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.
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
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