you have full control of your life and your future.
You may be reading this as someone who has just been told you have pre diabetes, as someone who has been diagnosed but has no complications or as someone who has already lived with diabetes for a while and is experiencing some of the complications that can occur.
All too often we hear people say “I’ve only got a touch of diabetes” or “I haven’t got the bad on”. Instead we should be hearing them saying “I know how serious this can be – what can I do to best help myself or my loved one”.
You may even be someone who is feeling good (and rightly so) because you have managed to reverse your type 2 diabetes.
One thing is common to all our situations and that is that our feet have to carry us every step of our lives. On average they will take us around the world 5 times and every step we take they have to amazingly transform from being shock absorbers as we hit the ground to becoming rigid levers as we push off. They are really amazing pieces of engineering. Every step you take walking each foot has to process one and a half times your body weight in force through it and when you run that increases to four and a half times.
So its hardly surprising that the older you get the more problems you are likely to develop with your feet even without diabetes.
It is common sense that if you have diabetes or are at risk of developing it that you take ownership of yourself and look after the one pair of feet you have been blessed with that are designed to last a lifetime.
If you haven’t already read the book Undefeeted by diabetes then it would make sense to pick it up and start gaining the knowledge you need so that you can begin to get into the diabetic sweet spot.
If you have read the book then you will be aware of the various resources available both on this website and in the form of online support and mentoring that can help you understand your personal risk and hold you accountable to taking action which often means changing the habits of a lifetime.
To learn more about your diabetes and how it can affect your feet click on the relevant link below
If you are unsure of how best to tackle your personal journey through life with diabetes then I suggest arranging a brief skype overview where one of our team can help advise you on the best route for you.
This is not the place to go into detail of your disease (see more about type 1 diabetes) but the point needs to be made that it is largely the continued hyperglycemia (high blood glucose) associated with all types of diabetes that leads to the majority of complications including those in the feet.
Some diabetes diagnoses are more shocking than others and this is usually the case with type 1. Take for example my 11-year-old daughter. Just three days before starting secondary school on what seemed like a routine visit to the doctor she was diagnosed with type 1, rushed into hospital and put on insulin that same night. It was her diagnosis rather than my own that shook me up so much that it prompted me to create the global Undefeeted&trade campaign and write this book.
Once diagnosed with type 1 in theory you can control your blood sugars well by administering the right doses of insulin for the carbohydrate you are consuming. However in practice particularly as most type 1’s are diagnosed as children or teens their blood glucose control can be very erratic and so by the time they reach their late teens there can already be deterioration in their blood vessels and nerve supply to their feet putting them at risk of limb threatening complications at much earlier ages than most type 2’s.
I realized that for her if I had not been her dad there was not likely to be anyone stressing to her the importance of looking after her feet and getting them checked regularly by a Podiatrist. We as Podiatrists are renowned for waiting for the problem to come in to see us rather than raising awareness and preventing the problems ever occurring.
This I felt needed to stop and thus Undefeeted was born. I urge you to take your foot care seriously and spend some time learning about those 2 amazing things on the end of your legs that will carry you to see many wonderful things and create some fantastic memories. The book Undefeeted by Diabetes aims to equip you with all the knowledge you could ever need to ensure you are in the best possible place to live safely with your type 1 diabetes.
Undefeeted are also committed to preventing amputations by helping find a cure for type 1 and so have partnered with JDRFUK making a donation from every book sale to support their wonderful work searching for that cure and ways to make life easier for people like you living with type 1.
Life is a rollercoaster: we’ve all had experiences that brought us pleasure and happiness and others that have plunged us into despair and misery. One of those big dips could have been finding out that you or someone you love has diabetes.
If its type 2 then it’s often a gradual process: we trundle along and discover that we’re pre diabetic (or as it was called previously, borderline). We may not take the threat seriously. That’s one of the huge dangers of type 2 diabetes because you can live with it for many years without being aware you have it and yet all the time the elevated blood glucose will likely be affecting your body, particularly your feet, eyes, kidneys and cardiovascular system. Maybe you were diagnosed from a routine blood test having presented with some of the common symptoms of thirst, tiredness and going to the loo more frequently. Possibly you were diagnosed following a complication with your feet such as a sore that wouldn’t heal or numbness or burning sensations in your feet.
With type 2 particularly it is often the gradual insidious effects of your elevated blood glucose levels over a period of years that has a steady effect on your blood vessels and nerves leading to complications with the feet that all too often end with an amputation.
Undefeeted’s success in helping people across the world live healthier and safer lives is built on the concept of helping you and other individuals live in the safest possible way with your diabetes. The cornerstone of this concept is what Peter Allton calls the “Diabetic sweet spot- By diabetic sweet spot I mean that you will have put yourself in the best possible place to live safely with your diabetes. My life with diabetes has helped me realize that there are three factors we need to take seriously in order to live with the least risk of developing complications. These factors can be applied to every aspect of diabetes be it diet, exercise, taking your medication, or foot care.
The sweet spot values:
1. Knowledge about your condition.
2. Awareness and acceptance of your personal risk.
3. Taking appropriate action
I urge you to take your foot care seriously and spend some time learning about those 2 amazing things on the end of your legs that will carry you to see many wonderful things and create some fantastic memories.The book Undefeeted by Diabetes aims to equip you with all the knowledge you could ever need to ensure you are in the best possible place to live safely with your type 2 diabetes.
This is usually a transient condition in a pregnant lady resolving itself when the baby has been born although she may be at greater risk of developing type 2 later in life.
During pregnancy the mother’s hormones are constantly changing and from three months onwards certain hormones produced by the placenta resist insulin. At the same time the baby is growing and these two factors mean that the mother requires two to three times more insulin than before the pregnancy. In approximately one in 20 pregnancies(The NHS puts the figure at 1 in 6 while Diabetes UK and the American Diabetes Association agree on 1 in 20.) the mother is not able to make enough insulin causing blood sugars to rise and gestational diabetes.
Ladies at greatest risk of developing gestational diabetes are likely to have one of the following risk factors:
• They have a close relative who has had gestational diabetes or is now type 2.
• They have had gestational diabetes themselves.
• They are of Asian, Middle Eastern or Afro-Caribbean descent.
• They have a BMI greater than 30.
The symptoms for gestational diabetes are similar to type 2 namely: thirst, dry mouth, tiredness, having to urinate more often, and having infections such as thrush (a yeast infection).
Applying the principles of the Diabetic sweet spot will be enough for most women to control their gestational diabetes (learning about their condition, recognising the risk they are at and then acting appropriately by increasing exercise and adapting their diet).
However if blood glucose control is not maintained well medication and even insulin may be required as high blood glucose can be fatal for the baby, for example if the mum develops ketoacidosis. This happens when there is not enough insulin and the body has to get its energy from burning fatty acids, a by-product of which is acidic ketone bodies. This can also happen in type 1 and 2.
The symptoms to look out for are:
• Dehydration and thirst.
• Breathing becoming deep and laboured.
• Becoming confused and disorientated.
• Loss of consciousness and even coma.
Thankfully being diabetic doesn’t mean you will inevitably have an amputation, it’s just that you are more at risk of that fate. However if you have already had the misfortune of undergoing one whether it be a toe, a partial foot or below knee, then you are at a greater risk statistically of either further amputation or even death. This is a harsh truth but needs to be told as you can still take control of your life There are several reasons you are at increased risk which you should take into account.
For you, getting back into the sweet spot is likely to require very specific knowledge, risk awareness and actions.
Having undergone an amputation, it is likely that your diabetes has developed to a stage where your lower limbs are already at risk. Indeed in the Traffic Light system just having had an amputation in the past automatically puts you in the red high risk category.
Once you have had the amputation the new wound has to heal so you will be given specific advice regarding things like the frequency of dressing it, how to offload the area and how to keep it dry.
When it’s healed it is likely that you will need bespoke shoes to offload any new areas subjected to increased pressure.
Often the intact leg is favored and so the increase in pressure can cause that foot to develop pressure sores, especially under areas of significant callus. Remaining in the safety zone of the sweet spot will often entail you being given in-depth knowledge of the specific problems you are likely to encounter. It will mean you need to realize just how much more at risk you are and it will also mean you have to fall into line and actively start changing your lifestyle and habits for the better.
Examples of how your lifestyle may have to change will vary on an individual basis but may include:
• Having to attend a hospital clinic several times a week to ensure the wound heals.
• Resting the foot or leg to avoid the wound being subjected to further trauma.
• Not being able to work.
• Having to wear a cast or boot to offload any remaining areas of the foot which otherwise would be subjected to further trauma.
You may not be able to walk as you used to and yet you still need to keep active. You therefore may need to begin some upper body exercises to keep the blood pumping and to burn up those blood sugars.
You may not be able to wear conventional shoes and have to have special surgical shoes made. These are unlikely to be fashionable but they will keep you safely in the sweet spot.
One of the key attitudes for a person who has undergone an amputation is vigilance. Keeping an eye open for further problems either at the site of the amputation or elsewhere is absolutely vital.
One of the key attitudes for a person who has undergone an amputation is vigilance.
By itself though, this vigilance is useless unless you or your carer take action. Speed of implementation for this action is critical and any changes in either foot should be reported that day to the specialist diabetic foot protection team. You should have been given their contact details on being discharged from the hospital.
If your diabetes has become bad enough to have led to an amputation then not only are you likely to heal slower, be more at risk of infection, to have lost sensation and have peripheral vascular disease, but also you are more likely to have had changes in your eyes.
If you have developed retinopathy it’s all very well me telling you to be vigilant but you may not even be able to see your feet. This is where having a friend, spouse or carer as a buddy can be essential as they can (and should) do daily checks of both of your feet. Again they should immediately report any deterioration to your foot protection team. If you don’t have anyone you can ask, then buy yourself a camera and take photos of your foot both on top and underneath by photographing the soles’ reflection in a mirror leaning against the wall.
Better still get a selfie pole and use its remote and your phone to take a photo of the underside of your feet. Some of the better ones have a button on them that remotely takes the photo. You can then send it by email or whatsApp to a buddy, family member or friend who can alert you to any issues so that you can get help.
Undefeeted is also planning to offer a service assessing photos remotely, you can find out more about it at www.undefeeted.org/footieselfie. Of course actually having a buddy inspect your feet in person is always better than someone looking at a photograph as they can check for such things as temperature, but a professional eye cast over a photo may well spot something of significance that the untrained eye could overlook. I suppose the best long distance option is having someone else take the photo and sending it, along with their observations, to a professional.
You will be able to do this via the Undefeeted app once it has been launched. Check out www.undefeeted.org/footieselfie and we will keep you updated on the launch date for this service.
If you are reading this because you’ve been told you have pre diabetes then be thankful that you have been given a warning at this stage. Many people live in this state for many years having not been warned and it is very possible that their elevated blood sugars are still doing some damage.
The fact that you are aware of where you are heading means you can take charge of the steering wheel and make the changes to your journey so needed to prevent you tipping over into a diabetic state.
We have heard of people who laugh off the fact that they have been warned of the impending onset of Type 2 diabetes. Think about it, if you saw the doctor and he said that you had the early signs of cancer how would you react – probably seriously, quickly and obediently to whatever the doctor advises.
Often people with diabetes (let alone pre-diabetes) seem to have the mindset of “I’ve only got a touch of diabetes,its not too bad.”
Yet each year currently more people die from diabetes than from Breast cancer, AIDS, and Malaria combined.
Let me encourage you to have the same attitude towards your diabetes as you would towards cancer and then the same determination and strength in doing all you can to beat it or at least control it.
Whether you are a parent, carer or friend the part you play in your loved ones walk with diabetes should not be under estimated.They need you provided that is that you are committed to being a positive influence.Some of the greatest success stories and achievements in the history of the world have come about because of people working together with a common goal and the same mindset. Think about your own life.
How do you feel when surrounded by negative pessimistic people. Often it can bring you down whereas if you are with a group of excited enthusiastic people you will probably feel the same after being with them for a short while, it sort of rubs off on you.
Be honest with yourself and do your best to be positive for your loved one. You are just as important to their success as they are. We are in the process of making a series of videos to help you the family member be most effective in helping your loved one.
The most important thing is that you recognize that you need to be able to help your loved one live in the diabetic sweet spot and so you need to have knowledge of what it means and what can go wrong. For that you should seriously consider reading their Undefeeted by diabetes book ,or better still read it together or get your own copy. It will equip you with all you need to know about what can go wrong and to understand your loved ones particular risks and weaknesses.
Your knowledge could literally save your loved one’s leg or even life.
If our mission resonates with you and you want to be a part of helping our vision become a reality then please consider the following ways you can help.
1. Sharing some of your time or skills.
2. Simply spreading the word regarding undefeeted on social media and word of mouth.
3. Financial donations sponsoring our work here in the UK and overseas:
a. one off
c. Legacy gift
Thank you for considering helping us in this battle to prevent the 1.3 million avoidable amputations that take place annually. Click below to contact us regarding any of these ways of helping.