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 situation.

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:

  • Tingling
  • Weakness
  • 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.

Poor circulation

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.

Kidney disease

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 function.
  • 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.

Eye problems

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


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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.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.


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