Friday, July 4, 2008

Dealing with Complications of Diabetes

Both Type I, or juvenile, diabetes, and type II, or insulin-resistant, diabetes have a plethora of complications. Even though the two types of diabetes have different causes and somewhat different biological effects, both types can cause problems ranging from heart disease, serious eye problems such as diabetic retinopathy, and susceptibility to infections, circulation problems, gangrene, and strokes.

The most important way to avoid or minimize complications is to keep one’s blood sugar carefully regulated. For some type II diabetics this may be able to be accomplished with diet alone, while others may need a combination of diet and an oral medication. For type I diabetics, a carefully restricted diet must be augmented by regular insulin injections. In addition to merely monitoring blood sugar and tracking food, making sensible food choices can help considerably. Eating a piece of raw fruit instead of drinking fruit juice and choosing whole grains over refined pastas and breads will provide valuable nutrients while having a less dramatic impact on blood sugar.

Beyond diet and medication, other things can be done to minimize problems. Caring immediately for any scratches, wounds, or other skin problems is important, as is protecting oneself from injury to the skin and to the extremities in the first place. For people susceptible to skin problems, specially created diabetic socks provide a supportive fit while helping keep the feet dry to prevent the growth of harmful bacteria and fungus. Avoiding stress and getting enough sleep also helps the body cope with the disease.

Of course, proper medical care is also important. Like many serious chronic diseases, diabetes requires regular medical appointments with an endocrinologist. It’s also important to communicate with the doctor about acute illnesses that crop up, including colds, the flu, and other common infectious diseases. A simple cold can make a non-diabetic individual miserable for a week; a diabetic, on the other hand, can have his or her blood sugar levels thrown off wildly, and need serious adjustment.

The bottom line for diabetics: eat right, monitor your blood sugar and medication levels carefully, care for all skin problems, get enough sleep, and most importantly, don’t go it alone. Find a good doctor, follow his or her recommendations, and then follow up frequently. Diabetes is a serious illness with potentially serious complications, but being on top of it can mean avoiding many, if not all, of the problems that can crop up.

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Scary Complications of Diabetes

As a diabetic, you are at a constant risk of developing complications. What are these complications? What are their symptoms? Which body part is most affected? Let’s have the answers to these questions.

Blood Vessels

Diabetes could harm your small blood vessels. The small vessels include those in your eyes, kidneys, and nerves. The larger ones include those in your heart and lower legs.

Kidney

Kidney damage is very common in diabetes. The disease varies with each patient and the rate of its progress. Diabetic nephropathy occurs when your small blood vessels present in your kidneys get damaged. This leads to a leak of protein into your urine. As a result, your kidneys lose their ability to filter your blood. At times, dialysis may be required to flush out the toxins from your blood. In extreme cases, you may require a kidney transplant.

Nerves

Nerve damage can lead to a complete loss of sensation in your feet. Sometimes, the reverse happens. You feel constant pain in your feet. It becomes difficult to wear shoes or sandals. Even a small wound can develop into a serious infection, rotting ulcers, gangrene, and even amputation of the affected part.

In men, nerve damage may lead to impotence. Diabetic neuropathy affects the nerves connecting to the penis, thus, not letting the penis get an erection. If the penis does not get the required amount of blood flow, it may lead to erectile dysfunction.

Eyes

Your eyes are other organs to get affected. It is called diabetic retinopathy and it usually occurs in patients suffering from diabetes for as long as five years. The damage of blood vessels located at the back of your eye leads to a leakage of protein as well as blood into the retina. It also causes small aneurysms. The new blood vessels develop but are brittle. There might be bleeding from the newly developed blood vessels, which may lead to scarring, and your retina may get detached resulting in a damaged eyesight.

These complications are scary enough to make you sit up and take notice. Well, they are dangerous enough to take your life too! So, start caring for your body today!

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Complications of Poorly Controlled Diabetes

What is known about the risk of complications in Type 1 diabetes?
It is unusual for people with type 1 diabetes to have complications such as retinopathy and nephropathy within the first five years of their diabetes.

Studies have shown that the risk of kidney damage and eye disease are more common in people with poor control. This risk rises steeply above HbA1c values of 9% and is highest if the HbA1c value is above 12%.

The Diabetes Control and Complications Trial (DCCT) showed that 12% of people Type 1 diabetes who were intensively treated (tight control) developed new retinopathy changes after nine years, compared to 54% of people who were treated with conventional (less tight control) methods. Progressive retinopathy was uncommon at HbA1c levels below 7%. People with very mild retinopathy were also less likely to progress to severe retinopathy if they were well controlled.

Similar observations have been made for diabetic nephropathy. Once retinopathy or nephropathy are well established, tight control is unlikely to provide a significant benefit. Prevention of complications is therefore desirable in people with Type 1 diabetes by tight control, started early, in suitable people.

What is known about the risk of complications in Type 2 diabetes?
The main concern in Type 2 diabetes, is with regard to the risk of vascular complications. This form of diabetes carries a heightened risk of heart attacks, stroke and circulatory problems.

The United Kingdom Prospective Diabetes Study showed that high blood glucose concentrations contribute to the risk of small vessel disease in type 2 diabetes as well. The researchers examined over 4000 people with type 2 diabetes, once again looking at the effects of 'intensive' and 'conventional' treatment. Over a period of ten years, people in the intensively treated group, who had an HbA1c level of 7.0% (compared to 7.9% in the conventional treatment group) were found to have a 25% risk reduction in complications such as eye and kidney disease.

Does everyone with diabetes develop complications?
No, not everyone who has diabetes will develop complications. There is good evidence that good control of blood sugar, blood pressure, cholesterol lowering, a healthy lifestyle with plenty of exercise and no smoking will prevent complications in most people.

Can these complications be cured?
Acute complications of diabetes usually resolve completely with treatment.

Once the chronic complications of diabetes are extablished, they rarely resolve completely. The best counsel therefore, is that of 'prevention'. Much can be done to alleviate the problems associated with chronic complications of diabetes.

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