By anguillian September 14, 2012 09:21



Many individuals inAnguillaare affected by Diabetes Mellitus. Although most of the long-term complications of diabetes develop gradually, they can eventually be disabling or even life-threatening.Good control of diabetes can lead to a reduction in the complications associated with it, and help decrease the morbidity and mortality of this chronic condition.


What are some complications associated with diabetes?

Diabetes affects many major organs including your heart, blood vessels, nerves, eyes and kidneys. Controlling your blood sugar levels can help prevent these complications. Complications include the following:

•    Heart and blood vessel disease. Diabetes dramatically increases the risk of various cardiovascular problems including coronary artery disease with chest pain (angina), heart attack, stroke, narrowing of arteries (atherosclerosis) and high blood pressure. The risk of stroke is two to four times higher for people with diabetes, and the death rate from heart disease is two to four times higher for people with diabetes than for people without the disease.

•    Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Poorly controlled blood sugar can eventually cause you to lose all sense of feeling in the affected limbs. Damage to the nerves that control digestion can cause problems with nausea, vomiting, diarrhoea or constipation. For men, erectile dysfunction may be an issue.

•    Kidney damage (nephropathy). The kidneys contain millions of tiny blood vessel clusters that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, requiring dialysis or a kidney transplant.

•    Eye damage. Diabetes can damage the blood vessels of the retina (diabetic retinopathy) potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma.

•    Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can become serious infections. Severe damage might require toe, foot or even leg amputation.

•    Skin and mouth conditions. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections. Gum infections also may be a concern, especially if you have a history of poor dental hygiene.

•    Osteoporosis. Diabetes may lead to lower than normal bone mineral density, increasing your risk of osteoporosis.

•    Alzheimer’s disease. Type 2 diabetes may increase the risk of Alzheimer’s disease and vascular dementia. The poorer your blood sugar control, the greater the risk appears to be.

•    Hearing problems. Diabetes can also lead to hearing impairment.


How to decrease diabetic complications?

Goodcontrolof blood glucose levels can decrease many of the complications associated with diabetes. The following are some useful tips:

Choose carbohydrates carefully

Diabetes does not mean you have to cut carbohydrates completely. Choose carbohydrates that break down in the body slowly, providing steady energy. Use whole grains, beans, nuts, and fresh vegetables and fruits.  A dietitian or your doctor can help you learn how much is right for you.

Lose weight if you are overweight

If you are overweight, shedding just a few pounds can improve the body’s ability to use insulin. It will help lower your blood sugar and improve your blood pressure and blood fats. You will also have more energy.  Aim to burn more calories than you eat. To start, try cutting fat and calories,  such as chips or fries, from your diet.


Get adequate sleep

Getting too much or too little sleep can increase your appetite and cravings for high-carb foods. That can lead to weight gain thus increasing your risk for complications such as heart disease. Aim for seven or eight hours of sleep a night. If you have sleep apnea, treating it can improve your sleep and lower your blood sugar levels.


Be active: Exercise

Choose an activity you like — walking, dancing,swim laps, biking, or just pacing the floor while you are on the phone. Exercise 20-30 minutes a day; work up to that if you need to. Exercise can help you lower your cardiovascular risks, cholesterol, and blood pressure levels, and keep your weight down. Exercise also relieves stress and may help you cut back on diabetes medication.


Monitor your blood sugar levels

Checking your blood glucose levels can help you avoid diabetes complications, like nerve pain, or keep them from getting worse. Checking it can also help you see how foods and activities affect you, or if your treatment plan is working. Your doctor can help you set a target glucose level range. The closer you get to your target, the better you will feel.


Manage stress

When you have diabetes, stress can cause your blood glucose levels to rise. Try to get rid of whatever physical or mental stresses you can. Learn coping techniques to deal with others. Relaxation techniques such as breathing exercises, yoga and meditation may be especially effective if you have type 2 diabetes.


Decrease saltintake

Reduce the salt in your diet. It may help lower blood pressure and protect your kidneys. Not salting the food on your plate may not be enough. Most of the salt in our meals comes from processed foods. Avoid convenience foods and use fresh ingredients when you can. Season your foods with herbs and spices instead of salt when you cook.

Adults age 51 and older, and individuals with high blood pressure, diabetes or chronic kidney disease, should reduce their sodium intake to 1,500 mg a day — that’s less than half a teaspoon of salt.

This is a measure of your average blood sugar control for the last 2-3 months.


Take care of cuts and bruises

Diabetes raises your risk of infection and slows healing, so treat even simple cuts and scrapes quickly. Properly clean your wound and use an antibiotic cream and sterile bandage. See a doctor if it is not better in a few days. Check your feet every day for blisters, cuts, sores, redness or swelling. Moisturize them to prevent cracks.


Stop smoking

People with diabetes who smoke are two times more likely to die prematurely than those who don’t. Quitting helps your heart and lungs. It lowers your blood pressure and risk of stroke, heart attack, nerve damage and kidney disease. Ask your doctor about help for quitting tobacco.


Choice the right foods

There is no single diabetes diet.  The following should be  kept in mind: Enjoy super foods like berries, sweet potatoes, fish with omega-3 fatty acids, and dark green, leafy vegetables. Look at food labels and avoid saturated fat and trans fats. Instead, opt for mono and polyunsaturated fats like olive oil. A registered dietitian can give you personalized advice.


See your doctor

Expect to see your doctor two to four times a year. If you take insulin or need help balancing your blood sugar levels, you may need to visit more often. Also get a yearly physical and eye exam. You should be screened for eye, nerve, and kidney damage and other complications. See a dentist twice a year. And be sure to tell all health care providers that you have diabetes.

Try to get regular blood pressure checks. Try to have a goal below 130/80 mm Hg.

Cholesterol. Goal: LDL below 100 mg/dl; HDL above 40 mg/dl; and triglycerides below 150 mg/dl.

Have your A1C levels done.You may need it checked two or more times a year. Talk to your doctor about setting a goal.



Healthy lifestyle choices can help you prevent type 2 diabetes. Even if diabetes runs in your family, diet and exercise can help you prevent the disease. If you have prediabetes, lifestyle changes can slow or halt the progression from prediabetes to diabetes. If you have already been diagnosed with diabetes, the same healthy lifestyle choices can help you prevent potentially serious complications. Diabetes mellitus is major health disorder inAnguilla. Do your part in the management of this chronic condition.


Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over twenty nine years in clinical practice. Dr Hodge has a medical practice in theJohnsonBuildingin The Valley.


By anguillian September 14, 2012 09:21


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