Constant diabetes management is the first key to success when it comes to diabetes complications. We can't stress that enough! Getting control of your blood glucose levels with healthy lifestyle changes, insulin, and/or medications is the best way to prevent or slow down diabetes-related complications, and the benefits of a healthy lifestyle while managing your diabetes are endless. From diabetes-related eye, kidney, and nerve diseases to problems with your teeth, gums, and digestion, high blood glucose levels can cause damage to practically every organ system in your body. Want to find out more? Learn about the complications facing people with diabetes and what you can do to stay
healthy and prevent the complications from complicating you! Cognitive Issues
Higher A1C levels are associated with lower scores on tests that assess
cognitive function. A study also found that those with diabetes were slower and less precise in their responses to those tests. In another study, seniors who experience low blood sugar were more than twice as likely to develop Alzheimer's disease.
What Can You Do?
Daily diabetes care is the best prevention there is. In addition:
• Eat healthy! Choose a low-glycemic, healthy diet to help you maintain the best blood glucose control.
• Always take your medications as prescribed.
• Get active! The benefits of exercise and building lean muscle tissue are incredible. Being active can improve how your body makes use of blood glucose and insulin.
• Ask about vitamin supplements at your next doctor visit. Vitamins C (1,000 mg) and E (800 IU) have been found to help people with diabetes avoid mind fuzziness after eating a high-sugar, high-fat meal.
• Lower your stress level. It can make your quality of life higher and your blood sugars lower.
Diabetes Complications, Continued
• Brainstorm! Literally. It's just as important to exercise your mind as it is your body. Keep things moving up there by doing the crossword puzzle in your daily newspaper; play along with your nighttime Jeopardy, Are You Smarter
Than a Fifth Grader, or Family Feud reruns; or pick up a controller and try out
the latest video games. Skin Problems
The skin is the largest organ of your body. There are many skin conditions associated with diabetes - Acanthosis nigricans, Diabetic dermopathy,
Necrobiosis Lipoidica Diabeticorum - but the most common condition is simply dry skin. Blood vessel and nerve damage, along with dehydration (which can also affect blood sugar) from constant high blood glucose, can cause dry skin. If that couldn't be itchy enough, dry, cracked skin can be a breeding ground for infection and can cause earlier wrinkling and premature aging.
What Can You Do?
Again, while consistent diabetes management is the first key to success, and prevention is the best remedy, these might help too:
• Stay moisturized both inside and out. Drink plenty of water and use mild soaps and other gentle skin care products.
• Keep a firm grip on managing your blood glucose and blood pressure. High blood glucose can cause dry skin.
• Eat a nutritious, balanced diet and exercise regularly. Healthy fluid intake can keep you hydrated, while physical activity gets the blood flowing and can affect the appearance of your skin.
• Always wear sunscreen, as some diabetes medications can cause sensitivity to sunlight.
• Your nervous system may no longer detect danger like it used to, so protect your skin from extreme temperatures. Avoid electric blankets, hot baths, and heating pads. Test the temperature of your showers with your elbow or a bath thermometer.
• If you must care for a wound, treat it by inspecting, cleansing, treating, and protecting it.
The most common visual complication associated with diabetes is diabetic retinopathy. It causes 12,000 to 24,000 new cases of blindness each year. Diabetic retinopathy occurs when the blood vessels leading to the eye's retina become blocked and/or leak blood or fluid into the eye. Other complications can include retinopathy, characterized by swelling of the macula that results in blurred vision; glaucoma, which is caused by fluid build-up and consequent high pressure in the eye and has the potential to damage the optic nerve, causing vision loss and severe headache; and cataracts, a clouding of the eye's lens that results in sensitivity to light and blurry vision.
What Can You Do?
In addition to being consistent with your diabetes management, here are some more tips:
• The American Diabetes Association suggests that people with diabetes get a dilated eye exam at least once a year to detect signs of early eye
disease.
• Positive health changes such as controlling blood pressure, keeping your A1C levels down, quitting smoking, and maintaining healthy cholesterol levels can help to lower your risk of eye disease.
• Early diagnosis and treatment can stop vision loss, but the majority of people with type 1 diabetes, and most people with type 2 diabetes, will eventually experience some degree of retinopathy. Talk to you doctor about medical options such as laser surgery and vitrectomy to see if this might be right for you.
Teeth and Gum Issues
People with diabetes are at a higher risk for developing mouth infections. Chronic high blood glucose levels can cause dental problems such as gum disease, dry mouth, halitosis, mouth infections, and even cavities.
What Can You Do?
Can you guess what we're going to say next? Take care of your diabetes daily. You can do these things too:
Diabetes Complications, Continued
• Keep your teeth and gums healthy by following a regular routine of brushing, flossing, and rinsing at least twice a day.
• If you wear dentures, keep them clean.
• Visit your dentist regularly to help prevent problems from happening (and make sure your dentist knows you have diabetes).
• Keep your blood glucose numbers in check. It can help to prevent mouth problems.
• Quit smoking, as it can make gum disease worse, among other things. • Check your mouth regularly for problems, such as bleeding gums, bad tastes in the mouth, white patches, and dryness or soreness. Tell your dentist if you experience any of these issues or others.
Muscles and Bones
The musculoskeletal system is made up of the bones, muscles, joints, and tissues in and around the joints. Poorly controlled blood glucose can affect the functioning of the musculoskeletal system and cause problems such as carpal tunnel, Charcot foot, stiff hands, frozen shoulder, and trigger finger.
What Can You Do?
Be consistent in your diabetes management and: Keep your blood sugar levels in control.
Visit your doctor regularly. What's just as important is seeking medical help the moment you notice or suspect any problems developing.
If you experience any of the complications mentioned, visit a physical therapist (PT). A PT can play a vital role in treating a variety of diabetes complications.
Peripheral Neuropathy
Peripheral neuropathy is a problem with the nerves that transmit information from the brain and spinal cord (the central nervous system) to every other part of the body. Pain in the hands, feet, arms, and legs is often associated with this form of neuropathy, with pain ranging from tingling and numbness to muscle weakness to painful burning and paralysis, which can result in sensitivity to hot and cold temperatures.
Risks associated with peripheral neuropathy include foot problems such as hammertoes and Charcot foot.
What Can You Do?
Ding ding ding! Consistent diabetes management is ideal, as no medical treatment exists as of now that can cure peripheral neuropathy (although peripheral neuropathy is one of the few diabetic complications that can actually reverse itself with good blood glucose management). Follow these tips to stave off the complications:
• See a podiatrist regularly.
• Keep control of your blood glucose levels.
• Positive health changes such as controlling blood pressure and cholesterol can help.
• Keep a look out for symptoms related to peripheral neuropathy such as muscle weakness, painful cramps, uncontrolled muscle twitching, bone degeneration, muscle loss, and changes in the skin, hair, and nails. SOURCE:
National Institute of Neurological Disorders and Stroke. Peripheral Neuropathy Fact Sheet. (Accessed 4/14/10).
Autonomic Neuropathy
Autonomic neuropathy is a form of peripheral neuropathy and does not strike in an obvious manner. Autonomic neuropathy is a group of symptoms that occur when there is damage to nerves that regulate blood pressure, heart rate, bowel and bladder emptying, digestion, and other body functions. Autonomic neuropathy can cause an array of symptoms, including
incontinence, dizziness, diarrhea, constipation, and excessive perspiration. What Can You Do?
While taking care of your diabetes is most important, follow these tips to stay in tip-top shape:
• Control your blood glucose levels, as this is the best defense against serious neuropathy complications.
Diabetes Complications, Continued
• If you are on medication, take them consistently. • Eat a nutritious, balanced diet and exercise regularly.
• Treatment depends on the condition and the symptoms experienced. SOURCE:
Medline Plus. Autonomic Neuropathy. (Accessed 4/15/10). Cardiovascular Complications
Do you know the leading cause of death among people with diabetes? Heart disease. There are several types of cardiovascular complications:
• Atherosclerosis narrows the arteries from high cholesterol and can lead to Coronary Artery Disease.
• Hypertension is also known as high blood pressure and causes a build-up in blood pressure within the arteries.
• Peripheral Vascular Disease is a narrowing of the arteries outside the heart and brain.
• Stroke is caused by blockage of the blood vessels or arteries that lead to the brain.
• Cardiovascular Autonomic Neuropathy is the result of nerve damage to the cardiovascular system.
• Peripheral Arterial Disease is a hardening of the arteries that prevents proper blood flow.
What Can You Do?
You should know it by heart now: Take good care of your diabetes. And like oh-so-many other complications, keeping a firm grip on your blood glucose levels is very important. Because high cholesterol can clog arteries with fat deposits, it's necessary to keep those levels down as well. Insulin resistance has also been associated with cardiovascular problems, so make sure to visit your doctor regularly for routine checks.
Kidney Problems
Want to know what the number one cause of chronic kidney failure is in the U.S.? Diabetes! It's estimated that 661,330 people will have kidney failure this
Early kidney disease doesn't have any symptoms and can become kidney failure if left undetected. Usually, when patients are not tested or treated for early kidney disease, it's discovered right before the kidney fails. BUT, it can be treated effectively if detected early.
What Can You Do?
Good blood glucose control and:
• controlling your blood pressure. High blood pressure is one of the reasons people with diabetes are at a higher risk for kidney disease.
• keep cholesterol levels in a safe range.
• get your kidneys screened! Early detection can prevent, possibly even reverse, kidney disease. Look out for signs and symptoms such as blood in the urine; frequent urination; burning during urination; puffiness and swelling in the face, hands, and feet; high blood pressure; itchy skin; nausea and vomiting; and weakness.
Digestion Issues
Even though gastroparesis is a form of autonomic neuropathy, it deserves a special mention as one of the common complications of people with type 1 and type 2 diabetes. Also called delayed gastric emptying, gastroparesis happens when stomach nerves are damaged and the stomach takes too long to empty its contents. Gastroparesis can make diabetes worse by making it hard to control blood glucose.
What Can You Do?
Say it out loud: Take care of your diabetes every day. In addition to consistency:
• Make sure you keep your blood glucose levels in check. High blood glucose can cause chemical changes in nerves and damages the blood vessels that carry nutrients and oxygen to the nerves.
• Be on the lookout for signs and symptoms of gastroparesis, including heartburn; nausea; vomiting of undigested food; an early feeling of fullness when eating; weight loss; abdominal bloating; arratic blood glucose levels; lack of appetite; gastroesophageal reflux; spasms of the stomach wall; and
Diabetes Complications, Continued
• The primary treatment goal for gastroparesis is to regain control of blood glucose levels. Treatments also include insulin, oral medications, and changes in what and when you eat. In severe cases, feeding tubes and intravenous feeding may be necessary.
Sexual Issues
The sex drives of both men and women can be affected by diabetes. As a result of nerve or vascular damage, impotence in men (erectile
dysfunction) may occur. Diabetes can also produce anxiety, stress, and depression, affecting libido and performance. For women, chronic vaginitis and infection can lead to sexual dysfunction, partly because of discomfort or embarrassment.
What Can You Do?
Prevent sexual issues from happening by managing your diabetes under the care of your physician. Here's more information that may help:
• Sexual dysfunction is highly treatable. A variety of treatment options such as medication, medical devices, surgical implants, and therapy are
available and effective.
• Talk with your doctor about the steps you can take to improve your love life and sexual health.
Feet Complications
The primary concern for many people with diabetes is amputation, which typically start with the feet. More than 60% of nontraumatic lower-limb amputations occur in people with diabetes. Other foot issues to be concerned about include peripheral neuropathy, Charcot foot, and foot ulcers and other wounds on the feet.
What Can You Do?
As if you didn't know already, consistent diabetes management is the first key to success. But following these tips wouldn't hurt either:
• See a podiatrist regularly. Additionally, preventative foot care is very important.
• Wash and inspect your feet and toes daily.
• Maintain a healthy weight. Eat a nutritious, balanced diet and exercise regularly.
• Always wear thick, soft socks. • Don't walk around barefoot.
• Cut toenails straight across instead of rounding the edges. • Stop smoking.
• Never try to remove calluses, corns, or warts by yourself.
• If you must care for a wound, treat it by inspecting, cleansing, treating, and protecting.
SOURCE:
1 - Diabetes Clearinghouse. National Diabetes Statistics, 2007: Amputations. (Accessed 4/15/10).
An estimated three out of five Americans with diabetes (57.9%) have one or more complications associated with diabetes. Don't become one of the statistics! We hope you've learned that knowing your ABCs - your A1C level, your blood pressure, and your cholesterol profile - is crucial in staying on top of your
diabetes management and lowering your risk of diabetic complications. Stay on top of your health and steer clear of the complications to live life, live long, and live happy!
Reviewed by Jason C. Baker MD, 3/13.
