Diabetes And Me... Life With Purpose!

Complications of Diabetes

• Heart Disease and Stroke
• Diabetic Neuropathies: The Nerve Damage of Diabetes
• Diabetic Retinopathy (Eye Disease)
• Erectile Dysfunction
• Diabetic Foot
• Hypoglycemia (Low Blood Glucose)
• Kidney Disease
• Sexual and Urologic Problems of Diabetes
• Stomach Nerve Damage (Gastroparesis)

Heart Disease and Stroke

Having diabetes or pre-diabetes puts you at increased risk for heart disease and stroke. You can lower your risk by keeping your blood glucose (also called blood sugar), blood pressure, and blood cholesterol close to the recommended target numbers?the levels suggested by diabetes experts for good health. (See your doctor) Reaching your targets also can help prevent narrowing or blockage of the blood vessels in your legs, a condition called peripheral arterial disease. You can reach your targets by

• choosing foods wisely
• being physically active
• taking medications if needed

If you have already had a heart attack or a stroke, taking care of yourself can help prevent future health problems.

Diabetic Neuropathies: The Nerve Damage of Diabetes

Diabetic neuropathies are a family of nerve disorders caused by diabetes. People with diabetes can, over time, have damage to nerves throughout the body. Neuropathies lead to numbness and sometimes pain and weakness in the hands, arms, feet, and legs. Problems may also occur in every organ system, including the digestive tract, heart, and sex organs. People with diabetes can develop nerve problems at any time, but the longer a person has diabetes, the greater the risk.

An estimated 50 percent of those with diabetes have some form of neuropathy, but not all with neuropathy have symptoms. The highest rates of neuropathy are among people who have had the disease for at least 25 years.

Diabetic neuropathy also appears to be more common in people who have had problems controlling their blood glucose levels, in those with high levels of blood fat and blood pressure, in overweight people, and in people over the age of 40. The most common type is peripheral neuropathy, also called distal symmetric neuropathy, which affects the arms and legs.

Diabetic Retinopathy (Eye Disease)

Retina damage happens slowly. Your retinas have tiny blood vessels that are easy to damage. Having high blood glucose and high blood pressure for a long time can damage these tiny blood vessels.

First, these tiny blood vessels swell and weaken. Some blood vessels then become clogged and do not let enough blood through. At first, you might not have any loss of sight from these changes. Have a dilated eye exam once a year even if your sight seems fine.

One of your eyes may be damaged more than the other. Or both eyes may have the same amount of damage.

Diabetic retinopathy (RET-ih-NOP-uh-thee) is the medical term for the most common diabetes eye problem.

You can get two other eye problems—cataracts and glaucoma. People without diabetes can get these eye problems, too. But people with diabetes get them more often and at a younger age.

• A cataract (KAT-uh-rakt) is a cloud over the lens of your eye, which is usually clear. The lens focuses light onto the retina. A cataract makes everything you look at seem cloudy. You need surgery to remove the cataract. During surgery your lens is taken out and a plastic lens, like a contact lens, is put in. The plastic lens stays in your eye all the time. Cataract surgery helps you see clearly again.
• Glaucoma (glaw-KOH-muh) starts from pressure building up in the eye. Over time, this pressure damages your eye's main nerve—the optic nerve. The damage first causes you to lose sight from the sides of your eyes. Treating glaucoma is usually simple. Your eye care professional will give you special drops to use every day to lower the pressure in your eye. Or your eye care professional may want you to have laser surgery.

Erectile Dysfunction

Erectile dysfunction, sometimes called «impotence,» is the repeated inability to get or keep an erection firm enough for sexual intercourse. The word «impotence» may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm. Using the term erectile dysfunction makes it clear that those other problems are not involved.

Erectile dysfunction, or ED, can be a total inability to achieve erection, an inconsistent ability to do so, or a tendency to sustain only brief erections. These variations make defining ED and estimating its incidence difficult. Estimates range from 15 million to 30 million, depending on the definition used. According to the National Ambulatory Medical Care Survey (NAMCS), for every 1,000 men in the United States, 7.7 physician office visits were made for ED in 1985. By 1999, that rate had nearly tripled to 22.3. The increase happened gradually, presumably as treatments such as vacuum devices and injectable drugs became more widely available and discussing erectile function became accepted. Perhaps the most publicized advance was the introduction of the oral drug sildenafil citrate (Viagra) in March 1998. NAMCS data on new drugs show an estimated 2.6 million mentions of Viagra at physician office visits in 1999, and one-third of those mentions occurred during visits for a diagnosis other than ED.

In older men, ED usually has a physical cause, such as disease, injury, or side effects of drugs. Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED. Incidence increases with age: About 5 percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience ED. But it is not an inevitable part of aging.

ED is treatable at any age, and awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for ED.

Diabetic Foot

People who have diabetes are vulnerable to nerve and vascular damage that can result in loss of protective sensation in the feet, poor circulation, and poor healing of foot ulcers. All of these conditions contribute to the high amputation rate in people with diabetes.

Hypoglycemia (Low Blood Glucose)

Hypoglycemia, also called low blood sugar, occurs when your blood glucose (blood sugar) level drops too low to provide enough energy for your body's activities. In adults or children older than 10 years, hypoglycemia is uncommon except as a side effect of diabetes treatment, but it can result from other medications or diseases, hormone or enzyme deficiencies, or tumors.

Symptoms of hypoglycemia include

• hunger
• nervousness and shakiness
• perspiration
• dizziness or light-headedness
• sleepiness
• confusion
• difficulty speaking
• feeling anxious or weak

Hypoglycemia can also happen while you are sleeping. You might

• cry out or have nightmares
• find that your pajamas or sheets are damp from perspiration
• feel tired, irritable, or confused when you wake up

Hypoglycemia can occur in people with diabetes who take certain medications to keep their blood glucose levels in control. Usually hypoglycemia is mild and can easily be treated by eating or drinking something with carbohydrate. But left untreated, hypoglycemia can lead to loss of consciousness. Although hypoglycemia can happen suddenly, it can usually be treated quickly, bringing your blood glucose level back to normal.

Kidney Disease

Each year in the United States, more than 100,000 people are diagnosed with kidney failure, a serious condition in which the kidneys fail to rid the body of wastes. Kidney failure is the final stage of kidney disease, also known as nephropathy.

Diabetes is the most common cause of kidney failure. Even when diabetes is controlled, the disease can lead to nephropathy and kidney failure. Most people with diabetes do not develop nephropathy that is severe enough to cause kidney failure.

Diabetic kidney disease takes many years to develop. In some people, the filtering function of the kidneys is actually higher than normal in the first few years of their diabetes. This process has been called hyperfiltration.

Over several years, people who are developing kidney disease will have small amounts of the blood protein albumin begin to leak into their urine. At its first stage, this condition has been called microalbuminuria. The kidney?s filtration function usually remains normal during this period.

As the disease progresses, more albumin leaks into the urine. This stage may be called overt diabetic nephropathy or macroalbuminuria. As the amount of albumin in the urine increases, filtering function usually begins to drop. The body retains various wastes as filtration falls. Creatinine is one such waste, and a blood test for creatinine can be used to estimate the decline in kidney filtration. As kidney damage develops, blood pressure often rises as well.

Overall, kidney damage rarely occurs in the first 10 years of diabetes, and usually 15 to 25 years will pass before kidney failure occurs. For people who live with diabetes for more than 25 years without any signs of kidney failure, the risk of ever developing it decreases.

Sexual and Urologic Problems of Diabetes

Troublesome bladder symptoms and changes in sexual function are common health problems as people age. Having diabetes can mean early onset and increased severity of these problems. Sexual and urologic complications of diabetes are related to the nerve damage diabetes can cause. Men may have difficulty with erections or ejaculation. Women may have problems with sexual response and vaginal lubrication. Urinary tract infections and bladder problems occur more often in people with diabetes. By keeping your diabetes under control, you can lower your risk of sexual and urologic problems.

Stomach Nerve Damage (Gastroparesis)

Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents. Normally, the stomach contracts to move food down into the small intestine for digestion. The vagus nerve controls the movement of food from the stomach through the digestive tract. Gastroparesis occurs when the vagus nerve is damaged and the muscles of the stomach and intestines do not work normally. Food then moves slowly or stops moving through the digestive tract.

The most common cause of gastroparesis is diabetes. People with diabetes have high blood glucose, also called blood sugar, which in turn causes chemical changes in nerves and damages the blood vessels that carry oxygen and nutrients to the nerves. Over time, high blood glucose can damage the vagus nerve.

Signs and symptoms of gastroparesis are

• heartburn
• pain in the upper abdomen
• nausea
• vomiting of undigested food?sometimes several hours after a meal
• early feeling of fullness after only a few bites of food
• weight loss due to poor absorption of nutrients or low calorie intake
• abdominal bloating
• high and low blood glucose levels
• lack of appetite
• gastroesophageal reflux
• spasms in the stomach area

Eating solid foods, high-fiber foods such as raw fruits and vegetables, fatty foods, or drinks high in fat or carbonation may contribute to these symptoms.

The symptoms of gastroparesis may be mild or severe, depending on the person. Symptoms can happen frequently in some people and less often in others. Many people with gastroparesis experience a wide range of symptoms, and sometimes the disorder is difficult for the physician to diagnose.