Diabetes Undershirt

Diabetes Diabetes is a chronic condition that affects the way the body uses glucose, a type of sugar, for fuel. Normally, when we eat, the pancreas releases insulin, a hormone that enables the body’s cells to take in or store glucose for energy. People with type 1 diabetes don’t make insulin. Those with type 2 diabetes are unable to effectively use insulin. In either case, despite high levels of glucose in the blood, the body’s cells are starved for fuel.

According to the American Diabetes Association, about 23.6 million people in the U.S. have diabetes. The majority of people (90 to 95 percent) have type 2 disease.

Diabetes and Foot Complications Over time, high levels of blood glucose can lead to a number of complications. About 60 to 70 percent of diabetics have nerve damage (neuropathy), which affects the ability to feel heat, cold and pain. They are also at high risk for circulation problems (peripheral vascular disease).

The combination of neuropathy and poor blood flow increases the risk for infections, especially in the feet. This is because patients are unable to feel the pain of a cut, sore or other type of injury. An injury on the bottom of the foot may also be unnoticed. Normally, the body would initiate a repair quickly, bringing blood cells to fight infection, remove dead skin cells and initiate healing. But poor circulation in diabetes reduces the ability of the body to heal. Even a small sore can quickly become infected and lead to a serious wound or non-healing ulcer. To keep severe infection from spreading to healthy tissue, doctors may recommend amputation (surgical removal of the infected part of the limb).

The Centers for Disease Control and Prevention reports about 60 percent of lower limb amputations performed in the U.S. are for patients with diabetes. In 2004, roughly 71,000 lower limb amputations were performed on people with diabetes.

Reducing Risk for Foot Complications David Armstrong, D.P.M., M.D., Ph.D., Podiatrist with the University of Arizona in Tucson, AZ, says people with diabetes need to stay active to maintain control over blood glucose levels and lower their risk for cardiovascular complications. On the other hand, increased activity may heighten the risk for foot injury.

Armstrong and his colleagues wanted to look at the specific types of activity that may raise the risk for foot complications in diabetics. A regular pedometer, however, only measures steps and doesn’t give an accounting of the types and length of activity.

For a better sense of activity, the researchers used a technology, called PAMSys™. It's a small battery-powered sensor that fits into the front center pocket of a specially-designed T-shirt. The sensor measures and records the type of activity (i.e., sitting, lying, walking or running), the duration of the activity and its intensity. In addition to providing a measure of total activity, it can also report a timeline of the day’s activity.

Armstrong says doctors used to believe that the risk for foot complications in a person with diabetes was related to the number of steps taken every day. In a study of diabetics using the PAMSys sensor and undershirt, investigators found starting and stopping an activity to be more risky than overall activity levels.

Armstrong cautions it’s still important for diabetics to stay active. However, patients may need to be more mindful of the types of activity they choose. In the future, devices such as the PAMSys diabetes undershirt, may be useful to monitor patients’ activity and warn them if they are doing too much of the wrong kind of activity.

For information about the undershirt monitoring system, go to http://www.biosensics.com/pamsys.html

For general information on diabetes and foot care: American Diabetes AssociationCenters for Disease Control and PreventionNational Institute of Diabetes and Digestive and Kidney Diseases