Diabetes complications - Prevention

Prevention:

You should learn basic diabetes management skills. They will help prevent complications and the need for medical care. These skills include:

• How to handle sick days
• How to recognize and treat low and high blood sugar
• How to take medications, if needed
• How to test and record your blood sugar level (See: blood glucose monitoring.)
• What to eat and when
• Where to buy diabetes supplies and how to store them

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:

• 80 - 120 mg/dL before meals
• 100 - 140 mg/dL at bedtime

EXERCISE

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:

• Get yearly tests to be sure your kidneys are working well (microalbuminuria and serum creatinine)
• Have your blood pressure checked at least every year (pressure should be 130/80 mm/Hg or lower)
• Have your cholesterol and triglyceride levels checked yearly (LDL levels should be 100 mg/dL or below)
• Have your glycosulated hemoglobin (HbA1c) check every 6 months if your diabetes is well controlled or every 3 months if it's not
• See the dentist every 6 months for a thorough cleaning and exam. Make sure your dentist and hygienist know you have diabetes
• Visit your ophthalmologist at least once a year -- more often if you have signs of diabetic retinopathy

FOOT CARE

To prevent problems with your feet, you should:

• Check and care for your feet EVERY DAY, especially if you already have known nerve or blood vessel damage or current foot problems. Follow the instructions below.
• Get a foot exam by your health care provider at least twice a year and learn whether you have nerve damage
• Improve control of your blood sugar
• Make sure you are wearing the right kind of shoes
• Stop smoking if you smoke

(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:

• As the first choice medicine for treating high blood pressure
• For those who have signs of early kidney disesae (microalbuminuria)
• ACE inhibitors include captopril (Capoten), enalapril (Vasotec), quinapril (Accupril), benazaeprl (Lotensin), ramipril (Altace), perindopril (Aceon), and lisinopril (Prinivil, Zestril)

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.