Month: September 2025

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

Two of the most common issues impacting millions of people annually in the world are diabetes and cancer. As much as they appear to be different conditions, studies have revealed that the two are strongly related. Research recommends that diabetics are prone to some cancers more than healthy people because of overlapping risk factors, hormonal alterations, and metabolic disproportions. This interconnection is also essential in preventing early diagnosis, and management of the two diseases.

What Is the Link Between Diabetes and Cancer?

The association of cancer and diabetes is multifactorial. Diabetics particularly type 2 diabetes are susceptible to many forms of cancer compared to non-diabetics. This is a risk that is thought to be affected by metabolic dysregulation such as hyperglycemia (high blood sugar), hyperinsulinemia (high insulin levels), chronic inflammation, and obesity. Such conditions may favor tumor growth, cancer development, and metastasis. Moreover, certain methods of treating cancer can precipitate an increase in blood sugar or diabetes in themselves. Diabetes also leads to increased cancer deaths. This relationship is caused by common risk factors like genetics, obesity, and inflammation. Knowledge of these mechanisms helps prevent, detect, and manage cancer among diabetic patients.

Key Points

• Diabetes predisposes some cancers such as liver, pancreas, colorectal, breast, and bladder cancer.
• Hyperglycemia and hyperinsulinemia provide an environment that favors the growth of cancer cells.
• Chronic inflammation and obesity, typical of diabetes, enhance cancer.
• Some treatments of cancer may cause diabetes or a rise in blood sugar levels.
• There is a correlation between diabetes and cancer mortality.
• The common factors are genetics, oxidative stress, and metabolic disturbances.
• As well, there is a two-way relationship between diabetes and cancer: each can have an impact on the other.

How Does Diabetes Increase Cancer Risk?

Diabetes increases cancer risk through several intertwined mechanisms:

1. Hyperinsulinemia, Insulin Resistance: With type 2 diabetes, there is hyperinsulinemia due to insulin resistance. Insulin and insulin-like growth factor 1 (IGF-1) increase cell proliferation and prevents apoptosis, stimulating cancer cell proliferation. Insulin and IGF-1 receptors tend to be more active on cancer cells and are, therefore, more sensitive to these growth factors.
2. Hyperglycemia: A high blood glucose level offers a lot of energy to fast-dividing cancerous cells (Warburg effect). Hyperglycemia also induces advanced glycation end products (AGEs) that amplify oxidative stress and inflammation, which, in turn, causes damage of DNA and tumorigenesis.
3. Chronic Inflammation: Diabetes-related chronic low-grade inflammation involves generation of pro inflammatory cytokines which favor cancer proliferation and progression. This inflammatory condition may favor tumors and metastasis.
4. Obesity and Metabolic Syndrome: This is typical of type 2 diabetes because obesity leads to disturbances in hormones, such as estrogen and adipokines, which may cause some types of cancers such as breast cancer and liver.
5. Oxidative Stress and DNA Damage: Hyperglycemia and inflammatory oxidative stress damages DNA thereby triggering carcinogenesis.
6. Effects of Cancer Therapy: There are cancer treatments that cause diabetes or aggravate glucose metabolism, which is a two-way relationship.

Types of Cancer More Common in People with Diabetes

The types of cancer that are more common in people with diabetes include:

• Liver cancer
• Pancreatic cancer
• Kidney cancer
• Colorectal cancer (colon and rectum)
• Breast cancer (especially in type 2 diabetes)
• Bladder cancer
• Endometrial (uterine) cancer
• Gallbladder and bile duct cancers
• Lung cancer
• Ovarian cancer
• Stomach (gastric) cancer
• Thyroid cancer
• Esophageal cancer
• Leukemia and lymphomas (e.g., Non-Hodgkin lymphoma)
• Oral cavity cancers
• Gliomas (brain tumors)
• Melanoma (skin cancer)

Differences in risk occur between type 1 and type 2 diabetes:

·       Type 1 diabetes predisposes people to liver, pancreatic, kidney, esophageal, stomach, lung, thyroid, squamous cell, and leukemia cancers. Surprisingly, type 1 diabetes decreases the prevalence of breast cancer over the general population.

·       People with diabetes type 2 have a higher risk of liver, pancreatic, kidney, lung cancer, leukemia, and more often develop bile duct, gallbladder, gastrointestinal, bladder, ovarian, endometrial, oral cavity, gliomas, and melanoma.

The Role of Medications and Treatment

Diabetes medications and therapies may affect the risks of cancer positively and negatively. The following is a summary of how diabetes drugs are involved in cancer risk and management:

Metformin

• Metformin is known to be less likely to cause several cancers such as pancreatic, breast, colorectal and prostate cancer.
• Its anticancer effects can be due to the ability to activate AMP-activated protein kinase (AMPK) that suppresses cell growth and protein synthesis and reduces insulin levels and inflammation.
• Clinical studies indicate that metformin can enhance the survival of diabetic patients with cancer.

Thiazolidinediones (TZDs)

• TZDs have moderate effects on reduction of risk to breast, lung, and liver cancer.
• They can have actions through the regulation of cellular metabolism, the decrease of oxidative stress, and alteration of inflammation pathways.

Insulin and Insulin Secretagogues

• Insulin and insulin secretion increasing agents may also be linked to liver and pancreatic cancer risks.
• Insulin use is known to cause increased cancer risk in certain locations and reduced risk in others, e.g., breast and prostate cancers, and this may be attributed to complex biologic mechanisms.

GLP-1 Receptor Agonists (GLP-1RAs)

• GLP-1RAs, including liraglutide and semaglutide, have been demonstrated to decrease risk of obesity cancers including esophagus, colon, endometrium, gallbladder, kidney, liver, ovary, and pancreas compared to insulin.
• They help to control glucose and to lose weight, which probably also helps to reduce the risk of cancer.
• Their potential protective value is an issue that needs to be investigated in the long run.

Other Considerations

• Extensive lifestyle and metabolic-bariatric interventions on diabetes and obesity also lower cancer risk.
• The effects of some cancer therapies are that they can lead to the deterioration of glucose metabolism or even the onset of diabetes, and they have to be handled with care.

You may also like to read: Impact of Environmental Toxins on Metabolic Health

Can Cancer Treatment Affect Diabetes?

Cancer treatment can significantly affect diabetes management and blood sugar control in several ways:

Effects of Cancer Treatment on Diabetes

• Immune Checkpoint Inhibitors (ICI): Can induce the onset of autoimmune diabetes in approximately 1-2 percent of patients, with permanent insulin dependence. Close monitoring is also required because ICI may deteriorate blood sugar levels in known diabetics.
• Corticosteroids: Steroids are commonly administered in cancer therapy to decrease inflammation and nausea, but steroids may result in insulin resistance, which results in hyperglycemia or aggravated diabetes. This necessitates the modification of insulin among other diabetes medications.
• Chemotherapy: Hypoglycemia: Side effects like nausea, vomiting, mouth sores, and loss of appetite cause changes in the blood sugar level, including low blood sugar level because of decreased food intake. Certain chemotherapy medications have a direct effect on glucose metabolism.
• Radiation Therapy: Radiation may cause systemic stress that results in high blood sugar and fatigue and that may interfere with diabetes management.
• Hormone Therapy: Hormonal therapies are applied in prostate and breast cancer that is particularly associated with nausea, fatigue, and metabolic side effects such as appetite and glucose regulation.
• Targeted Therapies and Immunosuppressants: medicines such as tyrosine kinase inhibitors (TKIs), mTOR inhibitors, and calcineurin inhibitors can disrupt the metabolism of glucose and aggravating diabetes.

Management Considerations

To prevent hyperglycemia or hypoglycemia, close monitoring of blood glucose should be done in cancer treatment.

·       Serial insulin regimens must be changed frequently. As an example, Type 1 diabetics might require extra insulin forms (e.g. NPH) when steroids are used since they have overlapping effects.

·       Continuous glucose monitoring and automated insulin delivery systems should be used in Type 1 diabetes to have the most optimal control in cancer therapy.

·       Multidisciplinary management: The challenges of cancer and diabetes are dual and therefore require the involvement of oncologists and endocrinologists.

Final Thoughts

The fact that diabetes and cancer are interrelated indicates the relevance of proactive health. People can reduce the risk of developing complications of either condition by acknowledging common risk factors, making healthier lifestyle changes, and remain consistent with regular screenings. This complicated association will be explained further by research, but in the meantime, the best weapon in the defense of long-term health is awareness and prevention.

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

Environmental toxins are everywhere, the food we consume, in the air we breathe, and in the products, we interact with day in day out. There is increasing evidence that these invisible pollutants have the potential to disrupt hormones, metabolism, and energy regulation increasing the risk of obesity, diabetes, and other metabolic conditions. Knowledge of how toxins affect metabolic health is the key to preventing disease and building a safer and healthier future.

Major Categories of Environmental Toxins

Significant groups of environmental toxins sometimes referred to as pollutants can be broadly categorized according to their nature, source, persistence and the medium in which they are contaminating. Key categories include:

Nature and Source

• Primary Pollutants: Direct emitters, e.g., smoke, dust, sulfur dioxide (SO2), nitrogen oxides (NOx).
• Secondary Pollutants: The products of the chemical reaction of the primary ones in the environment, e.g., ozone layer, and smog.

Persistence

• Degradable Pollutants: Degraded very fast by natural processes, e.g. domestic sewage.
• Slowly Degradable (Persistent) Pollutants: Remain in the environment, e.g. pesticides, such as DDT, plastics, heavy metals.

Environmental Medium

• Air Pollutants: They are gases (CO2, SO2, NOx), PM, volatile organic compounds (VOCs), and toxic industrial chemicals.
• Water Pollutants: Include heavy metals, detergents, fertilizers, pesticides, industrial waste and oil spillage.
• Soil Pollutants: Hydrocarbons, heavy metals, pesticides and herbicides that interfere with the quality of soil.
• Noise Pollution: Unwanted or undesirable sound that interferes with ecosystems and the health of humankind.
• Radioactive Pollution: The release of radioactive materials (nuclear activities).
• Thermal Pollution: Change in temperature on the natural water bodies due to industrial activities.
• Plastic Pollution: Buildup of plastic waste that affects wildlife and ecosystems.

Special Categories

• Endocrine Disrupting Chemicals: BPA and phthalates are some of the chemicals that disrupt hormonal activity.
• Heavy Metals: Toxic metals like lead, cadmium, mercury among other organs and metabolism.

This classification assists in figuring out their sources, environmental routes, and impact on human and ecological health.

How Toxins Affect Metabolic Health: Key Mechanisms

Metabolic health is impacted by environmental toxins in several important ways that disorientate normal metabolism:

Inflammation and Oxidative Stress

Toxins cause chronic low-grade inflammation and produce reactive oxygen species (ROS), causing oxidative stress. This dismays cellular structures like lipids, proteins and DNA, which disrupts insulin signaling and leads to insulin resistance, which is a feature of metabolic disorders.

Endocrine Disruption

Several environmental chemicals including bisphenol A (BPA) and phthalates are endocrine disruptors. They imitate or obstruct hormones and hormone receptors, change the metabolism of glucose, fat storage and 0-cell activity of the pancreas thereby inducing obesity, insulin resistance and type 2 diabetes.

Epigenetic Modifications

Epigenetic modification may be caused by toxins, such as DNA methylation and histone modification, which alters the gene expression related to metabolic control, inflammation, and immune response. The effects of these changes can be long-term on metabolic health and even intergenerational.

Mitochondrial Dysfunction

Environmental pollutants also damage mitochondrial activity, which decreases the generation of energy and elevates oxidative stress. This impairment inhibits fat and glucose metabolism that favors the development of metabolic syndrome, such as obesity and diabetes.

Gut Microbiota Alteration

The toxins interfere with the structure and activity of the intestinal microbiota, which is crucial in metabolism. Pollutant-induced dysbiosis may decrease beneficial metabolites (short-chain fatty acids), facilitate systemic inflammation, and alter metabolic homeostasis.

Disruption of Metabolic Enzymes and Pathways

Heavy metals and other wastes disrupt action of enzymes used in carbohydrate and lipid metabolism, and this further encourages metabolic abnormalities.

The combination of these processes leads to the formation and evolution of metabolic diseases, including insulin resistance, type 2 diabetes, obesity, and metabolic syndrome.

Evidence from Research

Research evidence robustly supports the idea that environmental toxins play a significant role in metabolic health disruption:

• Population, animal, and cell studies have established the associations of diverse classes of metabolic-disrupting chemicals (MDCs) with obesity, diabetes, and non-alcoholic fatty liver disease (NAFLD).
• Clinical intervention research reports that behavior modification that minimizes exposure to MDCs (e.g., the use of fewer personal care products, no plastic food wrappings and poor hand hygiene) reduce body burdens of these chemicals and their metabolic impact.
• The exposure to air pollution is associated with heightened insulin resistance and impaired vascularity in people with metabolic syndrome or diabetes, and particulate matter (PM2.5) particularly.
• Experimental research leads to highlighting disruptions of endocrine, oxidative stress, mitochondrial disturbance, and gut microbiota changes occasioned by pesticides, heavy metals, and synthetic chemicals, which lead to metabolic dysfunction.
• Heavy metals such as cadmium and lead have been linked to hypertension, renal dysfunction, and metabolic abnormalities and there is also evidence that the metals have been linked to the alteration in the composition of gut microbiota that is applicable to metabolic diseases.
• Research can go further in bioenergetics to understand the effects of these toxicants on cellular energy production and metabolism that can serve biomarkers to monitor exposure and subsequent disease development.
• A growing body of reviews and meta-analyses highlights the necessity of combining exposure data with toxicity profiles to focus on chemicals with significant metabolic health hazards and devise specific interventions.

All this evidence together calls to add environmental toxin mitigation as part of the global metabolic disease pandemic approach.

You may also like to read: Benefits and Challenges of Precision Medicine in Diabetes

Factors That Influence Risk

Several factors influence the risk of metabolic health disruption from environmental toxins:

Exposure Level and Duration

·       Higher intensity and long-term exposure to toxins such as pesticides, heavy metals and air pollutants predisposes metabolic disease including obesity, insulin resistance, and diabetes.

Chemical Type and Mixtures

• Endocrine-disrupting chemicals (EDCs) like bisphenol A (BPA) and phthalates are highly hormonal.
• The joint effect of various chemicals or pollutants could be additive or synergistic and enhance metabolic outcomes.

Genetic and Epigenetic Susceptibility

·       Individual genetic background has a role; epigenetic changes (e.g. changes in DNA methylation in response to toxins) can mediate long-term metabolic dysfunction and may be inheritable.

Age and Developmental Stage

·       Exposure at critical developmental stages like prenatal, childhood or puberty heightens the risk of having lifelong metabolic disorders due to interference with organ development and metabolic programming.

Socioeconomic and Lifestyle Factors

• Poor nutrition, inactivity, and poor socioeconomic status tend to augment toxin exposure and metabolic illness.
• Disadvantaged populations: The poorer ones might not access clean environments, which increases risk.

Microbiome Status

·       The gut and environmental microbiomes mediate toxin metabolism, dysbiosis can increase metabolic impairment.

Co-existing Health Conditions

• Pre-existing metabolic abnormalities or inflammatory conditions heighten susceptibility to pollutants’ harmful effects.

Together, these factors shape individual differences in how environmental toxins impact metabolic health, emphasizing the need for personalized risk assessment and targeted preventive strategies.

Strategies to Reduce Exposure and Support Metabolic Health

Strategies to reduce exposure to environmental toxins and support metabolic health include a combination of personal lifestyle changes, home environment adjustments, and broader community or policy-level actions:

Personal and Lifestyle Strategies

• Select organic or well washed fruit and vegetables to eliminate pesticide residues.
• Have non-toxic, fragrance-free household and personal care products, to reduce exposure to chemicals.
• Minimize plastic consumption, replacing it with glass or stainless-steel containers and do not heat food using plastic, which enhances chemical leaching.
• Raise the consumption of nutrient enriched and fiber heavy foods that promote the processes of detoxification (ex: fruits, vegetables, whole grains).
• Keep hydrated and do exercises to stimulate the removal of toxins through sweat and urine.
• You can use such supplements as glutathione, N-acetyl cysteine (NAC), milk thistle, and chlorella to aid in the process of liver detoxification and the removal of heavy metals.

Home Environment Adjustments

Enhance indoor air quality by ventilating, employing HEPA air purifiers, and indoor plants that aid in filtering the toxins.

Wipe surfaces frequently with wet cloths and vacuums with HEPA filters to minimize dust-borne toxicants.

Avoid products with dangerous chemicals like phthalates and parabens and watch out for unfortunate replacements with potentially dangerous ones.

Community and Policy Measures

• Support and advocate for clean air and water regulations that limit industrial emissions and toxic chemical releases.
• Participate in community education programs and environmental clean-up initiatives.
• Encourage implementation of exposure-informed care models that integrate preventive health strategies for vulnerable populations.

Collectively, these approaches reduce toxin burden, support the body’s natural detoxification, and help protect metabolic health over time.

Final Thoughts

Finally, another issue that is underestimated as a cause of poor metabolic health is environmental toxins. Air pollutants as well as heavy metals, endocrine-disrupting chemicals, and others can disrupt hormones, contribute to inflammation and worsen the balance of energy, leading to obesity, diabetes, and other metabolic diseases. Limiting exposure- by making informed lifestyle choices, better regulations, and cleaner environments can aid in preserving long-term well-being in addition to the aid of healthier communities.

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

The means of treating diabetes and its diagnosis is changing with precision medicine. This type of personalized approach will modify care to the needs of everyone through genetic, environmental, and lifestyle data analysis. Precision medicine can provide an opportunity to diagnose diabetes at earlier stages, tailor treatment, and achieve improved long-term results. Nonetheless, its use is not without its difficulties, both in terms of cost and accessibility and in terms of ethics. Appreciating the advantages and challenges are the keys to unleashing its full potential to people with diabetes.

Understanding Precision Medicine in Diabetes

In diabetes, precision medicine is a novel intervention, which tailors the diagnosis, prediction, prevention, and treatment to the unique genetic, environmental, and lifestyle factors of a person. As opposed to conventional methods of treating diabetes as general categories (type 1, type 2 and so on), precision medicine seeks to classify patients in a more precise way so that therapeutic can be maximized and side effects minimized. It combines multidimensional data, such as genomics, clinical, wearable, and biochemical data and customizes care based on the individual disease profile and risk factors of the individual patient.

Key Concepts in Precision Medicine for Diabetes

• Genetic-Testing-Based Diagnosis: Diagnosing diabetes subtypes with more precision by genetic testing and clinical manifestation (particularly in monogenic diabetes, due to single gene mutation), and increased precision in type 1 diabetes and type 2 diabetes.
• Personalized Treatment: Choosing the most effective medications and interventions according to genetic markers and individual response predictions to enhance efficacy and reduce side effects.
• Prevention and Prognosis: To determine those individuals at high risk due to genetic and environmental influences to use specific preventive care and predict disease progression.
• Technological Integration: Use of continuous glucose monitoring, insulin pumps and other tools to control and apply insulin treatment as needed.
• Multi-Factorial Data application: The integration of genetic profiles, lifestyle, environment, metabolomics, and clinical data, to obtain the complete picture of the disease in an individual.

Benefits and Focus Areas

• Precision medicine can be used to identify diagnosis and provide specific therapy choices with almost certainty in monogenic diabetes.
• In the case of type 1 diabetes (T1D), it combines the autoimmune indicators and genetics to classify subgroups and tailor preventive and treatments.
• Precision medicine, when applied to type 2 diabetes (T2D), aims to establish patient subsets that are most responsive to a particular intervention, such as metformin, SGLT2 inhibitors, and GLP-1 receptor agonists, based on genetic variation in response to drugs.
• It is also an effort to outgrow a glossocentric one-size-fits-all model by incorporating a wide range of factors that affect diabetes biology and lifestyle of patients.

Precision medicine in diabetes is a transition to more personalized, data-driven care, which enhances patient outcomes and quality of life by comprehending patient heterogeneity in the pathology and response to treatment in diabetes.

Challenges of Precision Medicine in Diabetes

The challenges of precision medicine in diabetes span several critical areas:

1. Complex Disease Biology: Diabetes, particularly type 2 is polygenic and heterogeneous, with several environmental factors and genes affecting the disease. This complicates the process of finding single genetic markers or pathways of interest to treat efficiently as monogenic or simpler diseases.
2. Data Interpretation and Integration: The massive biological data need the intervention of experts to prevent false classification and false diagnosis. The combination of genetic, clinical, lifestyle, and environmental data into practical clinical outcomes is an extremely complicated task.
3. Healthcare System Readiness: Healthcare systems should evolve, such as training of clinicians in genomics, data science and development of decision-support systems to take precision-based diagnostics and treatments into clinical practice.
4. Regulatory and Payment Matters: Regulatory bodies and payers experience difficulties in establishing guidelines concerning evidence and approvals and paying policies on accurate diagnostics and treatments. This makes it difficult to make wider use outside research markets.
5. Equity and Population Diversity: The research is largest in the populations of European ancestry, and therefore it is not generalizable. There should be inclusion of different ethnic and geographical populations to prevent the increased health inequalities.
6. Cost-effectiveness and Evidence Base: More pragmatic trials and cost-benefit studies are required to show actual utility and economic worth of precision diabetes care especially outside the monogenic forms.
7. Patient and Provider Engagement: Patients and clinicians should communicate effectively on risk and benefit, consider health literacy, and socioeconomic factors using shared decision-making tools.

You may also like to read: Role of Artificial Intelligence in Diabetes Management

Future Prospects

Precision medicine in diabetes has a transformative future on diabetes care because it can be used to approach diabetes diagnosis, treatment, and prevention in a highly personalized manner. Genetic testing, artificial intelligence, and analytics of big data are likely to enable clinicians to customize a treatment according to the personal genetic composition, metabolism, and lifestyle of the patient and achieve better treatment outcomes and fewer side effects. Subtype classification and individual predictive therapeutic responses Precision approaches are more practical as better diagnostic algorithms can classify diabetes subtypes more accurately and predict unique therapeutic responses.

Machine learning can be integrated with diabetes management, which will increase its effectiveness, real-time monitoring, and personalized care programs. Although precision medicine has already firmly established itself in the diagnosis of monogenic diabetes, its future development and use is to broaden it to the more common type 1 and type 2 diabetes. Further uptake will require overcoming issues like cost, integration of health care systems and equitable access. Finally, precision medicine is set to transform how diabetes is treated by no longer using standard guidelines but rather tailored therapy which helps to maximize health and quality of life in patients across the globe.

Bottom Line

Precision medicine presents enormous potential in transforming the treatment of diabetes to provide personalized treatment, early warning, and better patient outcomes. However, it is contingent on its ability to overcome price, availability, and information security. The potential of precision medicine can be realized by having healthcare systems encourage research, educating, and providing equitable access, which will be used to develop further, more effective, and personalized solutions to managing and preventing diabetes.

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

Diabetes is a rapidly spreading chronic disease in the global context. It requires more intelligent and efficient approaches to long-term care. AI is becoming an almighty ally, transforming patient, clinicians, and researcher conceptualizations and management of the disease. Artificial intelligence is being used to minimize the number of complications and overall quality of life of diabetic patients. It analyze real-time glucose data, predicting changes in blood sugar levels, and personalizing treatment plans. With the constant development of technology, the application of AI to diabetes management holds the future of more accurate, preventive, and patient-oriented treatment.

Understanding Artificial Intelligence in Healthcare

Artificial Intelligence (AI) in healthcare is an overall concept of utilizing AI technologies to process complex medical data. It enhance its accuracy of diagnosis, optimize treatment strategies, and increase care efficiency and operations. It is revolutionizing the healthcare delivery by automating high-volume work, early disease detection, personalized medicine, drug discovery, and remote patient monitoring. AI systems can process extensive clinical data fast, identify patterns, and make clinical decisions. Thereby, it enhance patient outcomes and lowering costs.

Applications of AI in Diabetes Management

Artificial Intelligence (AI) has multiple significant uses in managing diabetes. It enhance its prevention, monitoring, customization of treatment, and detection of complications.

Key Applications

• Customized Treatment Plan: AI uses multidimensional patient data, such as medical records, genetics, lifestyle, and continuous glucose monitoring (CGM) data. It tailor diet plans, exercise plans, medications plans, and insulin dosing plans that provide the most effective blood sugar management and minimized complications. Smart insulin pens and artificial pancreas technologies enable AI-driven platforms to adjust insulin dosages dynamically in real time, enhancing accuracy and patient adherence.
• Blood Glucose Monitoring: AI is interconnected with CGM devices that constantly measure the glucose levels without piercing fingers. Glucose trends are predicted by AI algorithms, which allow timely interventions to avoid either hypoglycemia or hyperglycemia. AI-driven closed-loop systems monitor glucose and automatically deliver insulin in real-time.
• Complication Detection and Prevention: AI-based software (in particular, deep learning) detects the presence of diabetic retinopathy at an early stage of the disease by analyzing medical imaging data, allowing timely intervention.
• The Risk Prediction and Early Intervention: AI knows individuals with high chances of developing diabetes based on their genetic and lifestyle data to facilitate earlier prevention strategy.
• Behavioral and Lifestyle Guidance: AI apps enable customized lifestyle suggestions regarding self-monitoring of activity and diet that helps diabetes patients to manage themselves better.
• Better Medication Management: Machine learning algorithms recommend the best drug prescriptions based on patient data in order to enhance the efficacy of treatments.

Benefits of AI in Diabetes Care

·       Better control of blood glucose levels by appropriate doses of insulin and constant monitoring.

·       Improved patient convenience and comfort of non-invasive glucose sensors and automated insulin delivery.

·       Early detection and management of complications of diabetes.

·       Better self-control and compliance with individual recommendations.

·       Less pressure on healthcare providers with automated decision support and data analysis.

Challenges and Limitations

The challenges and limitations of AI in diabetes management include:

Data Quality and Bias

• AI systems use high-quality and labeled information. Bad quality data (blurred pictures, the wrong tags, etc.) may disrupt the work of the model.
• Inadequate, incomplete, or biased datasets may increase healthcare disparities by race, ethnicity, gender, or socioeconomic status.
• It is important to make sure that AI training sets reflect social, environmental, and economic aspects that shape health fairly.

Technology Design and Usability

• Many AI-driven diabetes health technologies (DHTs) suffer from poor user-centered design, making them difficult to navigate and frustrating for patients.
• Lack of confidence with technology and poor interface design lead to non-adoption or early abandonment of AI tools by users.

Data Privacy and Security

• The diabetes AI systems are reliant on sensitive patient information. Data anonymization, data storage and data use are imperative.
• A system in the US, such as HIPAA has stringent privacy and security provisions but makes it difficult to develop and deploy AI systems.

Healthcare System Complexity and Integration

• Disjointed health systems, particularly in the nation such as India, where there is a divide between the city and country, do not support the smooth realization of AI.
• Introduction of AI tools into the current clinical processes is challenging. Unless systems are transparent, the physician acceptance can be low (black box problem).
• Regulatory certification like FDA approval involves hard testing and makes entry slow.

Cultural and Linguistic Diversity

• There is the need to have multilingual and culturally sensitive AI solutions to effectively serve diverse populations.
• Such cultural differences as attitudes toward health and technology affect the use of AI and trust.

Affordability and Sustainability

• There are high initial development and operation expenses that limit access to AI tools, particularly in resource-constrained environments.
• It requires scalable and sustainable solutions to be used in the long run.

Ethical and Legal Concerns

• Risks of data theft, patient privacy breaches, and ethical challenges in AI decision-making require careful governance

You may also like to read: Stem Cell Therapy

Future Trends and Innovations

The current trends and advancements in AI-based diabetes care are oriented to the improvement of personalized care, predictive analytics, and the use of smarter insulin delivery systems. The major future trends in 2025 are:

Intelligent Glucose Monitoring and Prediction

• Continuous glucose monitoring (CGM) systems are now not just reporting on glucose readings on the fly, but they are forecasting hypoglycemic and hyperglycemic events hours before they occur. These systems auxilia lifestyle data, including diet and physical activity, and give patients insights that allow them to make proactive choices.
• CGMs are linked to smartphone applications which can propose varying times to eat and other activities to offer personalized and dynamic guidance on diabetes management.

Smarter Insulin Delivery

• AI-driven insulin pumps operate with real-time glucose data and biometric signals to finely tune insulin delivery, mimicking the pancreas better than past technologies.
• Closed-loop, semi-automated insulin delivery systems based on machine learning reduce hypo- and hyperglycemic episodes and improve patient quality of life by decreasing the burden of self-management.

Predictive Analytics for Complications

• AI models analyze electronic health records, lab results, and wearable data to predict the risk of diabetes complications such as retinopathy, nephropathy, and cardiovascular disease early.
• These early warnings enable clinicians to intervene sooner, shifting diabetes care from reactive to preventive medicine.

Dynamic and Personalized Treatment Plans

• AI platforms synthesize a patient’s ongoing health data to recommend and adjust individualized treatment protocols, including diet, exercise, and medication, in real-time.
• Nutrition guidance is highly personalized using AI algorithms that analyze dietary logs alongside blood glucose responses, allowing patients to receive actionable advice fitting their lifestyles.

Virtual Diabetes Coaches

• AI-powered digital assistants provide continuous support through text or voice, offering reminders, answering questions, and adapting to patients’ preferences and challenges over time.
• These virtual coaches particularly benefit patients with limited access to endocrinologists or specialized care, helping bridge healthcare disparities.

Prevention and Early Diagnosis

• AI increasingly helps identify individuals at high risk for Type 2 diabetes based on genetic, lifestyle, and biometric data, supporting early intervention and lifestyle modification to delay or prevent disease onset.
• Real-time coaching and adaptive goal setting for prediabetic patients make preventive measures structured and personalized.

Integration with Emerging Technologies

• A combination of AI and digital twin technologies and neuromodulation procedures (such as transcutaneous auricular vagus nerve stimulation or taVNS) is a novel field that is anticipated to enhance glucose regulation more by means of noninvasive interventions.
• Reinforcement learning algorithms: The algorithms are used to optimize insulin dose and lifestyle advice based on continuous learning of response to individuals.

These trends make AI the basis of the new era of diabetes management in 2025, enabling smarter, proactive, and highly individualized therapy that enhances clinical and quality of life among patients.

Final thoughts

AI is transforming the management of diabetes by providing devices that help to make care smarter, faster, and more personalized. By enabling patients and health professionals to make superior choices and get healthier results, AI facilitates the anticipation of glucose patterns to early detection of complications. With such technologies being more available and more advanced, they can really make the diabetes care personalized and more proactive.

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

Diabetes is not a new large scale health issue, and millions of people worldwide are affected by it. It usually necessitate lifelong use of insulin or other drugs. Although the existing therapies aid in regulating the level of sugar in the body. They do not deal with the factual loss or defects of insulin-producing cells. The idea of stem cell therapy of diabetes is developed here as a new successful strategy. It promises to restore damaged cells, natural insulin production, and change the perspectives of diabetes management.

What is Stem Cell Therapy?

Stem cell therapy is an up-and-coming medical therapy. It applies stem cells to repair or replace the damaged cells and tissues in the body. In diabetes, it seeks to replace the activity of the insulin producing cells (islet cells) of the pancreas. Scientists have found ways of turning stem cells into pancreatic islet cells. It can produce insulin that could then be used instead of insulin injections.

Stem Cell Therapy for Diabetes

• The treatment entails the conversion of stem cells into functioning pancreatic islet cells. It can be implanted to diabetic patients to resume insulin production.
• In Type 1 diabetes, stem cells could preserve the surviving insulin-producing cells against immune attack, and repair insulin-producing cells.
• In Type 2 diabetes, stem cell therapy may be used to enhance glycemic regulation. It minimize the drug intake, and manage the instances of diabetes complications.
• Recent developments: A new technology is the use of personalized stem cell therapies. The patients are provided with their own cells, which are re-programmed and transplanted, with promising outcomes, including insulin independence in some.
• There are ongoing clinical trials and already cases of patients having long-term outcomes after receiving stem cell therapy.

Stem cell therapy is still in its experimental stages. It is not a generally consistent therapy. But it is one of the bright futures in the possibilities of curing, or at least improving, diabetes.

Current Research and Breakthroughs

Current research and breakthroughs in diabetes treatment in 2025 are rapidly advancing. Particularly in the areas of stem cell therapy, gene editing, and diabetes management technology.

Stem Cell Therapy Advances

• Recent reports indicate exceptional success of stem cell-derived islet cell therapies. It lessen or eradicate the requirement of insulin injections in type 1 diabetes patients.
• Clinical trials demonstrated that in many patients with severe type 1 diabetes. A single infusion of stem cell-based treatments cured or impacted a great deal on insulin independence.
• Scientists are working on CRISPR gene-edited pancreatic cells that are immune-evasive. It enable a longer-term manufacturing of insulin without immunosuppressive medications.
• The issues encountered include safety, transplantation efficiency and immune rejection. The current trials are encouraging in the field of personalized medicine strategies.

Other Research and Treatment Innovations

·       New classes of drugs, such as GLP-1 receptor agonists, developed to manage type 2 diabetes, are in testing to manage type 1 diabetes.

·       Artificial pancreas systems with continuous glucose monitoring with automated insulin delivery enhance quality life and glycemic control.

·       Gene therapy and regenerative medicine solutions are also trying to re-program other cells to manufacture insulin bringing us closer to possible remedies.

·       Technology in diabetes such as continuous glucose monitors and connected insulin delivery devices, are in constant development which provide closer glucose regulation and empower patients.

Key Benefits of Stem Cell Therapy for Diabetes

The key benefits of stem cell therapy for diabetes include restoring the body’s natural ability to produce insulin, achieving insulin independence, and providing a long-term solution for blood sugar control.

Key Benefits

• Replenishes Natural Insulin: Stem cells differentiate into insulin-producing beta cells, which substitute the damaged or non-functioning cells in the pancreas. This rejuvenation of beta cells assists in stabilizing the blood sugar levels.
• Gains Insulin Independence: A good number of patients gain a high reduction or even show no insulin injections. A clinical trial reveals clinical results that patients cut their insulin levels by 91-100% after treatment, and in some patients, there is even over 1 year insulin independence.
• Long-term Blood Sugar Control: In this case, it has been shown that optimum insulin synthesis and metabolism can be sustained for at least 12 months following treatment, resulting in superior glycated hemoglobin (HbA1c) levels in the acceptable range.
• Minimally Invasive Transplants: Stem cell therapy is usually done through injections, which do not carry the risks and recovery linked to major surgery such as those done in the pancreas transplant. It also helps to minimize lifelong immunosuppressive drugs.
• Treats the root causes: Unlike conventional therapies which aim at dealing with symptoms, stem cell therapy seeks to deal with the underlying causes of the disease by replacing pancreatic tissue and regulating the immune system response, particularly useful in type 1 diabetes where autoimmune attack destroys the beta cells.
• Mackay Reduce Insulin Resistance: The stem cells could release anti-inflammatory factors and growth molecules positively affecting the body in type 2 diabetes to make metabolic processes more efficient.

Overall, stem cell therapy offers a promising approach for both type 1 and type 2 diabetes by potentially curing or significantly improving the disease through regeneration, immune modulation, and sustained insulin production.

Challenges and Limitations

Stem cell therapy for diabetes, while promising, faces several significant challenges and limitations that currently restrict its widespread clinical implementation.

Safety Concerns:

·       What is a significant risk is tumorigenicity, particularly with pluripotent stem cells (ESCs and iPSCs) that have a high proliferative potential that can form tumors unless it is completely differentiated prior to transplantation.

·       Immunogenicity problems- transplanted cells can be rejected by the immune system, especially allogeneic cells having foreign human leukocyte antigen (HLA) systems.

·       Handling these risks is currently being worked on by techniques such as CRISPR gene editing and encapsulation technologies, which are yet to be completely demonstrated to work clinically.

Efficacy Challenges:

·       Surviving of the cells transplanted is poor; most of the cells transplanted succumb to immune assault and other metabolic burdens such as oxidative damages soon after injections.

·       Homing efficiency: the capability of stem cells to migrate and engraft well in pancreatic tissues is suboptimal because of limited knowledge of the controls.

·       Engrafted cells have variable functional potency, which affects the level of production of insulin and regulation of glucose.

Ethical and Regulatory Issues:

• Embryonic stem cells are associated with the ethical aspect of the destruction of embryos.
• Regulatory processes of stem cell therapy approvals are in transition and present a hindrance to speedy clinical implementation and standardization.

Scalability and Cost:

• It is costly and complicated to make high-quality and differentiated stem cells in amounts that are sufficient to treat.
• Quality control, preventing variability of stem cell preparations, and long-term safety make treatment more expensive and less accessible.

Patient-Specific Factors:

• Immune compatibility issues with autologous (patient-derived) versus allogeneic (donor-derived) cells.
• Variability in patient responses due to disease stage, immune environment, and metabolic conditions can affect therapy outcomes.

Despite these challenges, ongoing innovations in gene editing, cell engineering, 3D-bioprinting, and AI-driven personalized treatments are actively addressing these limitations, with expectations that these therapies will become safer, more effective, and more widely available in future diabetes care.

You may also like to read: Diabetic Foot Infections

Future Outlook

The future outlook for stem cell therapy in diabetes is very promising, with rapid advancements expected to transform diabetes care. The therapy offers a potential long-lasting or permanent solution by regenerating insulin-producing cells and modulating the immune system. Market growth is projected to be strong, driven by rising diabetes prevalence and ongoing clinical successes. Challenges like safety, immune rejection, and cost are being addressed by innovations such as gene editing, 3D-bioprinting, and personalized medicine. Overall, stem cell treatments are anticipated to become mainstream, offering hope for effective remission or cure of both type 1 and type 2 diabetes soon.

Final Thoughts

Diabetes remains one of the most pressing global health concerns, affecting millions of people worldwide and often requiring lifelong management with insulin or other medications. While current treatments help control blood sugar levels, they do not address the underlying loss or dysfunction of insulin-producing cells. This is where stem cell therapy for diabetes emerges as a promising new approach, offering the potential to regenerate damaged cells, restore natural insulin production, and transform the future of diabetes care.

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

Even simple activities, such as talking, eating, or swallowing, feel uncomfortable in case of a sore throat. It may be a cold, allergies, or the air may be dry, but it is necessary to find a quick and effective remedy. And in this article, we will discuss the top sore throat remedies, including home treatments and over-the-counter remedies, so that you can alleviate irritation and heal quickly.

Understanding Sore Throat

Pharyngitis, also known as sore throat, is a widespread ailment that causes pain, scratchiness or irritation in the throat that intensifies when swallowing or talking. It is mostly a result of viral infections like the common cold or flu and it normally clears on its own after a few days to approximately a week. In others, a sore throat may be caused by bacteria such as strep throat, and may necessitate antibiotic prescriptions. Allergies, irritants, such as smoke or dry air, and more rarely fungal or more significant diseases of various parts of the throat, such as tonsils, voice box, or epiglottis, are other causes. The symptoms may include redness and swelling of the throat, swollen glands, hoarseness and white patches on tonsils in rare cases. Sore throats are mild and temporary in most cases, and persistence or severity can require medical attention.

Causes of Sore Throat

• Viral infections (common cold, flu)
• Bacterial infections (Group A Streptococcus/strep throat)
• Allergies and irritants (pollen, smoke, dry air)
• Fungal infections (rare, usually in immunocompromised persons)
• Inflammation in specific throat areas (tonsillitis, laryngitis, epiglottitis)

Common Symptoms

• Pain or scratchy feeling in the throat
• Pain worsens with swallowing or talking
• Red, swollen throat and tonsils
• Swollen neck glands
• Hoarseness or muffled voice
• White patches on the tonsils (in bacterial infection)

Natural Home Remedies

Home remedies that offer relaxation, anti-inflammatory, and anti-infective properties are used to treat a sore throat; these include:

• Honey: The honey has some natural antibacterial and anti-inflammatory properties. They coated the throat, soothe irritation, usually taken as a standalone Honey or in warm tea.
• Saltwater Gargle: Warm saltwater gargles with swelling, bacteria, and looseness of mucus will make the throat feel better.
• Baking Soda Gargle: Baking soda and salt in warm water have the ability to neutralize acid, decrease bacteria, and reduce inflammation.
• Herbal Teas: Chamomile tea is anti-inflammatory and mildly sedative; peppermint tea cools and clears mucus; ginger tea relieves pain and inflammation.
• Fenugreek Tea: It has antifungal and antibacterial effects, which inhibit throat infection and inflammation.
• Turmeric Tea: This is a curcumin-rich tea that has anti-inflammatory and is antibacterial.
• Marshmallow Root Infusion: This is a mucilage that soothes the throat with ease.
• Sage-Echinacea Throat Spray: Can treat sore throat as well as antiseptic sprays.
• Coconut Oil: This is used as a lubricant to calm down any form of dryness and inflammation.
• Steam Inhalation: Soothes the throat and frees the mucus, decongesting the throat.
• Licorice Root: Traditionally used as a sore throat remedy, antibacterial, but should be used with care in pregnancy.
• Slippery Elm: Marshmallow root mucilage that coats the throat and decreases irritation.
• Garlic: It is an allicin which has antiviral and natural antibacterial properties and helps it cure sore throat.

Mostly, these remedies are safe and can provide relief from the symptoms. Intrusive or chronic symptoms need medical attention.

Over-the-Counter (OTC) Solutions

OTC medicines used to treat sore throat are aimed at first relieving pain, decreasing inflammation, and calming irritation of the throat. Common OTC options include:

• Pain Killers: Acetaminophen (Tylenol) will help a person to decrease pain and fever. NSAIDs, such as ibuprofen (Advil, Motrin) and naproxen (Aleve), also reduce inflammation and swelling, which also contributes to the pain relief.
• Throat Lozenges: (Menthol or benzocaine are the components) It is used to render the throat numb to give a cooling/soothing effect to the throat to ease the pain. Well-known brands are Cepacol and Halls.
• Throat Sprays: These sprays commonly have phenol or benzocaine to numb the painful part of the throat to relieve pain over the short term.
• Other OTC Products: Other products are demulcents (which line and soothe the throat) used with analgesics or anti-inflammatories.

Before taking these drugs, one should take directions on dosage and pay attention to allergies or health conditions. Constant or intense sore throat symptoms can be treated with prescription interventions like antibiotics in case of suspicion of bacterial infection.

You may also like to read: Munchausen syndrome

Lifestyle & Preventive Tips

To maintain throat health and prevent sore throat, the following lifestyle and preventive tips are effective:

• Wash hands frequently, at least 20 seconds, or apply alcohol-based hand sanitizer, particularly after touching common objects or ill individuals. Do not touch the face, eyes, nose, and mouth.
• Keep a distance with others who show signs of respiratory infections such as cold or flu, and do not share food, beverages, and utensils.
• Maintain the hydration of the throat by taking as much water, warm herbal tea, or broth as you can. Caffeine and alcohol are to be avoided as they may dry the throat.
• Regularly gargle warm saltwater to treat irritation of the throat and to decrease inflammation.
• To aid the immune system and voice rest to prevent strain, get enough sleep and rest.
• Do not expose yourself to fumes of chemicals, tobacco smoke, and dry air. Install a humidifier, which keeps the air moist in the environment, particularly in dry seasons.
• Eat soft or cold food to prevent the worsening of the throat pains and additional help can be made through sucking of ice chips or throat lozenges.
• The frequency of sore throats might be decreased by annual vaccination against flu and some underlying conditions like allergies or reflux.

Adopting these preventive measures helps reduce risks, speeds recovery from mild throat discomfort, and supports overall throat health.

When to See a Doctor

A person should see a doctor for a sore throat if any of the following occur:

• Sore throat lasts more than a few days or gets worse instead of better.
• High fever above 38°C (100.4°F) or over 101°F that persists.
• Severe throat pain or difficulty swallowing.
• Difficulty breathing or noisy breathing (stridor).
• Swelling or lumps in the neck.
• White patches or pus on the tonsils.
• Blood in saliva or phlegm.
• Signs of dehydration, such as very reduced urination or dark urine.
• Hoarseness lasting more than two weeks.
• Rash, joint pain, or swelling.
• Excessive drooling, especially in children, or inability to swallow saliva.
• Immune system weakening conditions like chemotherapy or diabetes, along with sore throat.
• Repeated sore throats or unusual mouth/throat lumps or ulcers lasting more than three weeks.

Seek urgent care immediately if experiencing severe symptoms such as breathing difficulty, severe pain, inability to swallow, drooling, or rapidly worsening symptoms.

Final Thoughts

Treatment of a sore throat does not always have to be complex, and simple, evidence-based solutions can help a lot. Warm saltwater gargles and honey drinks, lozenges, and hydration are all ways to alleviate pain and recover faster. In case the symptoms do not disappear or get acute, consult a doctor in order to get appropriate treatment and permanent relief.

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

Keratosis pilaris is a painful skin disorder that is quite frequent and has harmless, small rough bumps on the skin surface. It is also known as chicken skin and is typical on upper arms, thighs, cheek or buttock and may cause unevenness of the skin or skin drought. Although keratosis pilaris is not harmful, most individuals desire to have smooth and clear skin. The first step in managing this condition is to understand its causes, symptoms and treatment options.

What Is Keratosis Pilaris?

Keratosis Pilaris is a common, harmless skin condition characterized by small, rough bumps on the skin, often described as “chicken skin.” These bumps are caused by excess keratin, a protein that forms hair, nails, and skin’s outer layer, accumulating and plugging hair follicles. It typically appears on the upper arms, thighs, buttocks, and sometimes the face. The bumps can be skin-colored, red, brown, or white and the skin may feel dry and rough. Keratosis Pilaris is often seen in children and adolescents and generally improves with age, sometimes fading by early adulthood. While it is harmless and usually does not require treatment, moisturizing the skin and gentle skincare routines can help manage symptoms, especially dry skin. The condition has a genetic component and tends to worsen with dry skin or in cold weather but improves in warm weather.

Symptoms and How to Recognize It

Keratosis Pilaris is known to have some typical symptoms and visual appearance:

• Goosebump-like, small and painless bumps tend to occur in the upper arms, thighs, buttocks, cheeks, chest, or back. Such bumps are typically rough and may be sandpaper-like.
• The bumps may be of a skin color, red, white, pink, brown, or black, according to the skin of a person.
• The afflicted skin can be dry to rough, itchy or irritated. The bumps may be reddened or a bit inflamed, particularly when scratched.
• Keratosis Pilaris is usually aggravated during dry seasons, especially during winter and usually relieved during warm seasons.
• The disease is prevalent in children, teenagers and, in occasional cases, adults.
• Bumps are not painful but in some instances itching or pain can be experienced.
• An ingrown hair may be found in some bumps.
• The disease produces patches or scattered small bumps as opposed to diffuse rash.

Its characteristic feature which aids in its identification according to its appearance, is the rough, bumpy patches which are often referred to as chicken skin.

Causes and Risk Factors

This is caused by a deposition of keratin, a skin protecting protein, that blocks hair follicles and creates the rough, small bumps known as Keratosis Pilaris. This build-up of keratin is not completely understood as its cause, but genetics leads to it in many cases, and the condition is often familial.

Risk factors that put one in danger of developing keratosis pilaris include:

• Keratosis pilaris in family history.
• Suffers have dry skin that aggravates the condition.
• Skin disorders, such as eczema (atopic dermatitis) and ichthyosis vulgaris (excessively dry skin disorder).
• Indicating that it may be related to atopic diseases, asthma and hay fever.
• Overweight or obese body condition.
• Flare-ups triggered by hormonal changes during puberty and pregnancy.
• It is more prevalent in children, adolescents, and women.

Keratosis pilaris is not transmissible and occurs predominantly in parts of the body having hair follicles except the palms and soles. It can also be caused by vitamin A deficiency and treatment with vitamin A can be helpful. The condition normally manifests in childhood or adolescence and may pass by adulthood, though in a few cases.

Treatment and Management Options

The treatment of Keratosis Pilaris is aimed at modifying the looks and skin feel as it has no cure. Management generally entails:

• Moisturizing: It is essential to use moisturizers that are rich in emollients to hydrate and make dry and rough skin soft.
• Exfoliation: Topical creams of lactic acid, salicylic acid, urea, or alpha hydroxy acids aid the exfoliation process of the dead skin cells and keratin plugs, making the skin smoother.
• Topical retinoids: Retinoids like tretinoin or adapalene that are used by prescription stimulate cell turnover and diminish bumps.
• Topical steroids: Short term use to treat redness and itch when flare-ups occur but not as long-lasting treatment.
• Light skincare: Do not use hard soaps, tidy cleansers, tepid water and should not scrub (this will aggravate irritation).
• Lifestyle changes: Loose, breathable clothing, not shaving infected areas until healed, humidifiers in dry climates, washing bedding regularly, to minimize irritation.
• Light and laser therapies: In cases of severe or stubborn conditions, dermatologists can administer laser treatment or phototherapy to reduce redness, inflammation, and texture issues.
• Surgery: Surgical procedures can be done in rare cases such as hair or keratin plugs extraction, microdermabrasion or chemical peels.

The process of improvement typically requires weeks of regular treatment, and regular maintenance treatment is frequently required to avoid relapse. The condition can usually be alleviated by age and can be resolved on its own.

You may also like to read: Diabetic Foot Infections

Home Remedies vs. Professional Treatments

Here is a comparison table of home remedies versus professional treatments for keratosis pilaris:

Final Thoughts

Keratosis pilaris can be irritating, yet it is a noninfectious and quite widespread skin disease. Through soft exfoliation, frequent moisturising and the proper skin-care products, this can be significantly enhanced, and bumps kept within a healthy control. It is all about consistency – and if OTC remedies don’t work, a dermatologist can refer you to even more specific options that help make your skin smoother and healthier.

FAQs

What can be mistaken for keratosis pilaris?

• Acne Vulgaris.
• Eruptive Vellus Hair Cysts.
• Folliculitis.
• Keratosis Follicularis (Darier Disease)
• Kyrle Disease.
• Lichen Nitidus.
• Lichen Spinulosus.
• Milia.

What foods make keratosis pilaris worse?

Diet is not a causative factor of keratosis pilaris, but foods that cause inflammation may trigger or exacerbate the symptoms; therefore, it is recommended to avoid inflammatory-causing foods. Individuals with keratosis pilaris must not take dairy products, soy, peanuts, trans fats, sugar, or processed food.

Is KP related to gut health?

Keratosis Pilaris: Little heaps on the upper arm, thigh, or cheek can be an indicator of gluten intolerance and/or gut imbalance.

Why did I suddenly develop KP?

Keratosis Pilaris may be more likely to suddenly occur in patients with dry skin, eczema, asthma, excess body weight or hay fever.

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

Diabetics are more prone to foot complications, and diabetic foot infection is one of the most severe. The infections may arise when small cuts, blisters, or sores do not heal well because of poor circulation and nerve damage. Unattended, they can cause serious complications, such as ulcers or amputation. Educating about the reasons, early identification of the signs, and awareness of potential treatment available are crucial measures in preserving the health of the feet and general health.

What is a Diabetic Foot Infection?

A diabetic foot infection is a soft tissue or bone (below the ankle) infection in an individual with diabetes. It is common at the location of skin trauma or ulcers which is a common complication in diabetes, because of factors such as peripheral neuropathy, poor blood flow and immunity. Such infections may be mild on the skin and severe with deep tissue, abscesses and even bone infections (osteomyelitis). Aerobic gram-positive cocci, including Staphylococcus species (including methicillin-resistant Staphylococcus aureus (MRSA)) and in more severe cases polymicrobial, are known to cause diabetic foot infections. They cause lower extremity amputations in diabetic patients unless treated and managed.

Causes

Diabetic foot infections are multifactorial, and their causes are primarily linked to the underlying diabetic complications that affect the health and healing of the foot:

·       Peripheral Neuropathy: Loss of sensation and autonomic nerve functions cause unperceived injury, dry skin, skin cracking, and foot deformities, which contribute to skin breakdown and infection.

Trauma, or Wounds: Foot trauma, ulcers, or wounds- caused by pressure, poor footwear, or repetitive injury. Penetrating wounds lasting longer than 30 days are at greater risk of infection.

·       Peripheral Arterial Disease (PAD): This is the inability of blood to reach the tissues and provide oxygen and nutrients necessary to heal wounds and defend against infection.

·       Poor Glycemic Control and Immunocompromised: High blood sugar (hyperglycemia) impairs the body to combat infection and slow healer.

·       Other Factors: Smoking: Smoking leads to decreased blood flow, and delayed healing; foot deformities and calluses augment the number of pressure points; poor foot hygiene and improper nail care also elevate risk of infection.

All these predispose the diabetic foot to bacterial invasion and infection.

Symptoms

Diabetic foot infection has a variety of symptoms, which indicate infection, inflammation, and delayed healing. Symptoms to observe include:

• Skin changes and injuries: Cuts, sores, blisters, ulcers, or cracks on the feet that heal slowly, or slowly pus or fluid, with a bad smell.
• Redness, swelling, and warmth: Infected zones tend to be red, swollen, hot to touch, painful, but less painful in individuals with neuropathy.
• Discoloration: Skin discoloration around sores such as dark or black tissue which may be a sign of gangrene.
• Pain and numbness: Peripheral neuropathy develops pain, tingling, numbness, or loss of sensation, which can obscure signs of infections.
• Drainage: Yellow, green or smelly discharge around a wound or ulcer.
• Other signs: Shape of feet change, nail infection, loss of all hair on feet or legs, and in very serious cases, systemic, such as fever, chills, or extreme sickness in case of infection spread.

Early identification is essential to avoid development of severe infections, gangrene, or amputation.

Complications if Left Untreated

If left untreated, diabetic foot infections can lead to severe complications including:

·       Transmission of infection: The infection may easily expand to the deeper structures of muscle, tendons, and bones (osteomyelitis) complicating the treatment and recovery of the infection.

·       Gangrene: Tissues may die (gangrene) due to severe infection and inadequate blood circulation, a medical emergency that can require urgent surgery.

·       Amputation: Untreated infections may cause partial or total amputation of toes, foot, or even lower leg to avoid the further spread of infection and save the life of the patient.

·       Sepsis and systemic disease: Infection can be introduced into the blood and lead to sepsis. It is a life-threatening disease with systemic inflammation and organ dysfunction.

·       Types of chronic wounds: Chronic non-healing ulcers carry risks of repeated infections and disability.

·       Low-quality life: The pain, loss of mobility, prolonged stay in the hospital, and even loss of a limb affects the overall wellbeing and independence of patients.

These risks should be minimized by early diagnosis and treatment. It avoid long-term morbidity and mortality among patients with diabetic foot infection.

Diagnosis of Diabetic Foot Infections

Diabetic foot infection diagnosis requires a mixture of clinical evaluation and diagnostic tests:

• Clinical Examination: Diagnosis is mostly clinical, through demonstration of local infection, like redness, warmth, swelling, pain / tenderness, and purulent discharge. Depth and exposure of bone are evaluated by careful inspection following cleaning and debridement.
• Classification: The extent and systemic signs are used to classify the severity. In terms of the Infectious Diseases Society of America (IDSA) or International Working Group on the Diabetic Foot (IWGDF) as uninfected, mild, moderate, or severe infection.
• Probe-to-Bone Test: This is a simple test in which a sterile metal probe is applied to determine whether bone is palpable. It indicates osteomyelitis (bone infection). It is sensitive and specific and relies on operator expertise.

Imaging:

• Small-pox X-rays to identify the presence of bone or foreign bodies.
• MRI is indicated to diagnose osteomyelitis when there is inconclusive clinical evidence.
• Other imaging modalities such as PET, SPECT, or CT can be used in complicated cases.

Laboratory Tests:

• Blood tests such as complete blood count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) are used in diagnosis and evaluating inflammation.
• Blood cultures when there is a suspicion of systemic infection.
• Biopsy of deep wound or tissue samples to culture microbiological culture to identify causative pathogens and antibiotic therapy (superficial swabs are less reliable).

Other: Assessment of peripheral arterial disease, neuropathy, and overall health status is also essential in diagnosis and planning treatment.

Treatment Options

Management of diabetic foot infections (DFIs) mainly includes a combination of antibiotic treatment, wound care, and occasionally surgery. The practice relies on the severity of the infection, complications, and patient factors:

Antibiotic Therapy

• Mild infections: Oral antibiotics are applied that are directed toward common Gram-positive bacteria. MRSA coverage is commonly covered with cephalexin, dicloxacillin or trimethoprim-sulfamethoxazole in case of necessity.
• Moderate to severe infections: need broader-spectrum antibiotics that are usually intravenous, including Gram-positive, Gram-negative, anaerobes, and resistant bacteria, such as MRSA and Pseudomonas aeruginosa. They include vancomycin and piperacillin-tazobactam, cefepime, carbapenems or combinations based on culture findings.
• Typical duration is 1-2 weeks in mild cases but may last up to 3-4 weeks or longer in case of severe infections or slow to resolve infections or osteomyelitis. Step-down therapy is usually oral following initial IV therapy.

Wound Care

• Debridement and drainage of abscesses.
• Frequent dressing and cleaning to keep the wound wet.
• Unloading of the affected foot to help healing.

Surgical Treatment

• Indicated in patients who have gangrene, necrotizing fasciitis, or gangrene.
• Surgical denial of infected or necrotic tissue can be done.
• Severe or refractory cases may require limb salvage operation or amputation.
• To enhance blood circulation and healing, vascular interventions may be discussed in patients with peripheral arterial disease.

Supportive Measures

• Optimization of glycemic control.
• Management of comorbidities like peripheral arterial disease and neuropathy.
• Patient education to prevent recurrence and promote foot care.

You may also like to read: Importance of Foot Care in Diabetes Management

Prevention of Diabetic Foot Infections

The prevention of diabetic foot infections includes maintenance of foot health, early detection of issues, and risk factors. Major prevention measures are:

• Foot inspection and hygiene: Routinely examine feet to look for cuts, blisters, redness, swelling or wounds with a mirror or a helper (caregiver). Clean feet with tepid water every day, dry (with special care between them), and put between toes to avoid cracks and dryness, but do not apply moisturizer.
• Footwear: Wear well-fitting shoes, with adequate toe space, cushioning and support. Wear no tight or rough-edged or ill-fitting shoes, sandals or walking barefoot, even in the house. Diabetic shoes and pads can prevent pressure ulcers.
• Nail and skin care: trim toenails straight and file ends in order to avoid ingrown nails. Do not self-treat corn and calluses; contact a professional. Peel off calluses.
• Consistent check-up of the feet: Frequent foot examinations by medical practitioners to detect early issues and particularly in high-risk patients with neuropathy or peripheral arterial disease.

• Treat underlying conditions: Good glycemic control, cessation of smoking, exercise, and treatment of peripheral arterial disease enhance circulation and nerve condition, lowering the risk.
• Education and early treatment: Educate patients about foot care and seek medical attention to any abnormalities on the feet to avoid further development of an infection.

Such actions, can significantly decrease the risk of foot ulcers and follow-up infections among diabetic individuals.

Final Thoughts

Infection of diabetic foot infection is a severe problem. It must be treated well and immediately. Identifying the red flags, controlling blood sugar levels, and proper foot care help people with diabetes to significantly decrease their risk. Early diagnosis and timely treatment effectively preclude complications, as well as safeguarding long-term health and mobility. Foot care is one of the most useful precautions to maintain health and safety with diabetes.

Dr. Ahmad Shahzad
Founder | Lyallpur Diabetes Foundation
Consultant Diabetologist | Educator | Advocate for Preventive Care

Diabetes is more than just a matter of sugar management; it is also a matter of foot care. Diabetes may impact circulation and nerve damage, exposing the feet to infections, ulcers, etc. Foot care is one of the crucial aspects of managing diabetes, and it serves to avoid severe issues and avoid endangering health.

Why Foot Care Matters in Diabetes

Foot care is a concern in diabetes as diabetes may lead to the destruction of nerves (neuropathy) and inadequate blood flow which impairs the ability to detect injuries and slow wound healing. These complications put at risk unknown cuts, blisters, ulcers, and infections that may become severe and result in amputations without treatment. Early diagnosis and prevention of severe foot conditions, maintenance of mobility, and hospitalization risk can be achieved with proper daily foot care, frequent examinations and check-ups with healthcare professionals such as podiatrists. Foot care is therefore a significant component of diabetes management to ensure overall health and prevent loss of limbs.

Common Foot Problems in People with Diabetes

Common foot problems in people with diabetes include:

• Foot and toe ulcers: Open sores that are usually due to chronic friction or pressure. Approximately 15 percent of diabetics develop them, and they get infected and cause severe complications without treatment.
• Peripheral neuropathy: Damage to nerves causing a loss in sensation, pain, or tingling. It may cause invisible injuries and deformities such as hammertoes or claw toes, exposing more to ulcers.
• Peripheral vascular disease: Impaired blood flow that slows down healing and exposes to infection and gangrene (tissue death), which can amputate.
• Fungal infections: Fungal athletes’ foot and nail fungal infections: It causes itch, cracking, nail deformities and predisposes to bacterial infection.
• Calluses: Gruff skin along the pressure points or ill-fitting shoes that may become ulcerated unless addressed.
• Charcot foot: This is a rare but severe condition in which the weak bones fracture and distort the shape of the foot at risk of additional ulcers and infections.
• Small wounds may be infected; untreated infections can cause the development of abscess, tissue death, and surgical intervention.
• Amputations: Gangrene or non-healing ulcers may require partial amputation of the foot or leg to avoid life-threatening infection spreading.

The problems underline the need to be careful of your feet and to treat them early to avoid severe complications among diabetes.

Preventive Foot Care Practices

Preventive foot care practices for people with diabetes include:

• Foot care and hygiene: Inspect feet daily, looking at them to detect cuts, blisters, redness and swelling. Cleanse feet with warm, not hot, water and light soap, dry in between toes, and moisturize to avoid cracking, but leave between toes dry to avoid infection.
• Wear good shoes and socks: Wear good shoes and socks that cover foot. Do not walk barefooted even in the house and do not wear high heeled, pointed and open toe shoes. Wear change socks every day, in those of natural fibers, without tight elastic bands.
• Toenail care: Trim the toenails to make them straight and smooth the edges to prevent injury. Do not treat cornes or calluses by yourself, visit a podiatrist.
• Blood sugar management: Maintain normal blood sugar levels to limit the damage of nerves and unable blood flow that heightens the risk of foot problems.
• Regular check of the feet with a healthcare profession or podiatrist: Go and have feet assessed at least once a year or more often in case there is a high risk as early as possible.
• Protect feet during exercise: Wear bad footwear when exercising and do not exercise when the feet have open sores.
• Heat and injury: Test water temperature before taking a bath, do not use heating pads on feet, beware of heaters to avoid burns because nerve damage can cause loss of sensation.

These are evidence-based measures that greatly diminish chances of ulcers, infection and amputation, in diabetic individuals.

Role of Regular Medical Check-ups

Early detection and prevention of severe foot complications are essential in diabetes-related foot care due to regular medical check-ups. A healthcare provider or podiatrist conducts a diabetic foot exam during these check-ups and evaluates nerve function (neuropathy), blood flow (vascular status), skin integrity, and foot structure. This assists in detecting the problems of loss of sensation, infections, calluses, ulcers, or deformities before they escalate.

Foot check-ups should be done annually or more often according to the personal level of risk, including neuropathy, peripheral artery disease, foot deformity, or foot ulcer. Routine checks enable an early response (wound management, offloading, referral, etc.), minimizing the risk of infections, gangrene, and amputations.

Also, medical check-ups offer the possibility to teach patients foot self-care, blood sugar control optimization, and footwear. Regular monitoring also facilitates the modification of diabetes care to reduce the development of complications to the feet.

When to Seek Medical Help

Medical help should be sought promptly for diabetes-related foot problems if any of the following symptoms or signs appear:

·       Foot pain or ache.

·       Any fresh split, cut, blisters, and sores that fail to heal or discharge or bleed.

·       Redness, swelling, heat, spreading redness of the leg or foot.

·       Foot is warmer than it should be or has warmth and swelling.

·       Foul odor/new smell of the foot.

·       Symptoms of infection such as fever, chill, general malaise, or flu.

·       Skin or body temperature, including paleness, bluish color, or redness.

·       Gangrene, a symptom of tissue death (black, brown, or foul-smelling tissue) is a medical emergency requiring urgent treatment.

·       Symptoms of Charcot foot include foot deformity, painless swelling and instability.

·       The development or the aggravation of any blisters, ulcers or sores.

Emergency or urgent care is essential to avoid spread of infections, avoid severe complications such as gangrene, and amputations. Early diagnosis can result in timely therapeutic interventions that enhance outcome.

Bottom Line

To sum up, foot care is important in preventing complications and ensuring mobility in patients with diabetes management. Daily routines and regular medical examinations can help a lot to avoid severe problems. Focusing on the health of their feet, all diabetics will be able to preserve their quality of life and long-term health.