For many, the hardest part about having diabetes is living in fear. Fear of developing long-term complications such as heart disease, kidney failure or even losing your sight. While these are all real and potential complications, they only happen as a result of uncontrolled diabetes.
Choosing a lifestyle that keeps your diabetes well-managed will reduce your risk for such complications. In fact, changing behaviors now will lead to a healthier and more active life.
As Dr. Polonsky so boldly states:
“The #1 complication from well-controlled diabetes is NOTHING!”
But as shown below, uncontrolled blood sugars can lead to the following:
Our job is to teach you how to avoid the above complications.
The best way to prevent complications is to keep your blood vessels healthy by:
- Following a heart healthy meal plan
- Being active
- Consider taking baby aspirin (talk with your endocrinologist)
- Monitoring your blood pressure
- Avoid smoking
Heart Disease & Stroke
Heart and blood vessel disease are the most common health problems linked to diabetes.
A heart attack occurs when the blood vessels supplying your heart become partially or totally blocked by fat and cholesterol. This blockage cuts off the blood supply that keeps your heart beating.
A stroke occurs when the blood supply to your brain is blocked and results in damage to brain tissue.
***If you have any of the above warning signs, call 9-1-1 immediately***
Blood pressure is the force that moves blood through the body. Like water moving through a hose, when you turn the pressure on low, a gentle force is created. But when you turn the faucet all the way up, you create a very strong force. High blood pressure is dangerous because it can damage the large vessels leading to your heart, brain, and kidneys.
Your BP Goal: <140/90
The cholesterol and fat that are in your blood are called lipids. Cholesterol is made by your liver but also comes from the foods you eat. Your body needs lipids to stay healthy, but there must be a balance of the types of lipids.
HDL = H for High or Happy; these are helpful lipids
LDL = L for Low or Lousy; these are dangerous lipids
Triglycerides = major form of fat stored by the body
Your Cholesterol Goals:
HDL (male) >40
HDL (female) >50
LDL <70 (<55 with known heart disease)
Many forms of foot problems can occur in persons with diabetes. Common problems occur from nerve damage (neuropathy). This can cause tingling, pain (burning or stinging), or weakness in the foot. It can also cause loss of feeling in the foot. Poor blood flow or changes in the shape of your feet or toes may also cause problems.
Daily Foot Care
- Wash your feet every day with gentle soap
- Dry your feet after bathing, especially between the toes
- Examine your feet with a mirror every day for any symptoms listed above
- If your skin is dry use moisturizer but do NOT put moisturizer between your toes
- Do NOT try to take care of foot problems yourself
- Contact your physician right away if you notice any changes in your foot health
Annual Foot Exam Goals: No problems!
Uncontrolled blood sugars increase the risk of developing dental problems. Anywhere blood flows, glucose follows so gum health is critical to monitor. Gum disease can lead to infection or the loss of teeth or bone.
Daily Dental Care
- Visit your dentist every 6 months. Make sure your dentist knows you have diabetes.
- Keep blood sugar within your target range
- Brush at least twice per day with a soft toothbrush
- Floss daily
- Call your dentist if you notice red, swollen, tender, bleeding or painful gums
Dental Exam Goals: No problems!
Uncontrolled blood sugars and high blood pressure can put strain on the tiny vessels in your eyes. This can lead to vision changes or even blindness if left untreated. If cared for early, eye disease can be stopped or managed.
- Keep blood sugar and blood pressure within your target range.
- Visit your ophthalmologist annually for a dilated eye exam. Make sure your doctor knows you have diabetes.
- If you see dark spots, have a change in vision, eye pain or pressure call your doctor
Annual Eye Exam Goals: No retinopathy or other problems!
Similar to eye disease, uncontrolled blood sugars and high blood pressure can put strain on the tiny vessels in your kidneys. This can lead to kidney failure and the need for dialysis.
Caring for Your Kidneys
- Keep blood sugar and blood pressure within your target range
- Take annual blood test or urine test to check for kidney function
- Work with a dietician to be sure your diet provides the correct balance of nutrients and minerals
- Avoid smoking
Annual Test Goals:
- albumin/Cr ratio < 30mg/g
- eGFR >60ml/min
Nerves are everywhere, and when damaged the following can be affected:
- Sexual function
High blood sugars can lead to nerve damage and managing your blood sugars will help maintain the health of all your nerves.
High blood sugars can also damage the nerves and vessels that control sexual organs. The most common form of sexual dysfunction in men is erectile dysfunction (ED). This can be caused from high blood sugar, low testosterone, or heart disease The most common problem for women is vaginal dryness or urinary tract infections. Decreased libido is common for both men and women.
Palo Alto Medical Foundation: Understanding Type 2 Diabetes September 2017
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