There are many complications associated with diabetes. You should talk to your doctor about these complications. This section covers just three common complications. If you successfully manage your diabetes, then you may be able to avoid these complications. First, you will learn the bare basics glucose control. Next, you will learn about 1) diabetic neuropathy, 2) nephropathy, or kidney disease, and 3) retinopathy (eye disease).

 

BLOOD GLUCOSE CONTROL

Continued high blood sugar levels may lead to preventable complications

Complications arise from poor blood glucose control. For example, here are some general guidelines for what is considered poor blood glucose control:

• Having a before meal blood sugar level of more than 150 mg/dl
• Having a bedtime blood glucose level of more than 180 mg/dl
• To learn more about blood glucose levels and what you can do to control these and keep them within acceptable limits, please speak to your doctor and nutritionist
• For more information about glucose control go to the Resources section, or "google" blood glucose control to access many websites and papers on this topic
• Remember to speak to your doctor and nutritionist to determine what you need to do

WHAT IS DIABETIC NEUROPATHY?

• It is nerve damage to the legs, arms, feet, or hands (peripheral or sensory motor neuropathy). It can also occur to the nerves of the stomach, the reproductive organs, bladder and the circulation system (autonomic neuropathy)

 

WHAT IS THE COMMON CAUSE OF NEUROPATHY?

• Simply maintaining a high blood glucose level for a long period of time will begin to damage these nerves. There are other causes too.
• The symptoms may take a long time to develop.

WHAT ARE THE SYMPTOMS OF DIABETIC NEUROPATHY?

• Tingling sensation in the fingers and toes
• Feeling pins and needles in the hands and toes
• Burning or shooting pains in the feet
• Painful feet at night
• Very cold or hot feet and hands
• Loss of pain sensation in the feet and other areas

**For more information please go to www.diabetes.org/neuropathy

 

WHAT IS NEPHROPATHY?              

• Nephropathy is kidney disease caused by damage from long standing high blood sugar levels.
• Diabetes is the most common cause of nephropathy and end stage renal disease.
• Nephropathy is the most costly complication of diabetes due to kidney transplants and dialysis.
• Nephropathy develops in 40-50 percent of people with Type 1 diabetes over 20 years duration.
• Nephropathy develops in 5-10 percent of those with Type 2 diabetes (90-95% of people with diabetes have Type 2 diabetes).

 

ARE THERE ANY RISK FACTORS FOR NEPHROPATHY?

Identified combined risk factors include:

• High Blood Pressure (Hypertension)
• Poor blood sugar control
• Genetics/family history (hypertension and nephropathy)
• Smoking

 

ARE THERE WARNING SIGNS/SYMPTOMS FOR NEPHROPATHY?

• In the early stages, there may be no warning signs, therefore you must try to engage in preventive self-care practices.
• If you have Type 2 diabetes, ask your doctor at least once a year for a spot urine check when you visit.
• Depending on the result, he or she may order a 24 hour urine test.
• This is a very important test for diagnosis, so make every effort to collect your urine for 24 hours as soon as you are instructed to do so.

 

The following symptoms may appear when a good portion of the work of the kidneys is interrupted:

•         The person may complain of:

–        Loss of appetite, Nausea, vomiting

–        Frequent urination at night

–        Weight gain and swelling of the foot

–        Fatigue, muscle cramps, weakness, and anemia

–        Changes in concentration, consciousness, and behavior.

 

HOW TO DECREASE YOUR RISK

Because you have diabetes, the first step is to:

• Control your blood sugar level!
• If you have high blood pressure, control that, too (take your medications, cut back on salt, manage stress levels, stay away from fried foods)
• If you are overweight, work on losing some weight
• Stop smoking

 

For more information, please go to National Institute of Diabetes and Digestive and Kidney diseases at: http://www.niddk.nih.gov

OR call 1-800 860-8747.

 

RETINOPATHY

              

WHAT IS DIABETIC RETINOPATHY?

Diabetic Retinopathy is a vision problem which can result from damage to the small blood vessels in the eye that nourish the retina (the retina is responsible for images and light)

• Diabetic retinopathy is the most common diabetic eye complication among persons with diabetes
• Diabetes is the leading cause of blindness among persons between the ages of 20 and 74.

 

HOW COMMON IS DIABETIC RETINOPATHY?

• 21 percent of those with Type 2 diabetes are diagnosed with retinopathy at the time of a diagnoses of diabetes
• Over 90 percent of people under 30 years of age with Type 1 diabetes who are treated with insulin develop retinopathy
• More than 20 percent of patients over 30 years of age and treated without insulin develop retinopathy
• Of the 30% of people on work disability due to diabetes, 50-75% of them are disabled due to vision problems.

 

DIABETIC RETINOPATHY FACTS

• Diabetes is responsible for 12% of legal blindness in the United States
• Only 60% of people with diabetes receive necessary eye care
• More than 90% of vision loss can be prevented by proper treatment
• The onset and worsening of diabetic retinopathy depends on the individual's level of blood glucose control and the duration of diabetes.

 

WHAT CAN YOU DO TO PREVENT RETINOPATHY?

• Control your blood glucose level
• Help to control other risk factors such as:
  • High blood pressure
  • High cholesterol
  • Quit smoking
  • Plan all your pregnancies
  • Ask your doctor to check your eyes before becoming pregnant and while you are pregnant
  • Get laser treatment if it is recommended
  • Avoid activities that involve strenuous squatting and pushing (Valsalva maneuvers).

For more information go to: National Diabetes Education at http://www.ndep.nih.gov OR call 1-800 438-5383

 

OTHER CHRONIC COMPLICATIONS NOT MENTIONED INCLUDE:

• Cardiovascular Diseases (CVD)
• Stroke
• Peripheral Vascular Disease
• Hypertension
• Angina
• Heart Attack, Myocardial infarction
• Heart Failure
• Sudden cardiac death