Healthy Focus

An ounce of prevention: The Top 4 dangers of uncontrolled diabetes

If you have Type 1 or 2 diabetes, keeping track of your blood sugar may sometimes seem like a full-time job. But it’s a job you can’t afford to quit because of the strong links between untreated diabetes and other serious diseases that can develop.

Here’s how to confront and combat the four most serious complications that can develop when diabetes isn’t kept under control.

1) Heart disease can be tougher to beat

Heart disease is the nation’s No. 1 killer, but if you have diabetes, you’re especially at risk.

“With diabetes, you’re four times as likely to be diagnosed with heart failure,” says Kim Dempsey, MS, RD, LDN, CDE, Lead Clinical Dietitian and Program Coordinator for HCMC’s Department of Diabetes Education.

You’re also two to four times more likely to die from heart disease compared with adults who don’t have diabetes, according to the American Heart Association. People with diabetes are prone to diabetes dyslipidemia, which is marked by lower “good” cholesterol and higher “bad” cholesterol.

Preventive measure: Take all your medication as directed

To control your diabetes, your doctor may prescribe diabetes medication and insulin as well as medication to protect your heart. That could include aspirin therapy, an ACE inhibitor or other medication to control blood pressure, and statin medication, which is used to lower “bad” blood cholesterol levels.

“Diabetes patients can be put on a statin even if they don’t have high cholesterol,” says Dempsey.

However, you may be able to stop taking diabetes and heart disease-related medications if you keep your Hgb A1c—a blood test that averages your blood sugar during the previous three months—under 6.5 percent for 48 consecutive months.

“I’ve seen patients really turn their numbers around and get off their medication,” says Dempsey. “Just a 10-pound weight loss can make a significant difference in blood sugar levels.”

2) Kidney disease can silently set in

About 10 to 40 percent of adults with diabetes eventually will experience kidney failure, according to the National Institute of Diabetes and Digestive and Kidney Diseases. High blood sugar can damage the blood vessels in your kidneys, preventing them from doing their important job of filtering your blood. 

Preventive measure: Monitor your glucose levels closely

“Long-term high glucose readings are the biggest risk factor for developing diabetes complications, including kidney disease,” says Dr. Dempsey. If your doctor prescribes diabetes medication and/or insulin, fill your prescriptions promptly and take them as directed.

3) Diabetes can be a sight stealer

Diabetes can cause tiny blood vessels in the retina—the delicate, light-sensitive lining in the back of the eye—to leak, resulting in blurry vision. In later stages, the condition, known as diabetic retinopathy, can cause vision loss. Diabetes is the leading cause of blindness in the United States.

Preventive measure: Focus on getting an eye exam

If you’ve been diagnosed with diabetes, “see an eye doctor at least once a year,” says Dempsey, or as often as your healthcare provider recommends.

Regular eye exams are vital for preserving your vision. An eye exam can diagnose diabetic retinopathy at the earliest possible stage and help prevent it from getting worse. Diabetic retinopathy can be treated with medication or laser therapy. If the condition is caught early enough, treatment may not even be necessary.

4) Diabetes can get on your nerves

In fact, it can destroy them. Blood sugar that’s not well-managed can damage the blood vessels in your nerves, especially in extremities such as your hands and feet, which can lead to diabetic neuropathy and limb amputation.

Preventive measure: Take good care of your feet

At each office visit, make sure your doctor checks your feet, and check them yourself every day at home. Look for blisters, cuts, bruises, cracked and peeling skin, redness and swelling. Keep your feet clean and dry, and wear shoes and socks to protect them from injury.

If you spot problems, make an appointment to see your physician right away, because small sores can quickly turn into a major infection.

Smoking and diabetes don’t mix

Smoking increases the risk of death from heart attack in people with diabetes by 52 percent, according to a study in BMJ Open.

To increase your chances of kicking the habit, get support by calling the national tobacco quit line at 1-800-QUIT-NOW (1-800-784-8669). Or, join an online stop-smoking program, or participate in the American Lung Association’s Freedom from Smoking in-person program. For more information, visit Freedomfromsmoking.org.

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No complications: What you can do to help a wound heal faster

When you’re nursing a healing wound, the best strategy is simple but essential: Don’t wait to address any problems, no matter how minor they may seem.

“The longer a wound is open, the higher the chances of complications, so catching problems early and treating them immediately is key,” says Lindsay Foust, DPM, Podiatrist of Innovative Orthopedics.

The price for waiting can be high, because non-healing lower extremity wounds, for example, can lead to amputation. But whatever the type of wound, it’s important to understand the basics of wound care that can help you get better faster, and with fewer complications.

Follow instructions

Adhering to your doctor’s orders may seem like basic advice, but many patients find it difficult when doing so means altering their daily lives, says Dr. Foust.

“People with diabetic foot ulcers need to get weight off wounds to allow them to heal,”she says. “That may mean wearing therapeutic footwear, orthotic insoles or both. If it’s venous leg ulcers, patients often need to wear compression stockings. I recognize these things can be a nuisance, but they’re necessary for the wound to heal.”

Communication is key to closing the gap between what your doctor needs from you and what you can reasonably do. If your therapeutic shoes trip you up, or the compression stockings are so tight you can’t get them on, don’t be afraid to speak up.

“We understand that people battle these issues and others—medication side effects, for example—and we can sometimes make adjustments that make things easier,” says Dr. Foust.

Get educated

To avoid complications after surgery, patients should pay attention to specific details of their wound care regimen.

“You need to know when and how to change any dressings, when it’s OK to get the wound wet, and what to expect so you can get in touch with your surgeon if something doesn’t look right,” shesays. “Get good instructions and communicate with the surgeon or nurse about what is OK and what is not.”

Your surgeon will likely advise you to get up and move around as soon as you are able, to help prevent blood clots and constipation. However, he or she may also tell you to restrict certain activity depending on the location of your incisionor wound.

“Too much tension on a healing incision can cause it to separate, which might require another procedure to close it,” she says.

With foot and leg ulcers, healing the injury as rapidly as possible is the best way to prevent infection.

“That means keeping the wound properly dressed, not submerging it in water and having good nutrition to keep your immune system healthy so it can fight off infections,” Dr. Foust says.

Prevent infection

For wounds like simple foot and leg ulcers, your primary care physician may be able to manage the entire treatment. But if a wound hasn’t healed in a month, it’s time to seek specialized care, says Dr. Foust.

“Wound care centers can provide advanced care such as hyperbaric oxygen therapy and biologic products,” she says.

Always wash your hands before and after dressing a wound. “If you didn’t see a nurse or doctor wash their hands, ask. It’s one of the best ways to prevent infection,” she says.

Get a grip on lifestyle changes

Optimal wound healing requires patients to have a good handle on their overall health. That means controlling any underlying medical conditions, particularly diabetes, says Dr. Foust.

Along with cigarette smoking, poorly controlled blood sugar levels is the most common barrier to wound healing that Dr. Foust sees in his clinic. High blood sugar levels slow down the healing process by stiffening and narrowing arteries, which decreases the flow of blood, oxygen and other nutrients to the wound.

A nutritious diet will also help you heal better. Eating enough protein and other nutrients, such as vitamins A and C, gives skin and deeper tissues building blocks for repair, says Dr. Foust.

“Patients healing from wounds need about 25 percent more protein than normal,” she says.

Ask your healthcare provider to explain what amount of protein and other nutrients you might need based on your body weight, age and activity level, she says.

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Grilled Ratatouille Salad

Eggplants are high in antioxidants, may lower overall cholesterol, and help improve blood flow.

Ingredients:

2 Japanese eggplants
1 medium sweet onion, such as Vidalia
1 medium summer squash
1 medium red bell pepper
Olive oil
2 medium ripe tomatoes, chopped
2 tablespoons chopped, pitted black olives
1 tablespoon chopped fresh basil
1 tablespoon chopped Italian parsley
1/2 teaspoon crushed dried oregano
1/4 teaspoon crushed dried thyme
1 tablespoon red wine vinegar
Salt and pepper to taste
1/4 cup grated Parmesan cheese
2 cups cooked brown rice, optional 

Directions:

Slice the eggplants 1/2-inch thick. Slice the onion 1/2-inch thick. Quarter the squash lengthwise. Cut the bell pepper into 1/2-inch pieces lengthwise. Brush the eggplant, onion, bell pepper and squash lightly with oil. Place in a vegetable basket and grill on a hot grill. Remove the onion, bell pepper and squash after 10 minutes or when browned and tender; remove the eggplant after 12 minutes or when browned and tender. Coarsely chop the grilled vegetables.

Place in a bowl. Add the tomatoes, olives, basil, Italian parsley, oregano, thyme, 1 tablespoon olive oil, vinegar, salt and pepper to taste.

Toss with cheese. Spoon rice onto 4 plates, if desired. Top with ratatouille.

Serves 4.