Learn to keep track of the ABCs of diabetes -- A1C, blood pressure, and cholesterol.
Keeping these three in the healthy range can go a long way toward preventing
long-term complications. You want your A1C to be less than 6 or 7, your blood
pressure to be less than 130/80, and your LDL cholesterol to be less than 100.
A1C should be tested twice a year (as long as it is less than 7). Know your
latest numbers. If your A1C is greater than 6.7, your blood pressure is 130/80,
or your LDL cholesterol is 100, it's time to take action.
Over time, poorly controlled diabetes can lead to a variety of serious health
conditions, including heart disease, stroke, blindness, amputations, kidney
disease, and nerve damage. Maintaining a healthy lifestyle and regular checkups
are important throughout the life of a person with diabetes.
Heart disease and stroke
Over a period of years, diabetes can have a big impact on your heart and blood
vessels. The problem needs to be taken seriously -- people with diabetes are
at high risk of heart attack, stroke, and heart failure. According to the American
Diabetes Association, these problems can occur at a younger age than they do
in people without diabetes, and they are more deadly. In fact, heart disease
and related complications are the leading cause of death in people with diabetes.
|A heart attack or stroke may occur when an area
of plaque (atherosclerosis) ruptures and a clot forms over the location,
blocking the flow of blood to the organ's tissues.
You can take steps to minimize the risks:
- Keep hemoglobin A1C to less than 7 percent. (The official goal
for patients in general is less than 7%. But for an individual, the
ideal goal should be as close to normal as possible (less than 6%)
without significant episodes of low blood sugar (hypoglycemia).
- Maintain a healthy blood pressure -- for people with diabetes,
this means less than 130/80. Medication may be necessary.
- Have your cholesterol tested regularly and, if needed, take medication
to lower it. Your LDL-cholesterol levels should be under 100mg/dl.
- Don't smoke.
- Get enough exercise and eat right.
There are many ways to keep your heart healthy and reduce the risk of cardiovascular
problems down the road. Talk to your doctor to learn what may benefit your
Nerve damage (neuropathy)
Diabetes can damage the nerves and cause a complication called neuropathy.
This generally begins as loss of sensation in your toes, and possibly fingers.
Eventually, the neuropathy can move up your legs or arms. Symptoms to watch
out for include:
- Burning sensations
- Loss of sensitivity to warmth or cold
- Numbness -- if the nerves are damaged enough, you may be unaware that a
blister or minor wound has become infected.
- Abnormal blood pressure
- Problems with bowel and bladder control
- Impotence in men
- Bone deformity in foot ("Charcot foot")
You may even have a heart attack and not be able to feel any chest pain.
If you have diabetes, you are at risk for blood vessel injury, which may be
severe enough to cause tissue damage in your legs and feet. If nerve damage
is also a problem, then you may not be aware of the injuries that have occurred
in your legs or feet.
At that point, minor infections sometimes develop into deep tissue injuries
that may even require surgery. In extreme cases, amputation of the foot or
limb may be necessary. Good foot care is very important to prevent problems.
- Check your feet every day.
- If you have any questions about foot care -- calluses, sores, how to trim
nails, which shoes to wear -- call your doctor or diabetes educator.
- Report any problems (like loss of sensation or sign of infection) to your
doctor right away.
The kidneys filter and clean blood. Not surprisingly, having too much glucose
in the blood puts a strain on them. Over time, this can actually lead to kidney
failure. When this happens, dialysis or a kidney transplant may be needed.
- Kidney disease can be prevented through good control of glucose levels
and blood pressure.
- Make sure you get urine and blood tests each year to assess kidney
- Protein intake should be limited to the Recommended Dietary Allowance
(RDA) (0.8g/kg) in people with any degree of chronic kidney disease.
- Watch for kidney-related symptoms -- unusually colored urine, urination
frequency, back pain, chills, or fever.
- Finally, find out whether high blood pressure medicine is appropriate
for your situation.
Diabetes is the leading cause of blindness in adults. The most common eye
disorder in diabetes is retinopathy. This condition is caused by the excessive
amount of glucose in the bloodstream, which weakens and damages the blood vessels.
A weakened blood vessel may bulge out (aneurysm). The blood vessel may even
rupture, leaking blood and fluid into the surrounding tissues (hemorrhage.)
Either of these can cause vision problems. Diabetes puts you at higher risk
for developing cataracts and certain types of glaucoma.
- See an eye doctor at least once a year. Even if vision problems have
not started, a doctor can detect early warning signs.
- Notify your eye doctor of any problems -- such as blurred vision, spots,
rings around lights.
Other possible complications
- Gum disease
- Respiratory infections
- Urinary tract infections
Review Date: 5/1/2006
Reviewed By: Alan Greene, M.D., F.A.A.P., Department of Pediatrics, Packard Children's Hospital, Stanford University School of Medicine; Chief Medical Officer, A.D.A.M., Inc.
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