Avoiding the Long-Term Complications of Diabetes
How can one avoid the serious complications that diabetes can cause? The message from several very large studies is clear. Whether you have type 1 or type 2 diabetes, you should work with your healthcare providers to achieve blood glucose levels as close to normal as possible to reduce the risks of long-term complications. Some people discover that, despite their best efforts, their diabetes is so difficult to manage that they cant achieve the type of control they want. And despite their hard work, other people still develop complications. This can be very discouraging. But remember, by doing the best job you can with your diabetes day-to-day, you are lowering your risks of developing further complications later on, and you are slowing the progress of complications that may be just beginning.
Controlling blood glucose is the first step, but diabetes affects the whole body including blood vessels and nerves. Therefore, controlling cholesterol and blood pressure can decrease risks for complications even more! Your healthcare provider will perform the following tests, but then you need to learn the results of the tests and what they mean.
A1C A blood test that measures average blood glucose over the past 2 to 3 months and is the best way to measure overall glucose control. It should be measured 2 to 4 times a year with a goal of less than 7%.
Blood pressure Measures the pressure against the walls of your blood vessels. High blood pressure is more common in persons with diabetes and increases risk of stroke, heart attack, kidney and eye diseases. It should be measured at every visit, or at least once a year, with a goal of 130/80 mm Hg or lower.
Cholesterol A blood test that measures the amount of fat (lipid) circulating in your blood stream. LDL cholesterol can clog the walls of the arteries but if caught early, can be treated. Blood fats (lipids) should be tested once a year with an LDL cholesterol goal of at least less than 100 mg/dl, and in people who are at high risk, such as those with diabetes and coronary heart disease, the LDL goal is now recommended to be 70 mg/dl. Further, the HDL cholesterol goal should be greater than 40 mg/dl for men and 50 mg/dl for women; the total cholesterol goal should be less than 200 mg/dl; and the triglyceride goal should be less than 150 mg/dl. Medications can be used to lower your cholesterol if needed, along with a meal plan low in saturated and trans fat.
Microalbumin A urine test that measures how well your kidneys are working. If you catch problems early, they can be treated. Microalbumin measures small amounts of protein in the urine and should be measured at least once a year with a goal of less than 30 micrograms per milligram creatinine. Medications called ACE (angiotensin-converting enzyme) inhibitors or ARBs (angiotensin receptor blockers) can help control microalbumin and blood pressure.
Eye exam To protect your eyes you should have a dilated eye exam every year. Drops will be put in your eyes to dilate your pupils. This makes it easier to see inside your whole eye. Medications or laser surgery can stop problems from getting worse, reduce the risk of vision loss, and in some cases restore useful vision.
Foot exam Remove your shoes and socks for a foot check at each appointment with your healthcare provider. Check your feet daily to prevent problems.
