Diabetes Complications: What's Your Risk?
Why are people with diabetes at high risk of nerve pain, heart disease, and blindness?
Preventing Diabetes Complications With Medication
Getting blood sugar under control isn't always difficult. Sometimes all you
need are lifestyle changes -- eating right, getting regular exercise, losing
weight -- to get it into a safe range. If you're a smoker, there's no question
-- you've got to quit.
Also, finding ways to ease the stress in your life helps control blood
sugar, as does treatment for depression. Both stress and depression increase
the level of cortisol, a hormone that affects blood sugar. "Cortisol makes the
diabetes worse," Ziemer tells WebMD. "There is evidence that treating
depression may help blood sugar control." He is heading a study investigating
For some people, taking just one diabetes medication helps tremendously.
Complex new drugs like Byetta, Januvia, and Symlin work from different angles
to attack high blood sugar. "All the new drugs hold a lot of promise," says
Ziemer, who is also a professor of endocrinology at Emory University School of
Medicine in Atlanta.
If you need to take insulin, you'll find the injections aren't that bad.
"The new versions of insulin are far less cumbersome," Ziemer explains. You
don't need to lay out a lot of needles and vials on the table. The insulin can
be discreetly injected via a little pen -- much like a cartridge writing pen.
Insulin mouth sprays and insulin patches are being developed.
Fewer Diabetes Complications = Less Pain
By reining in blood sugar, you slow down the damage to the body's nerves and
blood vessels. You can even halt damage altogether. The benefits show up in
You can ease the pain or numbness you feel in hands, arms, feet, and legs.
"When you prevent more damage to nerves, you keep pain from getting worse,"
Ziemer explains. "We don't have any medications to repair nerve damage. Mostly,
we're protecting what's left."
Gum disease and tooth loss can be halted when blood sugar is controlled,
adds Ziemer. "In fact, when you get gum infection under control, you help keep
blood sugar under control. Infection in the gums increases inflammation in the
body, which makes controlling diabetes harder."
Don't put dental visits on the back burner, says Ziemer. "A lot of folks end
up losing lots of teeth. Nobody likes going to the dentist, me included. But
seeing a dentist is very important."
Blood sugar isn't the only issue, diabetes experts agree. If there are
cholesterol and blood pressure problems -- as there typically are -- they need
aggressive treatment with medication. Both these conditions affect the health
of large and small blood vessels, and greatly aggravate the damage done by
Cholesterol-lowering drugs like statins are a mainstay in diabetes
treatment. Blood pressure drugs like ACE inhibitors can also improve blood flow
throughout the body, including legs and kidneys. "These drugs protect kidneys
from damage and they protect the heart muscle, which helps prevent heart
failure," Ziemer tells WebMD.
With these diabetes complications, there's a lot at stake. Can you really
prevent the worst-case scenario? "Absolutely," Goldberg tells WebMD. "If you do
all these things, you can substantially reduce risk of heart attack, stroke,
and the blood vessel damage that leads to blindness, amputations, and kidney
damage. But you must start doing them as early as possible. And you have to
keep things under control ... strict control."