The consequences of diabetes left uncontrolled are serious. Here are a few of the complications that can occur:
- Cardiovascular disease is by far the leading cause of death in the United States, but people with diabetes are at much higher risk.
- Kidney disease, also called nephropathy, occurs when the kidney's "filter mechanism" is damaged and protein leaks into urine in excessive amounts and eventually the kidney fails.
- Diabetes is a leading cause of damage to the retina at the back of the eye and also increases risk of cataracts and glaucoma.
- Nerve damage, especially in the legs and feet, may interfere with the ability to sense pain and contributes to serious infections.
Unfortunately, adding up the total toll of diabetes complications shows the disease is one of the nation's leading causes of death. All diabetes complications can be largely prevented by practicing what is known as "tight control," keeping your blood glucose level as close to normal as possible. This takes time and energy, but many people with diabetes do it successfully and live full lives without many complications.
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| Symptoms of diabetes |
The signs of
diabetes are not always dramatic. They may not even be noticeable.
In fact, the American Diabetes Association (ADA) estimates that
millions of Americans have type 2 diabetes and are not even aware
of it.
Watch for these symptoms. If you notice any of the following, ask
your doctor to test you for diabetes.
- For TYPE 1:
- Excessive urination
- Constant thirst
- For TYPE 2:
- The need to urinate more than usual
- Constant thirst
- Unusual weight loss
- Feeling weak or tired
- Blurred vision
- Tingling or numbness in hands or feet
- Cuts and bruises that are slow to heal
- Frequent and recurring infections such as urinary tract infections, boils, and fungus
- Difficulty with erections in men, and unusual vaginal dryness in women
- Extreme hunger
- Feeling nauseated and vomiting
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Tests to expect
Laboratory diagnostic tests also include measurement or analysis of:
- Ketones in the urine/blood
- Electrolytes
- pH level in the veins
- CBC (complete blood count)
- Islet cell antibodies
- Thyroid function tests and thyroid antibodies
- Kidney function tests
- Lipid profile
The importance
of a lipid profile
This
test measures the level of blood fats in your blood. People with
diabetes are prone to higher levels of blood fats in their systems
-- which puts them at increased risk of heart and blood vessel disease.
You should have these tests done at least once a year. Your total
fasting cholesterol should be less than 200 mg/dL. Your levels of
HDL (so-called good fats) should be greater than 35 mg/dL. Your
levels of LDL (bad fats) should be less than 130, and your triglyceride
levels should be under 200 mg/dL. If you have heart or blood vessel
disease, these levels may have to be even lower to prevent more
problems.
If your test
results don't fall in these ranges, your physician should be referring
your to a dietitian for help with lowering the overall fat content
in your diet, and help in losing weight, if that is a problem. He/she
should also encourage you to begin an exercise program -- and should
recommend an exercise tolerance test before you embark on an exercise
program if you are over age 35 or have any diabetes complications.
If you have any diabetes complications, he/she should be referring
you to an exercise specialist (usually an exercise physiologist).
These are usually the first courses of treatment for a lipid problem.
He or she may also prescribe lipid lowering medications, if you
have found that these changes aren't having the desired effect. |
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| Diabetes facts you should know |
Caring
for the 99 million Americans with chronic conditions such as diabetes,
asthma and hypertension accounts for the majority of the 1 trillion
spent on healthcare annually.
Fifty percent of type 2 diabetics are diagnosed at time of their first
heart attack.
Young men between ages 15-25 already show significant cardiovascular
disease (CVD), an LDL is a major risk factor that is modifiable by
diet and exercise ~ if it is known to be elevated.
(USA Today Article)
There is the same risk of death in people with diabetes without known
CAD and patients with CVD and history of MI.
(Source: Indiana Heart
Institute)
At least 10.3
million Americans carry a diagnosis of diabetes mellitus. Another
5.4 million are estimated to have undiagnosed diabetes.
(Source:
American Heart Association)
CVDs are listed
as the cause of death in approximately 65 percent of people with
diabetes.
Diabetes acts as an independent risk factor for several forms of
CVD. To make matters worse, when patients with diabetes develop
clinical CVD, they sustain a worse prognosis for survival than do
CVD patients without diabetes.
(Source: American Heart Association)
Myocardial
ischemia due to coronary atherosclerosis commonly occurs without
symptoms in patients with diabetes. As a result, multivessel atherosclerosis
often is present before ischemic symptoms occur and before treatment
is instituted.
(Source: American Heart Association)
Improved glycemic
control, better control of hypertension, and prevention of atherosclerois
with cholesterol-lowering therapy may prevent of mitigate diabetic
cardiomyopathy.
(Source: American Heart Association)
Mortality from
stroke is increased almost 3-fold when patients with diabetes are
matched to those without diabetes.
(Source: Diabetes Care 1993;
16: 434-444)
Prospective
studies document an increased likelihood of sudden cardiac death
and unrecognized myocardial infarction in patients with diabetes.
(Source: American Journal of Medicine)
Coronary artery
disease is the most common cause of premature death in both men
and women with diabetes. Thus, optimal care should be to address
atherosclerotic risk factors, which in diabetic patients center
on elevated triglycerides levels and decreased high-density lipoprotein
cholesterol levels
(Geoffrey Gates, M.D., Mayo Clinic.)
Low HDL levels
and elevated Total Cholesterol: HDL ratios are associated with increased
coronary risk.
(Source: Framingham Study JAMA 1986) |
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Factors
that influence HDL
- Smoking, obesity, lack of exercise, androgenic steroids, and beta blockers are associated with lower HDL.
- Estrogens, smoking cessation, high saturated fat diet (also elevates LDL), regular aerobic exercise and ethanol ingestion elevated HDL.
- There is epidemiologic evidence that triglycerides are a risk factor for coronary artery disease. (Source: Framingham Study)
In 1997 the estimated cost associated with diabetes in the United States was $98 billion. That included $44.1 billion in direct costs and an additional $54 billion in indirect costs due to disability and mortality.
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While daily blood glucose testing tells you what your blood sugar
level is at the time you test, HbA1c testing tells you your "average" blood sugar level over
the past 2-3 months. These tests are very important in protecting your long-term health. Maintaining good
HbA1c levels will help reduce your risk of diabetes complications such as blindness, kidney disease, nerve damage,
stroke, and heart failure.
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