Diabetes Complications: The Long-Term Picture

Diabetes Complications: The Long-Term Picture

Diabetes is linked to the development of a number of serious complications. The risk of developing complications exists whether you have type 1 or type 2 diabetes. Heart disease, for example, strikes many people with diabetes – particularly when they do not manage their diabetes well. Fortunately, by managing your diabetes, you can lessen your risk of heart disease and all the other complications.

Achieving good blood sugar levels play a large part in preventing complications, but it’s suspected that genetics may also have a say. However, good control will reduce your chances of developing complications – and this means that, to a large extent, you are in control of your future.

If you already have developed a diabetes-related complication, rest assured that, particularly with early diagnosis, treatment can be very effective.

Your Arteries

Diabetes can cause blood vessel problems such as atherosclerosis (the build-up of plaque deposits in the blood vessels). This build-up can be particularly serious when it affects the coronary arteries, which apply your heart with blood. Also known as macrovascular disease or large blood vessel disease, partial or total blockage of the coronary arteries can lead to a number of very serious complications like angina (chest pains) and heart attack. We don’t know yet why people with diabetes are more likely to develop cardiovascular disease. But, research has found that high blood sugar levels do cause damage to the arteries.

Taking Care of Your Arteries

  • Maintain good blood sugar levels.
  • Don’t smoke.
  • Eat a well-balanced, low-fat diet. Consult a dietician.
  • Keep a healthy weight.
  • Exercise regularly.
  • Check your blood pressure regularly.
  • Also, have your doctor regularly check your cholesterol and blood fat (triglyceride) levels.

Your Eyes…

Did you know that diabetes is the most common cause of adult blindness in the western world? Microvascular disease, or small blood vessel disease, begins the process that can lead to partial and – if left untreated – total loss of vision. Retinopathy occurs when the small blood vessels in your retina, the light-sensitive inner lining in the back of your eye, become damaged as a result of high blood sugar levels. Because symptoms don’t arise until the advanced stages of the disease, only regular eye examinations, performed by an experienced eye specialist, will detect the early stages of the disease. Fortunately, with early detection, laser treatment may prevent further damage. Damage to the eye may include haemorrhaging in your eye, the development of scar tissue and retina detachment.

Taking Care of Your Eyes

  • Maintain good blood sugar levels.
  • Have your eyes examined by an eye specialist at diagnosis and then at least once a year after the age of 15 if you have type 1 diabetes. If you have type 2 diabetes, your
  • eyes should be checked at diagnosis, then every two to four years.
  • Have your blood pressure checked frequently – high blood pressure increases the risk of retinopathy.
  • Notify your doctor of any changes in your vision immediately.

Your Nerves…

Your nerves are covered by cells that are particularly vulnerable to the sugar in your blood. When you have chronic high blood sugar, damage to your nerves – called neuropathy – may occur. Neuropathy can be sensory – nerve damage that can affect your legs, arms, hands, chest or abdomen, resulting in a loss of sensation, pins-and-needles, tingling or pain (and in some cases, limb amputation). It can also be “autonomic”. This means damage to the nerves in your body that control the actions of a number of organs, including the bladder, stomach, intestine and penis (for example, nerve damage can cause impotence).

Taking Care of Your Nerves

  • Keep your blood sugar within normal or near-normal levels.
  • Inform your doctor about any tingling, pain or numbness in your limbs, chest or abdomen.
  • Practice good foot care.

Your Kidneys…

Your kidneys filter out waste products from your blood into your urine. Chronic high blood sugar levels, over time, damage the filtering units in your kidneys. The problem is that once your kidneys are damaged in this way, they cannot be repaired. Once damaged, your kidneys’ condition generally tends to get worse over time. Early detection and treatment are the keys. Early treatment can slow the progress of kidney, or renal disease, and slow the onset of end-stage renal disease. End-stage renal disease occurs when your kidneys function at only 10 percent or less capacity, and requires treatment with either a kidney transplant or dialysis treatment.

Taking Care of Your Kidneys

  • Maintain good blood sugar levels.
  • Have your blood pressure checked frequently, and treat high blood pressure promptly.
  • Know the signs of urinary tract infections – cloudy or bloody urine, a burning sensation, frequent urination, feeling the need for constant urination – and get treatment immediately.
  • Have your urine tested for protein at least once a year, including tests for microalbuminuria (small amounts of protein), one of the earliest signs of kidney damage. This may involve collecting your urine for 24 hours.
  • Have your blood tested for creatinine. This is a waste product which normal, undamaged kidneys will remove from the blood.
  • Eat a well-balanced diet.

Ensuring Good Blood Sugar Control

When you test your blood sugars at home, the meter tells you the level of sugar in your blood that exact moment. Your glycosylated haemoglobin (HbA1c) is a simple blood test done by your doctor. It measures your average blood sugar level over the past three months. It is a good indicator of your overall diabetes control, and a predictor of long-term complications. Have your doctor test your HbA1c every three to six months.

Two Key Words: Control & Prevention

You can greatly reduce your risk of developing the complications associated with diabetes. How? Simply put, what you do today has a good chance of helping you in the future. So, keep your blood sugars as close to normal as possible, maintain your weight at an acceptable level, and live a healthy lifestyle. Read on for practical tips on how to achieve all these.




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Constance Brown-Riggs, MSEd, RD, CDE, CDN—an award-winning RD, certified diabetes educator, and past national spokesperson for the Academy of Nutrition and Dietetics, is the author of The African American Guide to Living Well With Diabetes, which received the Favorably Reviewed designation from the American Association of Diabetes Educators, and Eating Soulfully and Healthfully with Diabetes.

Dr. Lori Shemek, PhD, CNC, CLC, the best-selling author of “Fire-Up Your Fat Burn! and leading health and weight loss expert, is also known as “The Inflammation Terminator.” She has made it her mission to educate the public on the toxic effects of certain foods and lifestyle choices and how they create inflammation in the body. She is a leading authority on inflammation and its role in weight loss, preventing disease and optimizing health.

Rebecca Bitzer – MS, RD/LD, CEDRD is an award-winning Registered Dietitian, writer, speaker, blogger, and REBEL Dietitian business owner. Rebecca and her team of six Registered Dietitians have counseled thousands of clients struggling with diabetes for over twenty-five years. They work closely with each other along with internists, endocrinologists, therapists, and families.

Maureen Sullivan – RN, CDE has worked for many years as a Registered Nurse, most of them in emergency and trauma services. She is a Certified Emergency Nurse, Certified Diabetes Educator, and the former manager of a hospital stroke program. Maureen’s wealth of knowledge, passion for nursing and education, and ability to engage people makes her an excellent teacher and a captivating lecturer. Recently, Maureen has been concentrating on writing, speaking and teaching, as well as working on her award-winning weekly podcast, “The Health and Humor Show.”

Lauren Harris-Pincus, MS, RDN is a nutrition communications specialist, registered dietitian in private practice, social media consultant, speaker, spokesperson and corporate consultant. She is currently the owner of Nutrition Starring YOU, LLC and www.NutritionStarringYOU.com. Lauren strongly believes that we should “Think Healthy, not Skinny”, and “EveryBODY is unique, your diet should be too”. Lauren was co-host of the Family Food Experts Kitchen radio show, available for listening on iHeart Radio and iTunes. Also known as one of the “NutritionBabes”, Lauren co-founded NutritionBabes.com, a popular Health and Wellness website in 2009. NutritionBabes.com was voted one of Healthline’s Top 100 Health Blogs in 2011, 2012 and 2013.

Mark Heyman, PhD, CDE is a clinical health psychologist and the director of the Center for Diabetes and Mental Health (CDMH). In addition to treating patients with type 1 and type 2 diabetes, Dr. Heyman provides training for health care providers on how to identify and address the emotional and behavioral aspects of diabetes in their patients. He also works with pharmaceutical and medical device companies to help them understand these issues and incorporate this information into their sales, marketing, and patient education materials. He is particularly interested in empirically supported behavioral interventions that promote behavior change and improve physical and mental health in people with diabetes.

Katie Ferraro, MPH, RD, CDE is a nationally-recognized registered dietitian, certified diabetes educator and author with an expertise in nutrition communications and curriculum development. She is the co-author of “Diet Therapy in Advanced Practice Nursing” (McGraw Hill, 2014) and an Assistant Clinical Professor of Nutrition at the University of California San Francisco and University of San Diego’s graduate schools of nursing.

Dr. Beverly S. Adler, PhD, CDE (aka “Dr. Bev”) is a clinical psychologist and certified diabetes educator, author and speaker. She specializes treating the emotional issues of people with diabetes. In her private practice, she provides individual, family and/or group therapy utilizing a cognitive behavior therapy orientation, combined with a spiritual approach. Her goal is to empower her patients to manage their diabetes.

Dr. Bev is the author of two self-help diabetes books. She has written numerous articles which are published in print and online – always focused on diabetes from the emotional perspective. She also speaks to audiences of people living with diabetes, as well as, to audiences of healthcare professionals and diabetes educators. Dr. Bev, herself, has been living successfully with type 1 diabetes for 40+ years.

In August 2016, Dr. Bev was honored to receive the “CDE Entrepreneur of the Year” Award from her Metropolitan NY Association of Diabetes Educators.

Jill Weisenberger, MS, RDN, CDE, FAND is an internationally recognized nutrition and diabetes expert with more than two decades experience. Through writing, speaking and one-on-one coaching, Jill empowers people to grab control of their health. She has worked as both a nutrition counselor and a diabetes educator in the hospital and research settings, and now in private practice in Newport News, VA. Jill is known for her practical approach and caring attitude. Her no-nonsense strategies to eating well include foods that both taste good and are good for you.

Marlene Koch (pronounced ‘cook’) is a nationally recognized nutritionist, popular TV personality and New York Times bestselling author. She graduated Magna Cum Laude from UCLA with a Bachelor’s degree in Nutritional Science. She is a registered dietitian and one of a select group of dietitians to hold an advanced certificate in Child and Adolescent Weight Management from the Academy of Nutrition & Dietetics.

Marlene has taught professional chefs from the American Culinary Federation the principles of healthy cooking and eating. She has been adjunct Nutrition professor and cooking instructor for Columbus State College and the Columbus State Culinary Academy, and she is a nationally recognized expert in weight loss, diabetes, child and adolescent nutrition, and sugar substitutes.

Marlene has sold over one million cookbooks, and is a regular guest on QVC.

Barbara Ruhs – MS, RDN is a Registered Dietitian Nutritionist and owner of Neighborhood Nutrition LLC, a consulting firm focused on providing solutions to help food companies and supermarkets improve consumer health & wellness. She’s a former supermarket dietitian and has run a successful business for 17 years. A leader in the field of nutrition, her mission is to help people by impacting the way food is produced, marketed and sold. She’s a strong advocate for supermarket dietitians and believes the retail food industry has the greatest potential to impact public health.

Cheryl Orlansky has over 25 years of experience in health promotion and chronic disease prevention and management. Her first career as a registered dental hygienist led her towards a path of wellness and nutrition! Her expertise is in diabetes, weight management and cardiovascular disease for individuals and groups. She works in a large private practice including endocrinology, internal medicine, rheumatology, neurology and sleep medicine. She is an award winning dietitian with current leadership positions in state and local dietetics organizations.

She has been interviewed and quoted in media outlets for WebMD, Atlanta Sports and Fitness, Georgia Public Broadcasting, and the Atlanta Journal and Constitution. She has partnered with V-103 Radio to lead supermarket tours as part of a community outreach during National Nutrition Month.

Cheryl helps her clients reach balance through lifestyle choices: cooking and eating, activity and purpose in life.

Jackie Newgent, RDN, CDN, is a registered dietitian nutritionist and classically-trained chef. With a passion for helping people (including her father) with diabetes, she’s author of The With or Without Meat Cookbook: The Flexible Approach to Flavorful Diabetes Cooking and the award-winning The All‐Natural Diabetes Cookbook, both published by the American Diabetes Association. Jackie is also author of 1,000 Low-Calorie Recipes and Big Green Cookbook. Her next book, The All-Natural Diabetes Cookbook—2nd Edition, was published in 2015.

Nutritionist Rania Batayneh, MPH is the author of the best-selling book, The One One One Diet. She holds a master’s degree in public health nutrition from the University of Michigan School of Public Health and is also a Wellcoaches Certified Health and Wellness Coach endorsed by the American College of Sports Medicine (ACSM).

OmnichannelHealth Media, publisher of DiabetesDigest.com, does not provide medical advice, diagnosis or treatment. See additional information.