Complications of diabetes
Diabetes is a chronic (lifelong) disease marked by high levels of sugar in the blood. Those with diabetes are at high risk for a number of complications.
Insulin is a hormone made by the pancreas, an organ located behind the stomach. Insulin is needed to move glucose (blood sugar) into cells, where it is stored and later used for energy.
Diabetes is caused by a problem in the way your body makes or uses insulin. There are several types of diabetes. This article discusses the possible complications related to diabetes.
If you have diabetes, you should see your health care provider every 3 months. At these visits you can expect the health care provider to:
For additional information, see: Diabetes resources.
After many years, diabetes can lead to serious problems throughout your body, including your eyes, kidneys, and nerves.
Diabetes can also damage blood vessels in the eyes, causing vision problems or blindness. Conditions may include:
FOOT AND SKIN PROBLEMS
People with diabetes are more likely to have foot problems because of nerve and blood vessel damage. Small sores or breaks in the skin may turn into deep skin ulcers if not treated properly. If these skin ulcers do not improve, or become larger or go deeper, amputation of the affected limb may be needed. (See: Diabetes foot care.)
HEART AND BLOOD VESSELS
If you have diabetes, your risk of a heart attack is the same as someone who has already had a heart attack. Both women and men with diabetes are at risk. You may not even have the typical signs of a heart attack. Other problem with the heart and blood vessels include:
Diabetes can damage nerves, which means you may not feel an injury until a large sore or infection develops. Nerve damage causes pain and numbness in the feet, as well as a number of other problems with the stomach and intestines, heart, and other organs. (See: Diabetic neuropathy.)
Call your health care provider if you have:
You should learn basic diabetes management skills. They will help prevent complications and the need for medical care. These skills include:
It may take several months to learn the basic skills. Always continue to education yourself about the disease and its complications. Learn how to control and live with diabetes. Over time, stay current on new research and treatment. (See: Diabetes education.)
The American Diabetes Association recommends keeping blood sugar levels in the range of:
Regular exercise is important for everyone, but especially if you have diabetes. Regular aerobic exercise lowers blood sugar without medication and helps burn excess calories and fat so you can manage your weight.
Exercise can help your overall health by improving blood flow and blood pressure. Exercise also improves your ability to handle stress.
The following are important for preventing complications of diabetes:
To prevent problems with your feet, you should:
(See: Diabetes foot care.)
MEDICATIONS TO PREVENT COMPLICATIONS
Since those with diabetes have a much higher chance of developing heart disease, kidney disease, and other medical problems, they may need to take certain medicines to treat or prevent these problems.
An ACE inhibitor (or ARB) is often recommended:
Statin drugs are usually the first choice to treat an abnormal cholesterol level. Aim for LDL cholesterol level less than 100 mg/dL. (See: High cholesterol and triglycerides.)
To prevent heart disease, aspirin is recommended most often for people with diabetes. Ask your doctor if aspirin is right for you.
American Diabetes Association. Standards of medical care in diabetes -- 2009. Diabetes Care. 2009;32:S13-S61.
Buchwald H, Estok R, Rahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(3):248-256.e5. Review
Eisenbarth GS, Polonsky KS, Buse JB. Type 1 Diabetes Mellitus. In: Kronenberg HM, Melmed, S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008: chap 31.
In the clinic. Type 2 diabetes. Ann Intern Med. 2007;146:ITC-1-15.
U.S. Preventive Services Task Force. Screening for type 2 diabetes mellitus in adults: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;148(11):846-54.
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