"How do I avoid complications with diabetes?..."
Having Diabetes does NOT have to mean you will have complications.
I recently posted on Facebook and asked, what do you want me to write a blog on for August?
A man requested to write on “The long-term effects of being non-compliant.” He then posted, “It’s something that’s very personal, my dad started out as a type 2 and didn’t keep his sugars in check and he ended up with a LOT of problems and passed at 71. “
What I understand from his post and his request for the blog article is he wants people with diabetes to know what some of the problems that may occur if not following a treatment plan. He doesn’t want others to have problems like his dad did.
Wow, this is a tough one to write about! Diabetes is so individual. What is good for one person may not be good for another person. As a Health care provider, my job is to make people aware of the importance of following a treatment plan recommended by the Primary MD. Your MD is your advocate and with the knowledge he or she has is recommending the best plan based on what he or she knows through their expertise. The person with diabetes is the #1 person on this health care team. If for some reason you do not agree with the doctor, speak up. See if there are other options. What I do is ask questions to find out the reason why someone is not following the treatment plan.
Some may call it “non-compliant or non-adherent. I always like to get to the reason why someone may not be following the recommended treatment plan. There are numerous reasons this happens. Reasons are varied:
Financially- The person cannot afford the medication that has been prescribed.
Denial of the Problem- This is particularly true if the person “feels fine” or has no symptoms of illness.
Difficulty following the regimen- Perhaps there is a memory problem and the person forgets to take the medication or takes insulin and does not want to take injection when away from home.
Unpleasant side effects- May not take insulin due to fear of a low blood sugar or have stomach upset with a pill.
Addiction- Smokes cigarettes or drinks too much alcohol.
Lack of trust- If a person believes the treatment is not going to make a difference in health, may not be motivated to follow treatment.
Lack of Knowledge- Possibly the person does not understand what could happen if does not follow treatment.
My colleague Marilyn and I educate the nurses and Providers on Diabetes at the health care system I work at. We have a power point slide that shows a picture of the human body. The caption says, “Wherever blood goes, sugar goes.” What this means is from head to toe the body can be impacted with high blood sugar.
Diabetes makes your blood sugar higher than normal. This is because either the body does not make enough insulin or the receptors on the body cells are not working well. After many years, too much sugar in the blood can cause problems in your body. It can harm your eyes, kidneys, nerves, skin, heart, and blood vessels.
Long-term complications of diabetes develop gradually over time. The longer you have diabetes, and the less controlled your blood sugar, the higher the risk of complications. Information adopted from article https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444
Heart Disease (cardiovascular) Diabetes increases the risk of various heart problems, heart attack, stroke and narrowing of arteries (atherosclerosis). If you have diabetes, you're more likely to have heart disease or stroke. This is the #1 complication of diabetes.
Nerve damage (neuropathy) Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in your legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhea or constipation. For men, it may lead to erectile dysfunction.
Kidney damage (nephropathy). The kidneys contain millions of tiny blood vessel clusters that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, which may require dialysis or a kidney transplant.
Eye damage (retinopathy). Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma.
Skin conditions. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections.
Hearing impairment. Hearing problems are more common in people with diabetes.
Alzheimer's disease. Type 2 diabetes may increase the risk of dementia, such as Alzheimer's disease. The poorer your blood sugar control, the greater the risk appears to be. Although there are theories as to how these disorders might be connected, none has yet been proved.
Depression. Depression symptoms are common in people with type 1 and type 2 diabetes. Depression can affect diabetes management.
Osteoporosis. Bone loss and fractures are more common in people with diabetes when diabetes is uncontrolled. https://www.everydayhealth.com/hs/type-2-diabetes-treatment-diet-exercise/bone-health-with-diabetes/
Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot problems. Left untreated, cuts and blisters can develop serious infections, which often heal poorly. These infections may ultimately require toe, foot or leg amputation.
Here is some good news…….
A landmark study, Diabetes Control and Complications Trial (DCCT), proved that tight blood glucose control can substantially reduce the risk of developing the devastating medical complications of diabetes.
“The effect of intensive treatment on diabetic complications was stunning. Intensive insulin therapy reduced the risk of developing diabetic retinal disease by 76%, diabetic nerve disease by 60%, and diabetic kidney disease by 54%. These results were published in a 1993 issue of The New England Journal of Medicine.”
Another large significant study called the United Kingdom Prospective Diabetes Study (UKPDS) was published in another noteworthy Medical Journal called The Lancet in 1998. The DCCT and the UKPDS both have answered the question of whether blood glucose control is beneficial for people with type 1 and type 2 diabetes. Now instead of just hypothesizing that good blood sugar control mattered in prevention of long-term diabetes complications, we now had evidence.
Seven Steps to take to move toward health:
Most important, talk to your MD if you are not following the treatment plan. It may benefit you to have a different medication or even to meet with a Certified Diabetes Educator or take a Diabetes class to learn more about what you can do to improve your health.
Take your medication as prescribed. If not, talk to your MD about alternatives.
Do not smoke. Smoking makes you at more of a risk for diabetes problems. Smoking constricts blood vessels which makes it difficult to get oxygen and nourishment to your organs. My experience has taught me that if you smoke and have Diabetes you will get a complication.
Lose even 5-7% of your total weight. This will help manage blood sugar.
Reduce food portions. Too many calories can lead to weight gain and higher blood sugar and higher blood pressure.
Talk to your MD about best exercise for you. Increasing activity has proven to assist with blood sugar control. Move the body more.
Check blood sugar daily and record. Learn reasons why blood sugar may be too high (or too low).
Just because you have diabetes does not mean you will get a complication of diabetes. Untreated Diabetes can lead to complications but managing diabetes well, controlling blood pressure and no smoking can lower the risk.