If you have diabetes, you face serious dangers all over your body, ranging from eye, mouth and foot problems to kidney damage and heart disease. But can you prevent complications once you have the disease? Read on for expert advice on avoiding serious diabetes troubles.
Diabetes is a complex disease that can affect your entire body, from top to bottom. Unchecked, it could leave you needing a seeing-eye dog, kidney transplant or foot amputation.
“Having chronic high blood sugar damages blood vessels throughout the body, so you can have [problems] anywhere,” says Judith Fradkin, M.D., director of the diabetes division at the National Institute of Diabetes and Digestive and Kidney Diseases.
It also harms the nervous system, which further impairs blood flow.
“Controlling blood sugar, blood pressure and lipids can prevent those complications,” she adds.
Learn how to prevent or halt diabetes complications for each precious body part by following this expert advice.
Eyes
Diabetes is the leading cause of blindness in adults aged 20-74, according to the American Diabetes Association (ADA).
The culprit is diabetic retinopathy, a condition that damages blood vessels in the retinas. This may cause leaking blood or abnormal blood-vessel growth in the inner eye.
Strictly controlling blood-sugar levels can help prevent diabetic retinopathy from progressing, according to a 2010 National Institutes of Health study published in the New England Journal of Medicine.
Most people with diabetes have only minor eye disorders – and regular check-ups can help keep them from getting worse, according to the ADA.
The best way to prevent eye problems? By tightly controlling blood sugar and blood pressure, and getting annual exams with an optometrist or ophthalmologist (not an optician, who doesn’t perform medical tests), the ADA says.
And if you smoke, stop. Smoking increases your risk for eye problems, according to the Centers for Disease Control and Prevention (CDC).
For sudden sight disturbances – including floaters that block part of your field of vision, or worsening peripheral vision (so you can’t see things at the side) – see an ophthalmologist right away. Also, seek immediate treatment if your vision becomes blurry, you start seeing double, your eyes hurt or are persistently red, if you feel pressure, or if straight lines appear wavy.
Blood-vessel damage in the eyes can’t be cured, but you can stop it from progressing, so it's important to seek help.
“Laser therapy can prevent people from going blind,” Fradkin says. “And there are drugs that inhibit blood-vessel growth in the eye.”
Mouth
Gum infections and severe gum disease (periodontitis) are common diabetes complications, especially if blood glucose levels are poorly controlled, because the body is more susceptible to bacterial infections.
“It can be a vicious cycle,” Fradkin says. “Diabetes makes gum disease worse, and gum disease makes diabetes worse.”
Good oral care is especially important for people with diabetes, so keep those twice-yearly (or even more often, if necessary) appointments with your dentist and/or periodontist
Gum disease has been linked to cardiovascular disease – another diabetes complication – so better oral hygiene may lead to better health.
Skin
When you have diabetes, you’re more prone to fungal or bacterial skin infections anywhere on the body.
“Blood sugar coats the infection-fighting white blood cells, so they're not able to [get rid of] bacteria as well,” says podiatrist Lee C. Rogers, DPM, associate medical director at the Amputation Prevention Center at Valley Presbyterian Hospital in Van Nuys, Calif.
See a dermatologist or your diabetes specialist for prompt treatment if you notice rashes or itchy areas on your skin – they could be signs of bacteria or fungus.
“Fungal toenail and foot infections are common in diabetes,” Rogers says. “You need to have them treated before you get cracks in your skin and bacterial infection.”
Heart
Diabetes and heart disease are closely linked: You’re 2-4 times more likely to have a heart attack or stroke if you have diabetes.
“Having diabetes is considered a coronary equivalent, meaning it’s like having had a previous heart attack – which raises future heart attack risk,” Rogers says.
But diabetes patients don't always have typical symptoms, such as chest pain, chest pressure or pain in the shoulder or jaw.
“That’s because the nerves going to the heart or chest are damaged,” Rogers says. “Patients often have shortness of breath, but not the signs they’re taught to look for, so they may seek treatment too late.”
The best way to lower your risk for heart disease and stroke is to manage your blood glucose. (On the A1C test, which measures your average blood sugar over time, strive for less than 7% – or about 150 mg/dL – according to American College of Physicians guidelines.)
Once again, this means you need to get regular check-ups, and monitor and control your blood pressure and cholesterol carefully. Your doctor may also prescribe medications such as daily aspirin or statin drugs to help reduce heart attack risk.
Patients with high blood pressure who saw their doctors frequently were able to get blood-pressure levels back to normal sooner (1.5 months versus 12.2 months), lowering their risk of heart disease or stroke, according to a 2010 Harvard Medical School study published in the medical journal Hypertension.
Bones
Osteoporosis, a condition that makes your bones less dense and more likely to break as you age, is linked to type 1 diabetes complications. That may be because people who develop diabetes at a young age don’t gain as much bone density as healthy people, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
But type 2 diabetes can increase fracture risk too. Typically, osteoporosis and breaks are more common in thin or frail people, because they have less padding to protect their weakened bones when they fall.
But people with type 2 diabetes tend to trip and fall more often, often due to vision problems and nerve damage in the feet. They’re also more likely to be sedentary, a risk factor for osteoporosis.
The U.S. Preventive Services Task Force, a panel of health-care experts, recommends routine osteoporosis screenings for women aged 65 and older. But your endocrinologist or diabetes specialist may recommend earlier screenings based on your risk factors. Osteoporosis has “silent” symptoms, so testing may reduce your risk of fractures.
You should also ask your doctor if exercising more is a good idea.
“People should be cautious of doing too much exercise when they have diabetes and nerve damage, because the more walking you do, the more you risk injury [from falls] and foot ulcers,” Rogers says.
But exercise can be beneficial if your doctor gives you the go-ahead. “Even walking 10 minutes a day [can help] if you can’t walk half an hour,” Fradkin says.
Kidneys
Diabetes is the leading cause of kidney failure, with nearly half of all cases attributed to the disease, according to the ADA.
Kidney disease often develops silently over a decade or more, but you can help prevent it by controlling blood sugar and blood pressure.
“Your doctor will monitor your urine to see if you’re developing protein in [it], a sign of kidney damage,” Fradkin says. “With proper diagnosis and blood-sugar and blood-pressure control, we have evidence that we can reduce rates of kidney disease by 50%-60%.”
Bladder
Up to two-thirds of women develop bladder-control diabetes complications. If you experience incontinence, a urologist or diabetes specialist can recommend exercises or medication.
“Many bladder problems are related to nerve damage, because nerves control bladder function,” Fradkin says. “Controlling blood sugar can [reduce] nerve damage.”
If you’re overweight, dropping a few pounds can also help.
“Weight loss has been shown to make substantial improvement in reducing incontinence,” Fradkin says.
Those with nerve damage can improve bladder control with “timed voiding,” or urinating on a set schedule. You can also be taught how to recognize that your bladder is full, even if you don’t feel the urge to go. If leakage is the problem, strengthening muscles with Kegel exercises may help, but medication or surgery may be necessary.
Vaginal Tissue
After having diabetes for a number of years, you may develop sexual problems: vaginal dryness, pain during intercourse or a decrease in libido. Some women may have trouble getting aroused or reaching orgasm due to nerve damage and reduced blood flow.
Many women may not realize that these diabetes complications could be related to the disease, and assume that sexual problems come with aging or menopause.
“But people with diabetes develop these problems at higher rates,” Fradkin says.
That’s because hormonal changes can affect your blood glucose level, thus worsening mood swings, fatigue and hot flashes.
Besides watching your blood glucose, physical aids such as vaginal lubricants, as well as relationship counseling, can help.
Your doctor may also recommend weight loss.
“In our diabetes prevention clinical trial, losing about 15 pounds resulted in fewer problems with sexual function,” Fradkin says.
Legs and Feet
Up to 70% of people with diabetes have nervous-system damage. When the feet are affected, the resulting numbness can lead to injury, foot ulcers and even amputations.
“Foot problems are twofold,” Fradkin says. “Blood vessel damage can cause poor circulation to the feet, so wounds don’t heal.”
Meanwhile, people who have numbness or a loss of sensation in their feet (and legs, if the feet have been affected for a while) can’t tell that they’ve injured themselves.
“If you’re not able to feel things, you’re not warned about having an injury, like stepping on a tack,” Rogers says. “When healthy people get the smallest pebble in their shoe, they stop because it’s so bothersome. But diabetes patients don't feel it and get a blister, which develops into an ulcer that they can’t feel.”
About half of foot ulcers become infected, and 15% of those require amputations, according to Rogers.
Although nerve damage can’t be reversed, it’s possible to keep the damage from worsening (or affecting the legs as well as the feet) by controlling blood sugar and blood pressure.
Regularly seeing a podiatrist, who’s specially trained to detect potential foot problems, may be the best way to prevent them. A study presented at an American Podiatric Medical Association meeting in 2010 found that diabetes patients who saw podiatrists before they were diagnosed with foot ulcers had a lower risk of hospitalization or amputation.
For more information, visit our Diabetes Health Center.
How Much Do You Know About Diabetes?
In the United States alone, 23.6 million people have diabetes. And 5.6 million of them don’t even know it. Unfortunately, misinformation about the disease is rampant – and mixing up the facts can create dire diabetes complications.
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