Preventing Long Term Complications of Diabetes

Outline for the videotape "Preventing Long Term Complications of Diabetes", from The American Association of Diabetes Educators Patient Education Video Series, produced by Milner-Fenwick, Inc., copyright 2000 .

**Funded through a grant from the Friends of the University of Michigan Hospitals. **

  1. High blood sugar over time can lead to long term complications
    1. Damage to large blood vessels
      1. Higher risk with high blood sugar, high cholesterol, high blood pressure
      2. Atherosclerosis reduces amount of blood that can pass through the blood vessel leading to heart attack, stroke, and poor circulation
      3. Heart disease is leading cause of death
      4. Poor circulation causes pain, slower healing of cuts
    2. Damage to small blood vessels
      1. Diabetic retinopathy – vessels of the eye bleed or rupture; can reduce vision and lead to blindness
      2. Diabetic nephropathy – vessels of the kidney; can lead to kidney failure
      3. Diabetic neuropathy – damage to the nerve cells can cause:
        1. pain
        2. loss of sensation and muscle weakness of hands, feet, legs
        3. affect function of the heart, bladder, digestive system and sexual organs
    3. Combination of neuropathy, poor circulation, and skin breakdown may lead to need for amputation

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  2. There is a lot you can do to prevent these complications.
    1. Diabetes Control & Complications Trial (DCCT) study showed that the chance of developing the complications can be lowered:
      1. for kidney problems
      2. for nerve damage
      3. for eye problems
    2. KEY is to keep blood sugar under control
    3. Work with you diabetes care team

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  3. Diabetes Treatment Plan
    1. Healthy food choices and diet planning
      1. low in fats and sugar
      2. 3 meals and 1-2 small snacks spaced evenly throughout the day
      3. weight loss if overweight
    2. Exercise
      1. find an activity you enjoy and stick with it
    3. Medication, if necessary (insulin injections or diabetes pills as prescribed)
      1. understand when to take the medication and how much to take
    4. Monitor blood sugar levels regularly to determine how well treatment plan is working
      1. self-testing; review log with your diabetes care team
      2. Hemoglobin A1C test twice/year by your diabetes care team

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  4. Other risk factors besides high blood sugar
    1. Smoking – kick the habit
    2. High blood pressure – doctor may treat with medication
    3. High blood cholesterol – less foods high in saturated fats, e.g. fatty meats, fried foods, whole milk
    4. Exercise and weight loss help to lower blood pressure and blood cholesterol

      5.  
  5. Tell health care team if you are experiencing signs and symptoms of complications:
    1. Chest pain or shortness of breath during exertion
    2. Numbness or weakness on one side of body
    3. Slurred speech, dimness or vision loss in one eye
    4. Pain or ‘pins and needles’ in legs, cold legs
    5. Seeing spots or other vision changes

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  6. Other things to do to prevent long term complications:
    1. Yearly eye exam by an ophthalmologist
    2. Yearly blood and urine tests for kidney disease
    3. Watch your body, skin and feet for infection
    4. Take very good care of your feet
      1. inspect them daily and tell your doctor of anything unusual
      2. do not treat problems yourself
      3. properly fitting shoes and socks
      4. thorough foot exam every year by doctor or podiatrist
      5. request doctor to check feet on every visit
    5. Brush and floss teeth daily and see dentist regularly
    6. Report painful or frequent urination
    7. Report vaginal discharge and/or itching
    8. Report impotence

It is up to you to take control of your health.

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