From head to toe, the dangers of Diabetes can multiply


Nearly 1 out of every 3 Americans suffers from diabetes, with 1.5 million new cases diagnosed each year. The most common form, Type 2 diabetes, results when the pancreas fails to release the right amount of insulin to help the body absorb sugars. Complications of diabetes can impact the entire body, resulting in kidney failure, amputations, heart failure, and stroke. Diabetes is also the leading cause of blindness in working aged adults.

“Diabetes-related eye disease is due to changes in blood vessels in the retina,” says Cortland Regional Medical Practice ophthalmologist, Dr. Adam Miller. “The capillaries can leak or bleed, and that distorts vision. Sometimes diabetes causes the body to make new blood vessels, and there can be scar tissue that can cause a detached retina.”

When Dr. Miller conducts an eye exam with new diabetes patients, he looks for any existing problems and establishes a baseline to measure future changes against. He recommends annual eye exams to check for any progression in retinopathy – damage to the blood vessels of the light-sensitive tissue at the back of the eye.

“People are often surprised to learn about the connection between diabetes and eye disease,” Dr. Miller says. “But I can sometimes see changes in the blood vessels of a patient’s eyes and have them check their blood pressure, only to learn that their blood pressure is high.”

According to Dr. Miller, patients can delay the onset of diabetic retinopathy or slow its progression by following the general recommendations for controlling diabetes — controlling blood sugar with exercise, watching one’s weight, and maintaining blood glucose levels through proper diet.

Khette Fabarzak, Cortland Regional’s diabetes educator, helps newly diagnosed diabetes patient get off to a good start. She talks with them about medications they may need, how to use a glucometer to test their glucose levels at home, and how proper diet and exercise can help maintain sugar levels. “People need to take diabetes seriously, especially when they are first diagnosed, so they can prevent any of the complications before damage is done,” she says.

Fabarzak visits with anyone with a history of diabetes who is admitted to the hospital, to see if the illness is causing issues. She also conducts classes to help patients better manage their illness on their own. She brings in a dietician to discuss proper nutrition, and she holds a diabetes support group each month.

Fabarzak also provides diabetes patients with information about foot care. Thoroughly checking the tops and bottoms of feet and between the toes daily is important, because poor circulation in the feet can cause even small cuts to become big problems.

Kelley Johnson, clinical coordinator at Cortland Regional’s Wound Care Center, sees many of the diabetes patients who have slow-healing foot wounds. “Most of us have pain as a warning but with neuropathy (nerve damage caused by high blood glucose levels) these individuals can’t feel their feet. If they step on something small, or even have a crease in their shoe, it can cause a wound that we will need to address here,” she says.

The Wound Care Center offers several options for hard to heal wounds, from specially treated dressings and skin substitutes to hyperbaric oxygen therapy. “This is 100 percent oxygen, administered under pressure. The oxygen goes into the plasma and helps the wound to heal faster because most diabetic wounds don’t get the oxygen necessary for healing,” Johnson says. “Not everyone qualifies for this treatment, but we have found that along with antibiotics, hyperbaric oxygen treatments work really well for bone infections.”

The Wound Care Center team begins with a lengthy history of the individual, including all health issues and information about the person’s lifestyle, including exercise habits, diet, work, and home routines. Johnson agrees with Fabarzak and Dr. Miller that with diabetes, it’s not just about one thing. “It’s about everything that is going on with the patient’s life and overall health because that all affects the wound.”

Dr. Miller is accepting new patients at 607-753- 1017. For more information about the Cortland Regional Wound Care Center call 607-753-0993. Visit our events page at to attend a diabetes support group.

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