Putting the Brakes on Diabetes Complications

Centers for Disease Control and Prevention   (CDC)

January 2, 2018

We’ve come a long way in reducing the impact of diabetes on people’s lives. In the last 20 years, rates of several major complications have decreased among US adults with diabetes. The greatest declines were for two leading causes of death: heart attack and stroke. (People with diabetes are at higher risk for heart disease, and they may get it more severely and at a younger age than people who don’t have diabetes.) This is meaningful progress.

It’s important to note that during that same 20 years, the number of adults diagnosed with diabetes has more than tripled as the American population has aged. Diabetes complications still take a heavy toll on the health of millions of people and on our health care system.

Why Complications Are So … Complicated

Diabetes complications often share the same risk factors, and one complication can make other complications worse. For example, many people with diabetes also have high blood pressure, which in turn worsens eye and kidney diseases. Diabetes tends to lower HDL (“good”) cholesterol and raise triglycerides and LDL (“bad”) cholesterol, which increases the risk for heart disease and stroke. Smoking doubles the risk of heart disease in people with diabetes.

Take a closer look at these major diabetes complications:

·         Heart disease and stroke: People with diabetes are twice as likely to have heart disease or a stroke as people without diabetes.

·         Blindness and other eye problems: Diabetic retinopathy (damage to blood vessels in the retina), cataract (clouding of the lens), and glaucoma (increase in fluid pressure in the eye) can all result in vision loss. Diabetic retinopathy is also one of the most preventable causes of vision loss. Early detection and treatment can prevent or delay blindness in 90% of people with diabetes.

·         Nerve damage (neuropathy): One of most common diabetes complications, nerve damage can cause numbness and pain and can even be disabling. Nerve damage most often affects the feet and legs but can also affect your digestion, blood vessels, and heart.

·         Kidney disease: High blood sugar levels can damage the kidneys and cause chronic kidney disease (CKD). If not treated, CKD usually gets worse and can lead to kidney failure. A person with kidney failure needs regular dialysis (a treatment that filters the blood) or a kidney transplant to survive. About 1 in 3 adults with diabetes has CKD. You won’t know if you have CKD unless your doctor tests you for it. The earlier treatment is started, the better the outcome.

·         Amputations: Diabetes-related damage to blood vessels and nerves, especially in the feet, can lead to serious, hard-to-treat infections. Amputation can be necessary to stop the spread of infection.

·         And more:

o    Diabetes is associated with gum disease, which can lead to tooth loss and increased blood sugar, making diabetes harder to control. Gum disease itself can increase the risk of type 2 diabetes.

o    Diabetes increases the risk of depression, and that risk grows as more diabetes-related health problems develop.

o    Gestational diabetes, diagnosed during pregnancy, can cause serious complications for mothers or their babies, such as preeclampsia (pregnancy-induced high blood pressure), birth-related trauma, and birth defects.

Complications usually develop over a long time without any symptoms. That’s why it’s so important to make and keep doctor and dentist appointments even if you feel fine. Early treatment can help prevent or delay diabetes-related health conditions and improve overall health.

Your Prevention Toolkit

A healthy lifestyle is your road map for managing diabetes, which is the key to preventing or delaying complications:

·         Follow a healthy eating plan.

·         Be physically active for at least 150 minutes a week (just 30 minutes, 5 days a week).

·         Manage your ABCs:

o    A: Get a regular A1C test to measure your average blood sugar over 2 to 3 months; aim to stay in your target range as much as possible.

o    B: Try to keep your blood pressure below 140/90 mm Hg (or the target your doctor sets).

o    C: Control your cholesterol levels.

o    s: Stop smoking or don’t start.

For people with diabetes, controlling blood pressure has big benefits: it reduces the risk of heart disease by as much as 50% and the risk of kidney, eye, and nerve disease by about 33%.

·         Lose weight if you’re overweight—just a 5% to 7% weight loss lowers the risk for complications. That’s 10 to 14 pounds for someone who weighs 200 pounds.

·         Take medicines as prescribed, and talk to your doctor if you have questions about or problems with your medicine.

·         Make and keep appointments with your health care team (primary care doctor, dentist, foot doctor, eye doctor, and dietitian).

In Charge, But Not Alone

You’re in the driver’s seat when it comes to managing your diabetes—watching what you eat, making time for physical activity, taking meds, checking your blood sugar. Also be sure to stay in touch with your health care team to keep going in the right direction.

Everyone’s diabetes is different. Some people will still have complications even with good control. Maybe that’s you—you’ve been trying hard but not seeing results. Or you’ve developed a health problem related to diabetes in spite of your best efforts.

If you feel discouraged and frustrated, you may slip into unhealthy habits, stop monitoring your blood sugar, even skip doctors’ appointments. That’s when your team can help you get back on track, from setting goals and reminding you of your progress to offering new ideas and strategies.

For more support and to connect with others who know what you’re going through, check out the American Diabetes Association’s Community page and the American Association of Diabetes Educators’ Diabetes Online Community. If you’d like to connect in person, this directory will help you find a diabetes support group nearby.