Diabetes Health Related Issues: At a Glance

I know people that have had amputations as a result of their diabetes. Can I prevent that from happening to me?

Diabetes often causes a person with diabetes to lose some feeling to areas such as the feet. When you don't feel your feet as well, you could have a cut or sore that you don't notice. Over time, without treatment, this can lead to an infection and a wound that has trouble healing. Unnoticed and untreated foot problems can lead to amputation. To prevent this, you need to keep your blood glucose in good control, check your feet every day for any signs of trouble and report these to your health care provider. In this case the old adage really does hold true, "An ounce of prevention is worth a pound of cure."

I hadn't heard about problems such as heart attack or stroke with diabetes before.

Today there certainly is an increased emphasis on the effect diabetes can have on your blood vessels, which can lead to heart attacks and stroke. This is called cardiovascular disease. Even though these things can happen to people who don't have diabetes, there is a 3 times greater chance of heart attack or stroke in a person with diabetes. Taking care of your diabetes along with other things like your blood pressure and cholesterol level and taking aspirin can lower your risk of heart and blood vessel problems. Even if you already have some of these problems, taking good care of yourself can help lower your risk of complications in the future.

What can I do about all these problems?

By controlling your blood glucose, blood pressure and cholesterol levels, you can help decrease the risk of some of the health issues that come with diabetes. If you smoke, find resources to help you stop. Get regular health care. All of these things can work together to keep you healthy and prevent or delay complications of diabetes.

Let’s Take a Closer Look

Diabetes can affect the heart and blood vessels, the nervous system, eyes, kidneys, gums, teeth and skin.

Heart and Blood Vessels

Diabetes can lead to changes in your blood vessels. These changes can cause fatty deposits to build up in your blood vessels resulting in narrowing or blockages of the vessels that go to your heart. If this happens in the blood vessels that go to your brain, a stroke results. Keeping your blood glucose, blood pressure, and cholesterol levels in good control can help delay or avoid these problems. Also, if you smoke, ask your health care provider about resources to help you quit.

Peripheral Artery Disease (PAD): This occurs when blood flow to your feet and legs is decreased due to narrowed or blocked arteries. You may notice leg pain when walking that goes away if you rest for awhile. Numbness, tingling and coldness in the legs and feet can also occur and cuts and sores on your legs or feet may heal more slowly. Your health care provider can do a simple test in the office to see if you may have PAD. It involves checking blood pressure readings in your arm and ankle and comparing the results. You may also have other tests such as an ultrasound, MRI or angiogram to help with diagnosis. There are several treatment options for PAD including medications, exercises, and surgery. Smoking worsens PAD and it is very important that, if you smoke, you quit. PAD puts you at higher risk for heart attacks and stroke. Managing your blood glucose, blood pressure and cholesterol can help lower your risk of these problems.

Nervous System

About half the people with diabetes have some form of nerve damage called diabetic neuropathy. This damage can occur in nerve endings in the feet, legs, hands, digestive or urinary tract. Nerve damage can come on gradually and the symptoms may be mild, making it more difficult for you to recognize that you may be having trouble. It tends to occur more often in those who have had diabetes for a longer time. You'll need to pay special attention and check your feet every day to detect problems early and prevent major complications.

People with neuropathy may experience:

• Digestive problems such as stomach pain, diarrhea, vomiting and constipation
• Problems with erections
• Increased or decreased sweating
• Dizziness or faintness when getting up from a lying position
• Difficulty recognizing the signs of low blood glucose
• Double vision
• Carpal tunnel syndrome

Kidneys

A person with diabetes is much more likely to develop problems with their kidneys. This is called diabetic nephropathy. The kidney performs two important functions: ridding your body of unwanted substances and extra fluid through the urine, and keeping needed materials such as protein and minerals from leaving the body through the urine. They also help in blood pressure regulation, helping your bones and blood absorb calcium and signaling your bone marrow to produce red blood cells.

High blood glucose and high blood pressure can damage small vessels in the kidneys so they are not able to filter out unwanted substances and not able to stop protein from being lost through your urine. There may be no symptoms of kidney problems until the kidney has lost a great deal of its function. There are tests available to check your urine to see if kidney damage has occurred and treatments for early kidney damage that are very effective.

Eyes

Diabetes can affect the small vessels in the tissue in the back of your eye called the retina. This is called diabetic retinopathy. In the early stages, there is fluid buildup and swelling of the vessels and they may begin to leak. This is referred to as nonproliferative retinopathy. Later, new very fragile small vessels begin to grow along the retina and in the gel that lies in front of the retina and this is called proliferative retinopathy. Often there are no symptoms of retinopathy until the disease is quite advanced. Vision may not change until there is severe damage. High blood pressure can also contribute to this problem. Cataracts and glaucoma are also more common in people with diabetes.

Seeing an eye doctor once a year for a dilated eye exam is essential in detecting and treating early problems before they become major ones. If you smoke, try to quit. There are treatments, such as laser surgery, available to help stop leaks in the vessels and preserve your sight.

Skin, Teeth and Gums

Diabetes can make your skin dry if your blood glucose is high due to a loss of fluids. If you don't sweat as much due to your diabetes, your skin will not be as moist. If your skin becomes dry and cracked, germs can enter through the cracks and cause an infection if your glucose is not in control. It is important to keep your skin clean, apply lotion to dry skin, pay special attention to drying skin under the breasts, between your toes and in skin folds. Notify your health care provider right away for any wound or sore that doesn't heal and watch for and report any signs of infection such as redness, swelling or draining wounds.

High glucose levels can also cause dental problems. You may be more prone to swelling and redness of the gums called gingivitis. If ignored, gingivitis can lead to more serious dental problems such as periodontal disease leading to increased risk of infection and possible tooth loss. The same toxins that are made by the germs in plaque, a sticky film of germs that stick to your teeth, can travel to other areas of the body such as the heart causing additional problems. To reduce your risk of dental problems, brush your teeth regularly, use dental floss to clean between teeth, quit smoking, and see your dentist twice a year to have your teeth cleaned and checked.

Follow the ABCs of Diabetes Care

• Keep your A1C under 7%
• Keep your blood pressure below 130/80
• Keep your cholesterol under 200 mg/dL, LDL (bad) cholesterol under 100 mg/dL (your health care provider may suggest a lower level for you), HDL (good) cholesterol over 40 mg/dL for men and above 50 mg/dL for women and keep your triglycerides under 150 mg/dL.

Every office visit:

• Have your blood pressure checked
• Have your weight checked
• Talk to your health care provider about blood glucose levels and target ranges
• Remove your shoes and socks for a foot check
• Discuss any needed changes to your treatment plan
• Ask your health care provider if using aspirin is right for you (if you aren't already taking it)

At least every 3-6 months:

• Have your A1C checked

At least one time a year:

• Have a cholesterol check
• Have your kidney function checked with both a urine test for albumin and a blood test
• Have a dilated eye exam
• Get a flu shot
• Have a complete (comprehensive) foot exam

At least once:

• Get a pneumonia vaccine

The information presented here is meant to be strictly for informational and educational purposes. It is not to be considered as advice, including medical advice, from Liberty Medical Supply, Inc. None of the information is intended to serve as a substitute for diagnosis from, or consultation with, a health care professional. Always consult your doctor regarding any medical questions that you have, as well as before starting or changing your exercise or diet program, and before adjusting any medication.

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