Complications surrounding diabetes

How to prevent and treat complications which come along with diabetes

By Dr CM Batra

Diabetes is a dreaded disease due its many complications which are macrovascular and microvascular.

  • Microvascular complications are those affecting the eye, kidneys and nerves. Strict control of diabetes, blood pressure, cessation of smoking, ACE inhibitors have been shown to reduce the occurrence of these microvascular complications.

  • Macrovascular complications occur due to the clogging up of vessels with lipids. When the blood supply to these organs becomes critically reduced it leads to heart attacks, strokes or gangrene of the feet. It can be prevented by keeping the blood sugar levels controlled, keeping cholesterol and triglycerides within normal limits, blood pressure as close to 120/80 mm of Hg as possible, cessation of smoking, daily exercise schedule of an equivalent of 45 minutes brisk walk, 5 times a week and a low fat balanced diet.

  • Once detected, prevention of blindness is possible by laser photocoagulation or if there is vitreous haemmorhage, by a surgery called vitrectomy.

  • Nephropathy is diagnosed by checking the urine for presence of proteins and by checking the feet and hands for loss of jerks and sensations.

  • Once detected strict control of blood sugars, blood pressure, lipids, and cessation of smoking are instituted on war footing.

  • Diabetics are prone for infections because their immune system cannot fight these infections as vigorously as a healthy person and because the bacteria and fungi love the excess sugar in the blood stream.

  • The treatment is to fight these micro-organisms by depriving them of glucose by keeping a strict blood sugar control and early use of antibiotics to kill them fast.

  • The feet of a diabetic is known as the Achilles heel or the most vulnerable organ of a diabetic because of loss of sensations and high blood sugars and compromised blood supply due to narrowed vessels makes it prone to injuries and infections.

  • It can be prevented by keeping the feet clean and dry, trimming nails with a proper nail cutter, wearing soft well fitted foot wear and not walking barefooted even in the house.

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