Put the Brakes on Diabetes Complications

People with diabetes are living longer, with fewer complications, thanks to greater awareness and better management of risk factors.

Complications are falling

Over the last 20 years, rates of several major diabetes complications have fallen among U.S. adults with diabetes. The biggest declines were in two leading causes of death, heart attack and stroke. That is real progress: people with diabetes are at higher risk of heart disease, and may get it more severely and younger than people without diabetes.

They are linked

Diabetes complications often share risk factors, and one can make another worse. Many people with diabetes also have high blood pressure, which worsens eye and kidney disease. Diabetes tends to lower HDL ("good") cholesterol and raise triglycerides (a blood fat) and LDL ("bad") cholesterol, raising the risk of heart disease and stroke. Smoking doubles the risk of heart disease in people with diabetes.

The main complications

• Heart disease and stroke: twice as likely in people with diabetes.
• Blindness and other eye problems: damage to blood vessels in the retina (diabetic retinopathy), clouding of the lens (cataract), and raised fluid pressure in the eye (glaucoma).
• Kidney disease: high blood sugar can damage the kidneys and cause chronic kidney disease (CKD), which untreated can lead to kidney failure; about 1 in 3 adults with diabetes has it.
• Nerve damage (neuropathy): common, causing numbness and pain, most often in the feet and legs, but it can also affect digestion, blood vessels and the heart.
• Amputations: damage to blood vessels and nerves, especially in the feet, can lead to serious infections that are hard to treat; amputation may be needed to stop them spreading.
• And more: gum disease, which can cause tooth loss and raise blood sugar (and can also raise the risk of type 2 diabetes); a higher risk of depression, growing as complications add up; and, for gestational diabetes, serious complications for mother and baby.

Complications usually build up over a long time without symptoms, which is why regular doctor's appointments matter even when you feel fine: early treatment can prevent or delay them.

Your prevention toolkit

• Follow a healthy eating plan.
• Be physically active for at least 150 minutes a week.
• Manage your ABCs: a regular A1C test, blood pressure below 140/90 mm Hg, cholesterol under control, and stop smoking, or never start.
• Lose weight if you need to.
• Take medicines as instructed.
• Make and keep appointments with your health care team.

In charge, but not alone

You are in the driver's seat in managing your diabetes, but everyone's diabetes is different, and some people develop complications despite good management. Feeling discouraged can lead to letting things slip, such as skipping blood sugar checks or appointments. Your health care team can help you set goals, remind you of your progress and suggest new approaches, and can point you to support groups nearby or online.

Sources

• Centers for Disease Control and Prevention, "Put the Brakes on Diabetes Complications." https://www.cdc.gov/diabetes/prevention-type-2/stop-diabetes-complications.html
• A stock photograph is not reproduced here.