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Diabetes: long term outcomes

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Wednesday, February 1, 2012

Diabetes: long term outcomes

I know that I had already broken down the info related to Diabetes Type 1 and 2 and what causes it, but it was brought to my attention lately that a lot of people do not understand the long-term effects of poor blood sugar control.  Diabetes can be very serious and cause significant health problems if not controlled well.

What can happen?
-Elevated blood glucose (sugar) levels lead to cellular dehydration, which over time can cause kidney damage and lead to renal failure.
-High glucose in the blood can cause blood vessel damage: poor wound healing after cuts and scrapes, or after surgery, and it increased your risk of wound infections.
-Along with blood vessel damage, with poor blood flow to areas you can have: retinopathy (damage to the eye from poor blood flow), blindness, peripheral vascular disease, skin ulcerations due to lack of blood flow, tissue ischemia (poor blood flow to tissue), and gangrene (tissue death).
-With poor blood flow, can occur peripheral nerve death (nerves live off of the blood flow from blood vessels near them) which can lead to: heart arrhythmias, poor bladder control, decreased sensations in the hands and legs/feet (can be dangerous with holding hot objects- you can get serious burns and might not feel the damage).
-Secondary health issues: hypertension (high blood pressure due to the renal damage and poor blood flow) and atherosclerosis (a hardening of the arteries due to a build up of fat and cholesterol from poor renal function).
-Also, having poorly controlled blood glucose levels can decrease your immune system and not only put you at higher risk for infections with cuts and wounds, but also put you at higher risk for the common cold, flu, pneumonia, etc.

What are the treatments?
-The only "cure" for renal failure: Dialysis (where your blood is filtered by a machine that acts like your kidneys three to four times a week) and/or a kidney transplant.
-With wound infections you can be treated with antibiotics, require surgery to cut out the infected tissues, and have very long healing times that may require hospitalization.
- Poor blood vessel blood flow: retinopathy, blindness, and peripheral vascular disease have no cure. For issues with tissue ischemia, you can have surgery to "bypass graft" (basically re-route your vasculature to allow better blood flow to the area). With gangrene, the only treatment is to amputate (remove) the affected area completely.
-Peripheral nerve death: the arrhythmias, bladder control, and decreased sensations can all be treated with medications to deal with the side effects, they can't always be "cured".
- Secondary heath issues can be treated with medications
-Decreased immunity use needs assist with flu shots, good hygiene, and you need to be careful during high illness times.

It might seem like a pain to check your blood sugars,  treat yourself with insulin, and watch your carbohydrate intake, but doing so can help prevent all of these complications, that won't just happen when you are 70 or 80 years old, we see patients in their 30's with these issues due to poor diabetes management.  Take control of your life and your disease, and take a step towards health and wellness!

Yours in Good Health
B

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