As the world's population continues to age, researchers turn their attention from treatment of acute diseases to the prevention of chronic illnesses and the chronic complications caused by those diseases. In the United States, diabetes is the leading cause of blindness and kidney failure. Improving control over your blood glucose level is the key to preventing the progression of these types of diabetic complications. Your doctor or dietitian can help you to achieve this goal.
Retinopathy
Diabetic retinopathy is a complication of diabetes that can potentially lead to blindness. Improving your glucose control can not only delay the onset of the disease, but also slow the progression of existing retinopathy. High blood glucose damages the eyes either by causing an overgrowth of blood vessels on the retina, called proliferative diabetic retinopathy, or by causing small blood vessels in the eye to leak, resulting in macular edema. Proper medical control of blood glucose and eye care can prevent over 90 percent of visual loss from diabetic retinopathy, according to the book "Atlas of Clinical Endocrinology."
Nephropathy
Diabetes is the most common cause of chronic kidney disease requiring dialysis, according to the book "Principles of Diabetes Mellitus." Unfortunately, diabetic patients are less likely to be wait-listed for a kidney transplant because of the higher risk of post-transplant complications in diabetics. Kidney disease, or diabetic nephropathy, does not develop in every diabetic patient. Genetic susceptibility plays a role in increasing risk -- for example, having a diabetic sibling with kidney disease -- as does blood glucose control. Diabetic patients with prolonged A1c levels greater than 7.5 to 8 percent are at an increased risk. Maintaining strict control over your blood glucose levels reduces the risk of developing diabetic kidney disease.
Neuropathy
High blood glucose levels can damage nerve fibers in your body. The average onset of symptoms is 10 to 20 years after diagnosis of diabetes. Not every diabetic will develop neuropathy, although poorly controlled blood glucose levels significantly increase the risk. Damage to cranial nerves cause symptoms that include speech difficulties, drooping eyelids or facial muscles, and vision problems. Damage to nerves in the digestive tract can cause diarrhea, constipation or vomiting. With more peripheral nerve damage, symptoms include a loss of sensation or a tingling or burning pain in the feet and legs. Rigid control of blood glucose levels can prevent the development of neuropathy or prevent existing symptoms from becoming progressively worse.
Cardiomyopathy
Diabetic cardiomyopathy is diagnosed when there is an enlargement of the left ventricle without evidence of structural heart disease. This heart condition is a complication resulting from high blood glucose levels. Symptoms include labored breathing, fluid buildup in the tissues and exercise intolerance, symptoms typical of congestive heart failure. Along with cardiomyopathy, the diabetic patient is at an increased risk for high blood pressure. If you are having trouble controlling your glucose level, talk to your doctor. Controlling your blood sugar will help to reduce your risk of developing diabetic cardiomyopathy, according to the National Heart Lung Blood Institute.
References
- "Atlas of Clinical Endocrinology, Diabetes"; C. Ronald Kahn et al.; 1999
- "Principles of Diabetes Mellitus"; Leonid Poretsky; 2010
- MedlinePlus: Diabetic Neuropathy
- National Heart Lung and Blood Institute: Diabetic Heart Disease
