LONG-TERM DIABETES COMPLICATIONS

 

 

Sometimes, people who have had diabetes for a long period of time develop long-term diabetes complications. These complications can include damage to the eyes, kidneys, nerves, heart and blood vessels. They donÕt happen overnight. They develop over months and years. Often, they are not reversible. In most cases, you donÕt even know that the diabetes complications are occurring until they cause a serious problem, such as a heart attack.

 

Taking good care of your diabetes every day is the most important thing that you can do is the most important thing that you can do to prevent long-term complications!

 

 

Eye Damage

Diabetes can cause many types of eye disease, like diabetic retinopathy, glaucoma, and cataracts. While all three are serious, retinopathy and glaucoma can lead to permanent loss of vision if left untreated. Finding and treating eye problems early can help save your sight.

 

The retina is the lining at the back of the eye that senses light. It acts like the film in a camera. When you have a mild form of retinopathy (non-proliferative), blood vessels leak blood and fluid into the eye. In the more severe but rarer form of retinopathy (proliferative), new blood vessels sprout and grow out of control. They can bleed or cause scarring, which pulls on the retina.

 

 

Retinopathy may not cause any symptoms. Therefore, every year you should have a special eye exam called a Dilated Retinal Eye Exam. In this exam, special eye drops are used which allow the doctor to examine the retina of your eyes. The exam should be performed by a certified eye doctor.

 

See your doctor if you:

•have blurry vision                              •have pain in the eyes

•have double vision                 •feel pressure in the eyes

•see ÒcobwebsÓ in vision                  •have loss of side (peripheral) vision

•see spots or floaters              •have difficulty reading

 

You can prevent eye damage by:

•keeping your blood sugar levels well controlled

•having your eyes examined regularly

•having your blood pressure checked regularly and keeping it well controlled

 

The earlier you can catch retinopathy, the better the treatments will work. Talk to your doctor about what treatment option is best for you.

 

Treatment options for diabetic retinopathy include:

•laser treatment to seal off leaky blood vessels

•surgery that removes blood and scar tissue from the eye

 

5

Kidney Damage

Diabetes can lead to a serious kidney disease called diabetic nephropathy. High blood sugar circulating in the blood can damage the small blood vessels in the kidneys. The job of the kidneys is to filter waste from the blood. Over time, diabetes can cause the kidneys to lose their ability to filter the waste properly. As a result, protein that the body needs can be lost in the urine and wastes that the body doesnÕt need can build up in the blood.

 

Some symptoms of kidney damage are:

•swelling of feet

•loss of appetite

•skin problems such as dry itchy skin

•tiredness

•high blood pressure

 

People with kidney disease may have no symptoms until the kidneys are badly damaged. Kidney damage cannot be reversed, so it is important to prevent it.

 

You can prevent kidney damage by:

•keeping your blood sugar level well controlled

•eating healthy meals and snacks

•keeping your blood pressure down

 

Two types of treatment available for kidney damage:

•dialysis (a machine that cleans the blood)

•kidney transplant

 

Nerve Damage

High blood sugar levels can damage nerves over time. The damage that diabetes causes to nerves is called diabetic neuropathy. There are several types of diabetic neuropathy which vary depending upon what part of the body the damaged nerves are in. When nerves are damaged, they no longer carry messages properly. Neuropathy symptoms most commonly affect the feet and toes, and hands and fingers.

 

 

 

Symptoms of neuropathy include:

•prickling, tingling, burning, or jabbing feelings

•loss of feeling

•weak muscles

•cold or hot hands and/or feet

•fainting

•vomiting

•bladder infections

•diarrhea or constipation

 

To prevent nerve damage:

•keep your blood sugar level well controlled

•donÕt smoke

•drink little or no alcohol

•eat healthy meals and snacks

•exercise regularly

 

Symptoms of neuropathy can be treated in various ways. There are medications that can help. Talk to your doctor about what treatment option is best for you.

 

 

Heart and Blood Vessel Damage

 

The biggest problem for people with diabetes is heart and blood vessel disease, which can lead to heart attack and stroke. Diabetes makes you more likely to get hardening of the arteries. You can also have peripheral vascular disease (not enough blood reaches the areas farthest from your heart).

 

When you have diabetes, your blood may clot more easily. Your blood vessels may narrow. Fat may build up in your blood vessels faster. If you have poor circulation, you may have frequent infections. If your blood pressure or cholesterol level is high, this puts you at even greater risk for heart or blood vessel

damage as well.

 

Lower your risk for heart and blood vessel disease:

•keep your blood sugar well controlled         

•control blood cholesterol & triglyceride levels

•donÕt smoke

•exercise regularly

•eat low-fat, low-salt foods

•lose weight

•control high blood pressure

•limit alcohol consumption

 

People with diabetes should keep their blood pressure lower than 130/80. If you already have heart or blood vessel disease, talk with your doctor about appropriate treatment.

Other Complications

 

SKIN PROBLEMS: Damaged nerves and narrowed blood vessels can lead to dry, itchy skin. Poor circulation makes infections more frequent and longer lasting. Skin on hands and feet may become tight. Moisturize your skin (except between the toes as this area is already moist and the extra moisture could lead to infection). Call your doctor if a cut or a scrape doesnÕt heal promptly.

 

MOUTH PROBLEMS: People with diabetes are more likely to get infections in the gums. Like all infections, gum infections can cause your blood sugar to rise, making the problem worse. Poor circulation can slow down healing time. Without treatment, teeth may loosen and fall out over time. It is very important that you

let your dentist know that you have diabetes.

 

To help prevent damage to your gums and teeth:

•brush and floss every day

•have teeth cleaned every 6 months

 

FOOT PROBLEMS: Nerve damage and poor circulation can also have an effect on your feet. Nerve damage to the feet along with circulation problems are the main causes of amputations in people with diabetes. When you lose feeling in your feet, it is easy to bump and scrape them without even being aware of it. Poor blood flow then prevents the sore from healing. Review the Foot Care section on page 24 for helpful information.

 

How you take care of your diabetes day to day affects your long-term health. Because diabetes complications can progress silently and damage organs in your body, it is important to remember to maintain a healthy lifestyle

to lessen your chances of developing complications.

 

To prevent complications from occurring, follow these suggestions:

•Keep your blood sugar within your target range.

•See your doctor regularly and have the necessary tests (blood sugar testing,

  blood pressure, cholesterol, kidney function, eye and foot exams) you need to 

  check how your diabetes is affecting your body.

•Keep active! Do some form of exercise at least 3 times a week.

¥Take all medications prescribed by your doctor to control your diabetes, blood

  pressure, cholesterol, and triglycerides.

•Stop smoking.

•Limit alcohol consumption.

•Lose weight if you are overweight.

 

The following chart shows how the things that you can control today can have a direct effect on your long-term health. For example, by controlling your blood sugar level, you will help prevent high blood pressure, heart disease, kidney disease, eye disease, and nerve damage.

 

 

 

THINGS YOU CAN CONTROL:	HIGH BLOOD PRESSURE	HEART DISEASE	KIDNEY DISEASE	EYE DISEASE	NERVE DAMAGE
Blood Sugar Level	X	X	X	X	X
Weight	X	X
Physical Activity Level	X	X
Smoking	X	X			X
Alcohol		X			X
Sodium/Salt Intake	X	X	X
Protein	X		X
Saturated Fat