The most important ways to reduce your risk of developing complications associated with diabetes are to maintain tight blood glucose control and have regular checkups with your doctor. It's no secret that a person with diabetes is at greater risk for other health problems. However, studies show many of these problems can be prevented or successfully treated when they are identified early.
The American Diabetes Association strongly encourages people with diabetes to work with their doctor to develop daily blood sugar goals and not to alter their course of treatment without first talking to their doctor.
The association continues to advise people with diabetes to strive for an A1C (a measure of long-term blood glucose control) of less than 7 percent. Recent studies show that more than half of the population with diabetes in the U.S. have an A1C less than 7 percent and this overall level of glucose control appears to be of great benefit rather than harm.
Cardiovascular and Cerebrovascular Disorders
Heart disease, the number one cause of death in the United States, accounts for about half of all deaths. In people with diabetes, heart disease is an even greater threat since two-thirds of people with diabetes die of heart or blood vessel disease. Those with diabetes are also about five times more likely to have a stroke than people without diabetes.Along with controlling blood glucose levels, people with diabetes must be aware of other factors that can play a role in preventing the cardiovascular and cerebrovascular complications of diabetes. These include not smoking, maintaining normal blood pressure and blood cholesterol levels, eating a low-fat diet, and getting regular exercise. These lifestyle factors are particularly important for people with type 2 diabetes.
Eye Disorders
People with diabetes are at increased risk for developing eye problems. The most serious is a condition called diabetic retinopathy. Retinopathy is caused by damage to the blood vessels that nourish the nerves within the retina. Retinopathy is the leading cause of blindness in diabetes. Retinopathy often can be successfully treated with laser surgery when it detected early. All patients with type 2 diabetes should get an annual eye exam.Patients with diabetes also are at increased risk for developing cataracts (clouding of the lens of the eye) and glaucoma (caused by an increase in fluid pressure within the eye that damages the optic nerve). Annual eye exams can detect these conditions. Cataracts can be corrected surgically, and glaucoma can be treated with eye medication or surgery.
Nervous System Disorders
Diabetic nerve damage called neuropathy affects as many as 65 percent of those with diabetes. Diabetic neuropathy can cause many symptoms including pins and needles sensation and severe pain in the hands and legs, or a loss of pain sensation in the extremities (which can contribute to foot problems). Neuropathy also can affect the bladder, bowel and stomach along with causing sexual dysfunction in men. The most common type is peripheral neuropathy which affects the arms and legs.To prevent diabetic neuropathy, practice tight blood glucose control. You can reduce your risk of neuropathy by 69 percent if you maintain tight control over your blood sugars.
There are several ways to prevent or treat diabetic foot ulcers, open foot sores that lead to thousands of amputations each year in people with diabetes. One way is a wound dressing that is a cellular, bi-layered skin substitute intended to help aid healing by providing wound protection and fostering the growth of new skin.
A study funded by the National Institutes of Health examined a group of 85 diabetic patients at high risk of foot deformities or loss of sensation. Patients used a foot-scanning device to measure temperature at six spots on their feet twice daily. They were encouraged to get medical help and to reduce pressure on their feet when the temperatures rose more than 4 degrees Fahrenheit. Those patients were less likely to develop foot ulcers.
Kidney Disorders
Kidney damage called nephropathy occurs more commonly with diabetes and may cause end-stage renal disease. The earliest sign of kidney damage is when protein begins to spill over into the urine. This can be detected by a urine test that should be performed regularly as part of a diabetes health exam.Although heredity plays a role in the development of kidney problems in patients with diabetes, other factors such as controlling blood pressure, reducing protein in the diet and maintaining tight control of blood glucose levels can reduce the risk of kidney complications associated with diabetes.
Infection
People with diabetes run an increased risk of developing many types of infections. This risk is directly related to increased glucose levels, which provide an ideal growth environment for many disease-causing organisms and also hamper the immune system's ability to fight off infections.The best way for a person with diabetes to avoid infections is to practice tight control of blood glucose levels. Patients with diabetes should also closely examine their skin (especially their feet) for any evidence of breakdown or ulceration. Because many diabetes patients have decreased sensation in their extremities, they may have foot ulcers without pain.
Practicing good oral hygiene and visiting the dentist regularly can help someone with diabetes to avoid infections of the gums and mouth.
All cuts and open wounds need special attention. Wash any area of skin breakdown thoroughly with soap and water and check the area each day for redness, warmth, pus or other drainage and fever that are signs of infection. Call your doctor immediately if you suspect an infection.
How often do I need to see a doctor?
The American Diabetes Association recommends all patients with type 2 diabetes visit the doctor at least two to four times a year. If you are newly diagnosed or experiencing symptoms, you may need to visit your doctor more often.
During each doctor visit, discuss your home blood glucose readings. Patients should bring a written record of their blood sugars. Your doctor will record your weight and blood pressure at each visit. As part of your routine physical exam, the doctor should also check your eyes and feet to screen for diabetic complications.
An annual examination by an eye doctor is also recommended. Blood tests may be done to check your cholesterol, other lipids and glycosylated hemoglobin (a test that gives information about how well controlled your blood sugars have been during the last two to three months). A urine test should also be performed at least once a year to check for protein. During each office visit, review your treatment plan and set goals with your physician. Remember that diabetes management is a joint effort that will only produce good results when the patient and doctor work together.
Other Diabetes Tips:
- How Diabetes Affects Your Feet
- Diabetes and Peripheral Arterial Disease (PAD)
- Tight Blood Sugar Control to Help You Manage Diabetes
- How to Use Insulin Pens When You Have Diabetes
- How To Get Started Managing Your Type 1 Diabetes
- How To Plan For A Healthy Baby When Have Diabetes
- Diabetes During Pregnancy: Health Risks for Large Babies
- How Exercise May Help You Manage Your Diabetes During Pregnancy
References
- Sylvester B. 'Breakthrough' Diabetes Drug Tested. UPI Science News, June 2002.
- American Diabetes Association Annual Meeting, 2002.
- FDA TALK PAPER Food and Drug Administration US Department of Health and Human Services June 20, 2000.
- American Heart Association, Journal Report, 2002.
- National Institute of Diabetes Digestive and Kidney Diseases. National Diabetes Information Clearinghouse
- American Diabetes Association Clinical Practice Recommendations 2009. Diabetes Care, Vol. 32, Supplement 1, January 2009.
- Diabetes Control and Complications Trial (DCCT) Epidemiology of Diabetes Interventions and Complications (EDIC). NEJM;(2):2000.