Mayo Clinic Minute: 5 steps to diabetic foot care
5 Strategies to Avoid Diabetes Complications
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Today nearly 10 percent of the population of the United States has diabetes, according to the American Diabetes Association. And with diabetes comes a host of additional health concerns and potential complications. The most common among them is peripheral neuropathy — damage to the nerves in the hands and feet caused by chronically high blood sugar.
“The best way to prevent neuropathy is excellent glucose control,” says Jane Reusch, MD, a professor of medicine, biochemistry, and bioengineering at the University of Colorado School of Medicine, in Aurora, and the director of the Diabetes Care Team and the PEERS diabetes education program at the Denver VA Medical Center. “Dietary and nutritional management, as well as physical activity, can also help slow the progression of neuropathy.”
While peripheral neuropathy can cause pain and discomfort — and may sometimes lead to amputation — another, more serious complication to look out for is cardiovascular disease, says Dr. Reusch, like heart attack, heart failure, and stroke. That’s because, if left unmanaged, these heart-related complications can be damaging. In fact, people who have either type 1 or type 2 diabetes have a much higher likelihood of having shorter life spans and dying from cardiovascular disease than those who don’t have diabetes. So it’s critical for people with diabetes to control their blood pressure and cholesterol.
Another major complication of diabetes, says Reusch, is depression. And, depression can be cyclical — it can result in a lack of motivation, poor sleep habits, poor dietary habits, and reduction of exercise, all of which can negatively affect diabetes.
Additional potential health complications related to diabetes include, among other things, damage to the kidneys and eyes, according to the American Diabetes Association. There have been improvements recently in both the diagnosis and treatment of these kinds of complications, says Reusch. New screening tests allow doctors to detect protein in urine that indicates early stages of kidney disease, which can then be treated with medication. And instead of having to wait for patients to develop blurred vision or other eye symptoms, Reusch says, a common screening process involves taking a picture of the back of the eye; if retinal disease is detected, an antibody can be injected to slow progression of diabetic retinopathy and even prevent blindness.
So when you have diabetes, it’s important to manage not just your blood sugar but your health as a whole. Start with these strategies to help prevent the complications of diabetes:
1. Exercise around mealtimes.Data published in December 2019 inDiabetologiashowed that a taking a 10-minute after each meal can help lower overall blood sugar.
“For a drug to be approved by the FDA,” says Reusch, “it needs to lower A1C by .05 to .07 percent. And just 10 minutes, three times a day, of a brisk walk can lower A1C by that much. So [exercise] could potentially replace a drug.”
2. Follow the DASH diet.Rather than focusing on what you can’t eat, focus on healthy eating. The DASH diet — which is built around whole grains, vegetables, fruits, low-fat dairy, and lean meats, and is also low in saturated and trans fats — is known to help lower blood pressure. When combined with exercise and planned weight loss, it can also improve insulin sensitivity. Research conducted at Rush University Medical Center in Chicago in February 2019 showed an 11 percent lower risk for depression among participants who followed the DASH diet than among those who didn’t.
3. Work with your healthcare provider on weight loss.According to the 2019 National Diabetes Statistics Report of the Centers for Disease Control and Prevention (CDC), roughly 87 percent of people with diabetes are overweight or obese, and for those with this condition, weight does matter. “Seriously working with your doctor on obesity management to improve diabetes control — and to slow progression of the disease and the need for a lot of different medications — is a very viable and important strategy,” says Reusch. “If you can fully change obesity, a lot of time you can go from needing multiple medications to needing potentially none at all.”
4. Get immunized.Because people with diabetes are at higher risk of becoming ill from some preventable diseases, it’s critical that they stay on top of all immunizations, notes the CDC. That includes getting vaccinated for the flu, pneumococcal infections, hepatitis B, and shingles.
5. Check in with your doctor.Schedule regular visits with your doctor, who can evaluate your blood sugar levels, monitor hypertension and cholesterol concerns, and determine how well medication is managing your diabetes and any other health conditions you may have.
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