Diabetes - possible complications

Diabetes is a condition in which there is too much glucose (a type of sugar) in the blood. Over time, high blood glucose levels can damage the body’s organs. Possible complications include damage to large and small blood vessels, which can lead to heart attack, stroke and problems with the kidneys, eyes, feet and nerves.

Normally, our body’s blood glucose levels are controlled by a hormone called insulin, which is made in the pancreas. When a person has diabetes, the pancreas either can’t make insulin or the insulin it makes isn’t enough and doesn’t work properly. If the insulin can’t do its job, glucose builds up in the blood.

The good news is that the risk of most diabetes-related complications can be reduced. Regular check-ups and screening are important to detect complications early and to keep your waist measurement, blood pressure, blood glucose levels and cholesterol within recommended ranges.

The most common complications
The most common complications of diabetes include:

• Damage to the large blood vessels of the heart, brain and legs (macrovascular complications)
• Damage to the small blood vessels, causing problems in the eyes, kidneys, feet and nerves (microvascular complications).

• Have regular check-ups – see your doctor regularly.
• Don’t smoke – if you smoke, stop now. Speak to your doctor or call the Quitline for guidance and support.
• Lose weight if you are overweight – even a small weight loss, especially round the abdomen, helps reduce your blood pressure, blood glucose and cholesterol levels.
• Be as active as possible – do at least 30 minutes of moderate physical activity on most, if not all, days of the week.
• Eat healthy food – follow a healthy eating plan. It may help to consult a dietitian.
• Test your blood – test glucose levels as recommended. Aim to keep your blood glucose levels as normal as possible.

• Cholesterol and triglycerides – have a test at least once a year. Aim for total cholesterol of less than 4.0mmol/L and triglycerides of less than 1.5mmol/L.
• Blood pressure – have this checked every time you visit your doctor. It is important to keep your blood pressure under 130/80.
• Blood glucose levels – have an HbA1c (glycated-haemoglobin) test every three to six months. This test shows an average of your blood glucose levels over the last 10 to 12 weeks. The goal for HbA1c is no more than seven per cent.
• Medication – ask your doctor if you should be taking low dose aspirin, as this can help reduce your risk of heart attack. Take all medications only as directed.

• Have regular eye checks – everyone with diabetes should have a professional eye examination when they are first diagnosed and then at least every two years after that (children usually start this screening at puberty). If retinopathy or other abnormality is found, eye tests will be required every year or more frequently if advised by your eye care professional.
• Manage your health – keep blood glucose levels, HbA1c and blood pressure within the recommended ranges.
• Seek help quickly – if you notice any changes in your vision, notify your doctor or eye specialist immediately.
• Don’t smoke – if you smoke, stop now. Speak to your doctor or call the Quitline for guidance and support.

• Have your urine checked – everyone with diabetes should have a urine check for microalbumin at least once a year.
• Monitor your glucose levels – maintain BGLs within the recommended range of 4–8mmol/L. Have your doctor monitor your HbA1c every 3–6 months and keep HbA1C under seven per cent.
• Manage your blood pressure – keep your blood pressure less than 130/80 and cholesterol less than 4.0mmol/L. If you already have kidney disease, keep your blood pressure under 125/75.
• Reduce infection risk – see your doctor immediately if you think you have a bladder infection. Symptoms may include feeling the need to urinate more often, a burning sensation when passing urine, loss of bladder control and cloudy or sometimes bloody urine. Blood glucose levels will often be high when an infection is present.
• Don’t smoke – if you smoke, stop now. Speak to your doctor or call the Quitline for guidance and support.

• Manage your health – keep your blood glucose and HbA1c within recommended ranges.
• Reduce nerve damage risk – tell your doctor about any tingling, pain or numbness in your feet or hands.
• Protect and care for your feet – avoid foot injury and inspect your feet every day for any abnormalities. Treat foot injuries promptly and don’t delay seeking attention from your doctor or podiatrist for foot problems.
• Get regular foot checks – have a foot check by your podiatrist, doctor or diabetes educator at least once a year to detect changes in nerves as early as possible.
• Limit alcohol intake – if you drink alcohol, have no more than two standard drinks per day for men and one for women. Have two alcohol-free days per week.
• Look after your digestion – tell your doctor about any digestive complaints and see a dietitian who may be able to help you with your eating plan.
• Don’t smoke – if you smoke, stop now. Speak to your doctor or call the Quitline for guidance and support.

• Manage your health – keep your blood glucose levels and HbA1c within recommended ranges to reduce the risk of skin infections.
• Avoid overheating – don’t let your house get too hot, especially in winter when the heaters are on. If possible, increase the humidity.
• Protect your skin – wear gloves when you use household cleaners and solvents. Avoid very hot baths and showers.
• Take care of your skin – use a cream or lotion on your skin after bathing, preferably one that is not perfumed. Use non-scented soaps.
• Check your feet every day – if you have dry, rough or cracked skin on your feet, see your podiatrist or doctor.
• See your doctor – if your skin is very dry or irritated.
• Don’t smoke – if you smoke, stop now. Speak to your doctor or call the Quitline for guidance and support.

• Manage your health – keep your blood glucose levels within recommended ranges.
• Visit your dentist every six months (even if you wear dentures) – tell them you have diabetes and they will show you how to care for your teeth and gums.
• Avoid dry mouth – drink water if you have a dry mouth. Sugarless gum can help increase saliva production.
• Eat healthily – enjoy a wide variety of nutritious and healthy foods. Avoid snacking on sugary foods.
• Don’t smoke – if you smoke, stop now. Speak to your doctor or call the Quitline for guidance and support.

• Manage your health – keep your blood glucose and HbA1c within the recommended ranges.
• Speak to your doctor – you need to find out whether your erectile dysfunction stems from physical or psychological causes so that you can get the proper course of treatment.
• Don’t smoke – if you do, stop now. Speak to your doctor or call the Quitline for guidance and support.

• Manage your health – keep your blood glucose levels within the recommended ranges.
• Get plenty of rest.
• Wash your hands often.
• Protect yourself against infection – everyone with diabetes should have a yearly influenza (flu) injection. Ask your doctor about a pneumonia injection.
• Don’t smoke – if you smoke, stop now. Speak to your doctor or call the Quitline for guidance and support.
• See your doctor – at the first sign of an infection.

• Your doctor
• An Accredited Practising Dietitian, contact the Dietitians Association of Australia
• Podiatrist
• Eye specialist
• Diabetes educator
• Quitline Tel. 131 848
• Diabetes Australia – Vic Tel. 1300 136 588
• Baker IDI Heart and Diabetes Institute Tel. (03) 9258 5000
• Life! Taking Action on Diabetes Tel. 13 RISK (13 7475) – for information about preventing your risk of type 2 diabetes or to take a risk test online

• Diabetes-related complications include damage to large and small blood vessels, which can lead to heart attack and stroke, and problems with the kidneys, eyes, feet and nerves.
• The risk of most diabetes-related complications can be reduced.
• Regular screening is important to detect complications early and to keep your waist measurement, blood pressure, blood glucose levels, HbA1c and cholesterol within recommended ranges.
• It’s very important that you don’t smoke if you have diabetes as it increases the likelihood of complications.

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