DIABETES MELLITUS

Associated complications

Diabetes brings with it several serious complications related to the heart, eyes, blood vessels, kidneys, feet and nerves. Some of the cases include: diabetic retinopathy, a key cause of blindness and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. After 15 years of diabetes, approximately 2 per cent of people become blind, and about 10 per cent develop severe visual impairment.

Diabetic neuropathy is damage to the nerves as a result of diabetes, and affects up to 50 per cent of diabetes sufferers. Although many different complications can occur as a result of diabetic neuropathy, common symptoms are tingling, pain, numbness, or weakness in the feet and hands. Combined with reduced blood flow. Diabeteic neuropathy in the feet increases the chance of foot ulcers and eventual limb amputation.

Diabetes is among the leading causes of kidney failure where 10 to 20 per cent of people with diabetes die from this complication. It also increases the risk of heart disease and stroke. People with type 2 diabetes are over twice as likely to have a heart attack or stroke as people who do not have diabetes.

The overall risk of premature death among people with diabetes is at least double the risk of their peers without it.

Preventing complication in diabetics

Diabetes can affect any part of the body and can lead    to    serious    complications    such    as microvascular complications (retinopathy, nephropathy and neuropathy) and macrovascular ones (stroke, coronary artery disease and peripheral vascular disease). Working together, people with diabetes and their multidisciplinary health care providers can reduce the occurrence of these and other diabetes complications by controlling blood glucose, blood pressure and lipids as well as receiving the preventive care practices in a timely manner. High glucose alone is seldom the only metabolic abnormality and usually most cases have other risk factors that require detection and treatment.

Glucose control is extremely important as we generally know from various studies that it could reduce complications by 60 per cent and a reduction in results of A1C by 1 per cent could decrease diabetic complications by 40 per cent.

Blood pressure control have been shown to reduce cardiovascular disease and Microvascular complications, more in diabetic cases, by approximately 33 to 50 per cent. It is estimated that for every 10 millimeters of mercury reduction in blood pressure, the risk of any complications related to diabetes is reduced by around 12 per cent.
Lipids should be controlled in all diabetics and kept in target levels. This could translate to reducing cardiovascular complications by 20 to 50 per cent.

Preventive care practices by detecting and treating diabetic eye disease with laser therapy can reduce the development of vision loss by 60 per cent. Foot care can reduce amputation rates by 45 to 85 per cent.

Detecting and treating early diabetic kidney disease by use of ACE inhibitors and angiotensin receptor blockers, can reduce the decline in kidney function by 30 to 70 per cent.

The public and medical community awareness in diabetes should be raised and more aggressiveness in the prevention and control of this epidemic of diabetes should be encouraged.

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