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Feature:
Diabetes Complications

Preventing and Managing Diabetes Complications

Fast Facts

  • There are three main types of diabetes: type 1, when the body does not make insulin and people need to take insulin every day to live; type 2, the most common type of diabetes, in which the body does not make or use insulin well (people with type 2 may need to take pills or insulin to manage their diabetes) and gestational diabetes, diagnosed in some women during pregnancy. Most of the time, it goes away after the baby is born, but even if it goes away, these women and their children have a greater chance of getting type 2 diabetes later in life.
  • Diabetes can lead to problems with the heart, kidneys, eyes, skin, legs and feet, nerves, and teeth and gums. Good management can cut this risk in half.
  • 23.6 million Americans have diabetes—7.8 percent of the U.S. population. Nearly 1 in 4 of those don't know they have it.
  • About 79 million adults aged 20 years and older have prediabetes. This is a condition where blood glucose (sugar) levels are higher than normal but not high enough to be called diabetes. Prediabetes puts you at risk for type 2 diabetes and cardiovascular disease, but you can lower this risk.
  • People with diabetes have seen greater success in managing the complications of their disease. Between 1997 and 2006, death rates for people with diabetes dropped substantially, especially deaths related to heart disease and stroke, according to the Centers for Disease Control and Prevention (CDC) and NIH researchers.

Diabetes means your blood glucose, or blood sugar, is too high. With type 2 diabetes, the more common type, your body does not make or use insulin well. Insulin is a hormone that helps glucose get into your cells to provide energy. Without insulin, too much glucose stays in your blood. Over time, this can cause problems with your heart, kidneys, nerves, feet, and eyes.

Other long-term complications of diabetes include skin problems, digestive problems, sexual dysfunction, and problems with your teeth and gums. Very high or very low blood sugar levels can also lead to emergencies in people with diabetes. The cause can be an underlying infection, certain medicines, or even the medicines you take to control your diabetes. However, early diagnosis and strict management of diabetes have been proven to make a great impact in preventing or delaying complications of the disease.

Managing Diabetes

People with diabetes are living longer and healthier lives. They now have a much lower chance of developing kidney failure, heart disease, and amputation than they did in the past, thanks to advances in controlling blood glucose, blood pressure, and cholesterol, and greater prevention and education efforts. Now, more than ever, it is important to see your healthcare providers regularly to treat diabetes effectively. They will check your cholesterol, blood sugar, blood pressure, and weight. You may be asked to take medicines. A healthy lifestyle, especially watching how much you eat and exercising every day, can help prevent heart attack and stroke. A daily 30-minute walk can help you manage diabetes and lower your chances of developing problems associated with diabetes, such as heart attack and stroke.

People with diabetes who keep their blood glucose (sugar) as close to normal as possible soon after they are diagnosed have fewer heart attacks later in life and far fewer problems with their eyes, nerves, and kidneys.

A blood test called the A1C test shows what your average blood glucose has been over the previous two to three months.

Now, for people with type 2 diabetes, there are many choices of diabetes medicines. Your healthcare provider may ask you to take a medicine called an ACE inhibitor or a different medicine, called an ARB, or other medicines for high blood pressure or kidney problems. You also may be asked to take a medicine called a statin to keep your cholesterol down and an aspirin to prevent heart attacks.

What You Can Do to Help Yourself

Follow a meal plan that is planned for you with your healthcare team.

Look for recipes that are low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars. Experiment with recipes that include fruits and vegetables, fish, lean meats, chicken or turkey without the skin, dried peas or beans, and low-fat or nonfat milk and cheese. Other healthy ingredients are foods high in fiber, such as whole grain cereals, breads, crackers, rice, and pasta.

Limit your portion sizes:

Use the plate method; make half your plate vegetables and fruit, one quarter of the plate a lean protein food, and one quarter of the plate a whole grain food.

Exercise safely every day:

Talk to your healthcare provider before starting any exercise program, and take small steps until you can build up to at least 30 minutes most days of the week. A brisk walk is excellent exercise. Find ways to add in extra walking as you go about your daily activities.

Do not smoke cigarettes or use any tobacco products.

Tobacco, whether smoked or chewed, has a very bad effect on the entire body and can make diabetes complications worse. Talk with your doctor or nurse if you need help quitting. There are many programs to help you quit.

Take your medicines the way your healthcare provider asks you to.

Make sure that you are taking your medicines on time, without skipping them, which is very important to successfully manage your diabetes and its complications. If you can't afford your medications, ask if you can switch to less expensive medicines.

Take care of your feet.

Check your feet every day to see if there are any cuts, sores, or other skin problems. Use a mirror to look at the bottoms of your feet. Protect your feet by wearing comfortable shoes and socks, and avoid walking barefoot. Ask your healthcare provider to check your feet to see if you have nerve damage and should be taking especially good care of your feet.

Have your eyes checked regularly.

People with diabetes should see an eye care specialist, an ophthalmologist, at least once a year to check for damage to their retinas.

See your health professional.

Everyone with diabetes should see their primary health provider or diabetes doctor at least twice a year, and more often if you are not meeting your treatment goals. At these visits your healthcare provider may:


  • Ask you about your blood sugar levels
  • Check your blood pressure
  • Check the skin and feeling in your feet, sores, and blood circulation
  • Dilate your eyes
  • Send you to the laboratory for blood and urine tests to:
    • Make sure your kidneys are working well (every year)
    • Make sure your cholesterol and triglyceride levels are healthy (every year)
    • Check your A1C level to see how well your blood sugar is controlled (every 3-6 months)

Major Complications of Diabetes

  • Heart Attacks and Stroke: People with diabetes have a higher risk for heart attacks, strokes, and other cardiovascular diseases. High blood pressure and high cholesterol increase this risk even more. Controlling blood pressure and cholesterol can help prevent heart attacks and strokes. Thanks to improved medical treatment, better management of diabetes, and some healthy lifestyle changes, deaths from heart disease and stroke in people with diabetes dropped 40 percent between 1997 and 2004, according to a study published in the journal Diabetes Care.
  • Kidney Disease: Your kidneys filter the waste materials in your blood. Diabetes can damage your kidneys' ability to filter waste, which can lead to kidney failure or end-stage kidney disease. When the kidneys are unable to keep the body healthy—dialysis or a kidney transplant may be needed. Managing your diabetes and high blood pressure, and getting your blood and urine checked for kidney disease can help keep your kidneys healthy.
  • Eye Problems: Diabetes can damage the blood vessels in the retina (called retinopathy), which can lead to vision loss or even blindness. If caught early through regular eye exams treatment can prevent progression to blindness.
  • Foot Problems: Diabetes can damage the nerves in the feet and cause problems with blood flow to the feet. This can lead to loss of feeling in the feet (numbness) and sores and cuts on the feet that do not heal. If not treated right away, they can lead to more serious problems and even amputation of the feet and/or legs.
  • Nerves: Nerve problems don't just affect the feet. They can also cause problems with digestion and erectile dysfunction.
Read More "Diabetes Complications" Articles

Learning a Healthier Way to Live / Preventing and Managing Diabetes Complications / Personal Stories / Tailoring Diabetes Treatment to the Patient

Fall 2012 Issue: Volume 7 Number 3 Page 12