DAMMAM: “Keep your feet as clean as your face because diabetics are more at risk of having a foot or leg amputated than other people.” This is the advice from Dr. Biju Varghese, an internist at Badr Al-Rabie dispensary during a doctor's conference held at its auditorium entitled “Diabetes Mellitus – Current Approach in Management” as part of a continuing medical education (CME) program. “If both a mother and father are diabetic, there is a 100 percent chance of their children also being diabetic. The majority of people who develop diabetes also have pre-diabetes symptoms, but lack of knowledge leads them to become diabetic. According to recent studies, diabetes is not a disease, it is the condition or state of your body,” he said. “The term pre-diabetes is medical jargon for a condition in which your fasting blood sugar levels are higher than normal, (between 100 – 126 mg/dl) but not high enough to be classified as type 2 diabetes. Blood sugar at that level may indicate worsening insulin resistance, a marker which points to an eventual diagnosis of diabetes,” said Varghese. “The symptoms can start in childhood, and they seem to begin as insulin resistance gets worse with time. In diabetes patients, the risk of amputation comes from the damage done to nerves and blood vessels. The extremities of the body such as the feet are worst affected. However, with correct foot care and education, limb loss due to diabetes is not necessary,” he said. Varghese said that cases of diabetes among expatriates are high in the Kingdom. He attributed this to the unhealthy lifestyle of expats here. “Lack of proper exercise, stress, unhealthy eating habits are all reasons for the increased rate of diabetes among expatriates, especially those from the Indian subcontinent, in the Kingdom,” he said. He advised diabetic patients to exercise regularly and avoid fatty food and an unhealthy lifestyle. Varghese also said that once diagnosed with diabetes, patients who are advised to take medication must continue it until they get their sugar level under control. “People who try out alternatives from advertisements which claim to lower diabetes within 60 days and so on, end up having high blood sugar level” he said.