One of the problems of having diabetes is that you may feel perfectly fine even though your blood sugar levels are not in control. When this happens, the disease can impact several areas of your body. Potential complications of diabetes, along with ways that you may help to avoid them, follow.
The kidneys are one of the major organ systems affected by diabetes. In fact, damage to the kidneys as a result of diabetes (diabetic nephropathy) is the most common cause of kidney failure in the United States. As a result, several treatment options and ways of screening are aimed specifically at trying to prevent damage to the kidneys.
A common test to screen for harm to the kidneys is a urine microalbumin. Microalbumin is a protein that is rarely found in the urine of people with normal kidney function, but it can occasionally be found in those with diabetes as the kidneys begin to suffer damage. Healthcare providers frequently use the test to check the health of the kidneys in patients who have diabetes.
Many people with diabetes also have high blood pressure. On its own, high blood pressure can cause damage to the kidneys. If a patient has microalbuminuria and high blood pressure, in order to protect the kidneys, treatment may include an ACE inhibitor or ARB.
HEART ATTACK AND STROKE RISK
High levels of sugar in the bloodstream have been found to affect the health and diameter of the blood vessels (especially the arteries) over time. Many screening tests for diabetes — along with treatment options — focus on preventing harm to the blood vessels of people who have diabetes. The consequences of blood vessel damage could include poor wound healing, an increased risk of having a heart attack or a stroke, and vision changes.
One of the most important annual tests for people who have diabetes is a lipid profile to check for high cholesterol. Although most providers in the past based treatment for high cholesterol on the number/ratio of good vs. bad cholesterol, recent evidence suggests that this practice might have been incomplete. Available now is a “ten-year cardiovascular risk score,” which takes into account several different factors and provides an estimate regarding a patient’s risk of having a heart attack or stroke (cardiovascular event) in the next ten years. Based on this number, many providers decide whether treatment of cholesterol is needed.
The eyes are frequently one of the most common organ systems that people with diabetes neglect. They are also one of the most frequently affected organ systems in patients with poorly controlled diabetes. Retinopathy is a complication of diabetes that affects the eyes. It is caused by damage to the blood vessels of the tissue at the back of the eye, called the retina.
To preserve your eyesight, you should visit your ophthalmologist at least once a year to have a dilated eye exam. The eye doctor visit is one of the most important screening tests if you have diabetes, as your ophthalmologist can often detect damage to your eyes far before you begin to experience changes in vision. Frequently, treatment can begin before permanent vision changes take place. If you have not visited with an ophthalmologist in the past year, ask your provider for a referral.
Nerve pain (called neuropathy) is extremely common and almost guaranteed to develop in patients who have poorly controlled diabetes. Over a period of time, having high levels of blood sugar will frequently result in damage to the nerves.
One of the first signals lost when nerves are damaged involves sensation and touch. When this occurs, people with severe nerve damage are at significant risk for cuts and ulcers on the bottoms of their feet, as they frequently won’t feel an injury or cut to their foot until it has developed into a major wound.
To prevent this type of progression, many providers routinely perform foot exams on their patients with diabetes. A microfilament is placed on several areas of the foot to ensure that sensation is still intact. If sensation is lost, patients with diabetes are at significant risk for wounds to the bottoms of their feet that can result in ulceration and, in severe cases, infection of the bone (called osteomyelitis).
Remember that it is extremely important for you to pay particular attention to the health of your feet and, if you do develop diabetic neuropathy, to routinely check yourself for cuts on the bottoms of your feet. Wounds generally do not heal as quickly as if you did not have diabetes, so preventing one from forming is extremely important.
LUNG INFECTIONS AND VACCINATIONS
People with diabetes are also at risk for developing an infection of the lungs, so you should receive the flu vaccine annually to prevent becoming sick from the flu. The influenza virus (and all infections, really) carry a significant risk of significantly increasing the blood sugars of patients with diabetes. People with diabetes are also at increased risk of death from pneumonia. The Centers for Disease Control and Prevention (CDC) recommends that all people with diabetes receive the pneumonia vaccine as well.