PREVENTING COMPLICATIONS FROM DIABETES

Most people with diabetes can look forward to a long, healthy life if they take simple measures to avoid complications of the disease. It is important to understand these complications and the importance of good self-care as well as good medical care in order to keep as healthy as possible and enjoy life with diabetes.

Common complications of diabetes include:

• Cardiovascular disease: People with diabetes are two to four more times likely to develop heart disease and five times more likely to have a stroke than people without diabetes.
• Eye disease (diabetic retinopathy): People with diabetes are four times more likely to become blind than people without diabetes.
• Kidney damage: People with diabetes are 20 times more likely to develop kidney failure than people without diabetes.
• Nerve damage (neuropathy): At least half of all people who have diabetes for 25 years or more have neuropathy, which can result in such diverse symptoms as pain in hands, feet, thighs or face, digestive problems, bladder or bowel control problems, loss of sensation, muscle weakness, and impotence or other SEXUAL PERFORMANCE PROBLEMS.
• Infections: Excessive blood glucose can hamper the immune system, creating a greater risk for infections in the mouth and gums, lungs, skins, feet, genital areas, in the incision areas after major surgery. Neuropathy can also lead to increased infections: decreased sensitivity may cause small cuts, abrasions or burns to go unnoticed and therefore untreated until a major infection develops; neuropathy that affects the bladder may lead to bladder infections.

"Tight" Blood Glucose Control

Most diabetes complications are caused by too much glucose in the blood. Excess glucose makes the blood "sticky," so the small blood vessels that carry blood throughout the body become clogged. That’s why the most important good-health measure for people with diabetes is to control blood glucose levels.

In fact, a recent study of 1,400 people who had type I diabetes for 10 years showed that those who kept their blood glucose levels as close to normal levels as possible ("tight control") suffered fewer complications than those who did not. Achieving "tight control" required testing blood sugar levels four to seven times a day and following more complicated insulin injection schedules, but the results were more than worth the effort: This group had 76 percent less eye disease, 60 percent less nerve damage and 35 to 56 percent less kidney disease.

Researchers believe that tight control of blood glucose levels can also reduce the risks for complications for people with type II diabetes.

If you use insulin, controlling blood sugar levels means matching your insulin doses to your food intake and exercise. If you use oral diabetes medication, the technique is similar, although achieving the desired result may be more difficult.

In addition, whether you have type I or type II diabetes, watching your carbohydrate intake and getting regular exercise can help your body get glucose into your cells, where it can produce the energy you need.

Other Ways to Prevent Diabetes Complications

Quit smoking. Everyone is familiar with the connection of cigarettes and lung disease. But another effect of smoking is especially harmful to people with diabetes: smoking causes narrowing of blood vessels, restricting blood flow to cells, which results in cell death. This damage can lead to heart disease, impotence in men and amputation. When combined with the effects of too much glucose in the blood, the risks are even more pronounced. For information and help to stop smoking, talk to your doctor or diabetes nurse educator.

Control high blood pressure. High blood pressure that is untreated can damage your heart, blood vessels and kidneys. Some people are able to lower their blood pressure by losing weight, exercising and limiting the amount of alcohol they drink, and some are also helped by limiting the salt in their diet. Many people will also need to take medication to keep their blood pressure in the normal range.

Eat healthy foods. Eating well and following your diabetic diet plan (generally including lots of whole grains, fruits and vegetables and a moderate amount of protein) helps in several ways. A healthy diet helps keep blood glucose under control, reduces the risk of cardiovascular and kidney disease, and helps you look your best by keeping you close to your ideal weight.

Get regular exercise. Exercise also has multiple benefits. It can help stop or delay cardiovascular disease, clear glucose from your blood (which may lower the amount of insulin you need), control your weight, and provide a sense of well-being that can motivate you to work at effectively controlling your blood glucose level. Limit alcohol. Limiting alcohol not only helps control high blood pressure, it also helps prevent the nerve damage that can occur after a person has had diabetes for a long period.

Take care to prevent infections. To prevent gum disease, brush and floss daily and have your teeth cleaned by the dentist every six months. Pay special attention to FOOT CARE, examining your feet carefully for cuts, calluses, corns, etc., every day; also, wear only well-fitting shoes, and never go barefoot. Women who are susceptible to yeast infections should, in addition to seeking medical treatment, wear all-cotton underwear and avoid constricting clothing and pantyhose.

Get regular checks. It is important to see your physician regularly to ensure that you remain healthy. You should see your doctor every three months (or more often if needed) for GLYCOSYLATED HEMOGLOBIN TESTING and to have your feet examined. Each year, you should have a cholesterol test, including HDL level (or every two to three years if readings are normal); kidney function test; and an eye examination to check for early signs of retinal disease so treatment can begin before excessive vision damage occurs.

When Complications Occur

Many medical treatments are available to help when diabetes complications occur. In addition, the measures described above can still be of help by slowing or stopping the progression of the disease. So this is not time to give up. Instead, it is important to work with your doctor and diabetes nurse educator to help you keep working toward tight blood glucose control and following a program of healthy, low-fat eating, regular exercise and quitting smoking.

Warning Signs

If you experience any of the following symptoms of diabetes complications, report them to your doctor right away:

• Vision problems, such as blurry or spotted vision or flashes.
• Unexplained, overwhelming tiredness.
• Leg discomfort with walking.
• Numbness or tingling in your hands or feet.
• Chest pain that comes with exertion.
• Cuts or sores that stay infected or take a long time to heal.
• Constant headaches. Even without these symptoms, be sure to call your doctor any time you just don’t feel "right."