Board Certified Foot Specialists

Jack A. Reingold, D.P.M.

(Senior Associate)

Office, located in Encinitas

(next to Scripps Memorial)

1011 Devonshire Dr, Suite F
Encinitas, CA 92024

Voice: (760) 942-1890 
Fax: (760) 942-1895
E-mail: [email protected]

Posts for: May, 2011



Summer can be a very tempting time to want to kick of those shoes and feel that soft green grass or warm sand on your bare feet. People just can’t wait to toss their shoes aside and wiggle their toes in the cool of the grass, or the lake or ocean water.

Hold on! If you’re diabetic, doffing the shoes can be a serious mistake. According to San Diego podiatrist, Dr. Reingold, dangers to feet and ankles lurk everywhere. From unseen stones to buried glass, diabetic feet are in jeopardy without protective shoes, www.Active is a great place to find sandals and sneakers that are designed for diabetic feet. Sure, anyone can step on a nail, but for diabetics, there are special concerns attached to that type of accident.

A wound to a diabetic foot will heal more slowly because of a compromised blood supply. Peripheral neuropathy means a reduced sense of feeling in the feet. A stone could injure a heel, but because the diabetic doesn’t feel it, the wound might not even be noticed for days. By that time, infection could set in.

Infections can lead to gangrene and even amputation. It’s estimated that 75,000 diabetics lose limbs each year to gangrene from unchecked infections. To avoid this, protect feet and ankles by keeping shoes on. In addition, take a good look at your feet each day. Use a mirror to be sure to check all areas, and inspect feet carefully for cuts, swelling, or red
spots that could be precursors to blisters.

 Foot-care tips:

-       Don’t go bare foot on the beach or in the grass, wear tennis shoes

-       Wear socks with closed toe shoes

-       Clean your shoes, flip flops and feet regularly

-       When in the sun, don’t forget to apply sunscreen to your feet

-       When using nail polish, remember to use the 2 weeks on 2 weeks off rule, do not wear nail polish all the time


For more free foot health tips visit or Don’t let summer’s temptations endanger your feet. Protect them everyday, and if you detect any problems, promptly notify your podiatrist. Your foot doctor can give you more tips to keep your diabetic feet and ankles safe and healthy.

Article from:


Structured Exercise Training Associated With Improved Glycemic Control for Patients With Diabetes

ScienceDaily (May 4, 2011) — Implementing structured exercise training, including aerobic, resistance or both, was associated with a greater reduction in hemoglobin A1c levels (a marker of glucose control) for patients with diabetes compared to patients in the control group, and longer weekly exercise duration was also associated with a greater decrease in these levels, according to results of an analysis of previous studies, published in the May 4 issue of JAMA.

"Exercise is a cornerstone of diabetes management, along with dietary and pharmacological interventions. Current guidelines recommend that patients with type 2 diabetes should perform at least 150 minutes per week of moderate-intensity aerobic exercise and should perform resistance exercise 3 times per week," according to background information in the article. "Regular exercise improves glucose control in diabetes, but the association of different exercise training interventions on glucose control is unclear."

Daniel Umpierre, M.Sc., of the Hospital de Clinicas de Porto Alegre, Brazil, and colleagues performed a systematic review and meta-analysis of previously conducted randomized controlled clinical trials (RCTs) of at least 12 weeks' duration that evaluated the ability of structured exercise training or physical activity advice to lower hemoglobin A1c (HbA1c) levels as compared with a control group in patients with type 2 diabetes. The researchers identified 47 RCTs (8,538 patients) that met criteria for inclusion.

The researchers found that overall, structured exercise training (23 studies) was associated with a decline in HbA1c level (-0.67 percent) compared with control participants. In addition, structured aerobic exercise (-0.73 percent), structured resistance training (-0.57 percent), and both combined (-0.51 percent) were each associated with declines in HbA1c levels compared with control participants.

"Structured exercise durations of more than 150 minutes per week were associated with HbA1c reductions of 0.89 percent, while structured exercise durations of 150 minutes or less per week were associated with HbA1c reductions of 0.36 percent. Overall, interventions of physical activity advice (24 studies) were associated with lower HbA1c levels (-0.43 percent) compared with control participants. Combined physical activity advice and dietary advice was associated with decreased HbA1c (-0.58 percent) as compared with control participants. Physical activity advice alone was not associated with HbA1c changes," the authors write.

"This systematic review and meta-analysis of RCTs demonstrates important findings regarding the prescription of structured exercise training. First, aerobic, resistance, and combined training are each associated with HbA1c decreases, and the magnitude of this reduction is similar across the 3 exercise modalities. … Second, our findings demonstrate that structured exercise of more than 150 minutes per week is associated with greater declines in HbA1c than structured exercise of 150 minutes or less per week in patients with type 2 diabetes. This finding is important because the current guideline-recommended exercise duration is at least 150 minutes per week. Although high-intensity exercise has been previously shown to have an association with HbA1c reduction, our findings did not demonstrate that more intensive exercise was associated with greater declines in HbA1c."

The researchers add that the finding that physical activity advice is only associated with HbA1c reduction when accompanied by a dietary cointervention highlights the need for a combined recommendation of these lifestyle interventions.

Editorial: Consideration of Insurance Reimbursement for Physical Activity and Exercise Programs for Patients With Diabetes

Commenting on the findings of this study in an accompanying editorial, Marco Pahor, M.D., of the University of Florida, Gainesville, writes that "additional information regarding the potential benefits of structured exercise is needed, including data from rigorously conducted clinical trials that provide information concerning the efficacy and cost-effectiveness of a structured physical exercise program across a broad spectrum of important health outcomes."

"In summary, the meta-analysis by Umpierre et al in this issue of JAMA and cumulative evidence from a large number of randomized controlled trials conducted over the past few decades in the area of physical activity and exercise provide solid evidence for public policy makers to consider structured exercise and physical activity programs as worthy of insurance reimbursement to promote health, especially in high-risk populations."

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Board Certified Foot and Ankle Surgeons, Coast Podiatry Group of Solana Beach, Inc.
Serving patients in the Carmel Valley, Encinitas, Del Mar area