Preventing Complications From Diabetes

A poll on this Senior Health site has indicated that there is a lot of interest in prevention. As November is American Diabetes month, I thought this would be a good opportunity to discuss preventing complications from diabetes. Over 6 million older Americans have diabetes with 90-95 % of those having type 2 diabetes.

Persons with type 2 diabetes are still able to manufacture and use insulin, but are not producing adequate amounts of insulin to meet their needs. Insulin is the hormone that the body uses to transport glucose to the cells. Without adequate insulin the cells don't get the needed insulin and glucose accumulates in the blood and is excreted through the kidneys. Glucose is required for cell growth and repair. With out glucose the cells cannot do their work.

Type 2 diabetics generally are able to keep their blood sugar glucose) levels under greater control than are Type 1 diabetics. The most important factor in preventing the complications of diabetes is keeping the blood sugar level under control. Wildly fluctuating blood sugar levels place a person at much higher risk. Following the prescribed diet (with weight loss if needed), medication regimen (if prescribed), and the recommended exercise program should be the keys to controlling blood sugar levels.

There are 4 main complications that all diabetics are at risk for. We will examine each here separately with the steps that can be taken to minimize the risks.

Kidney Disease

Elevated blood sugar will cause elevated blood pressure. If a person has high blood pressure and diabetes their risk of kidney disease is even greater. Their doctor may recommend a blood pressure medication to control the blood pressure, and if so it is very important to follow the prescribed treatment. Continuing high blood pressure causes damage to the kidney's filtration mechanism and can eventually fail. If the kidneys are not able to filter out the toxins and waste products, the person with diabetes would need either dialysis or a kidney transplant. The doctor will monitor kidney function with blood tests done during checkups.

Vision Loss or Blindness

Diabetics are at greater risk of Glaucoma and vascular disease, which can affect vision. This can lead to severe vision impairment or even blindness. Any blurred vision should be reported immediately to the doctor. Part of the diabetic yearly check-up should be an eye exam.

Peripheral Vascular Disease

High blood sugar can cause blockage of the small blood vessels that supply the extremities with blood. This can nerve damage with a loss of sensation. Add this to slower tissue repair and this makes diabetics more prone to infections and amputation of the extremities. Diabetics should never walk around barefoot. Even the smallest cut can cause problems. Well fitting shoes with absorbent socks are a must. Diabetics should see a professional for care of their nails. A visual inspection of their feet by the doctor should be done at every visit and by the diabetic every day. Any small problem must be treated promptly.

Heart Disease and Stroke

Diabetics are at much greater risk for heart disease and stroke. High levels of glucose can cause a build up of plaque in the arteries of the heart (arteriosclerosis) and other arteries. Arteriosclerosis can lead to heart attack and stroke. By maintaining blood sugar at or near normal levels, along with exercise they can decrease that risk. Quitting smoking is also imperative.