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Diabetes Complications |
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High blood sugar levels over long periods of time cause damage to the body. This page gives some information about the sort of problems that can occur. Avoiding long term complications of diabetes.
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Diabetes And The Kidneys |
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What Do The Kidneys Do? The kidneys act like a sieve. They filter out the waste products from the blood stream and regulate blood volume and blood pressure. |
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What Can Happen To The Kidneys? Diabetes and blood pressure can damage the kidneys (nephropathy). High levels of sugar in the blood stream damage the walls of the small blood vessels (capillaries) in the kidneys affecting the filtering mechanism. Blood pressure increases the pressure within the kidneys and causes additional damage. The waste products are not filtered out in the urine; rather they accumulate in the blood. |
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How Do You Know If Diabetes And Blood Pressure Have Affected The Kidneys? Each time you visit the clinic the following tests are done to check on the kidneys:
Urine tests - An early sign that the kidneys are affected is leakage of protein into the urine. An ordinary dipstick urine test picks up a certain level of protein in the urine. The urine can also be sent to the laboratory to pick up even smaller amounts of protein leak from the kidneys called microalbumin.
Blood tests - The accumulation of waste products in the blood stream is measured by two chemicals:
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urea (should be less than 6.5mmol/L)
creatinine (should be less than 120mmol/L). Values above the normal range indicate that diabetes and blood pressure have affected the kidneys.
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Symptoms - in the early stages you will not have any symptoms. The aims of treatment are to try to stop the kidney damage progressing to a stage where it could cause symptoms and eventually kidney failure.
Blood pressure - This goes up when the kidneys are not working properly.
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What Can Be Done If The Urine Or Blood Tests Suggest The Kidneys Have Been Affected? There are two ways to try to preserve the kidney function:
Best possible blood sugar control - Good blood sugar control prevents kidney damage or prevents it getting worse. Someone with an HbA1c of 7% has about half the risk of someone with an HbA1c of 9%.
Best possible blood pressure control - We now consider a blood pressure above 140/90mmHg as high. If you have changes in the kidney, then we would try to reduce your blood pressure down to below 130/80mmHg, preferably to less than 125/75mmHg. These levels of blood pressure control are much tighter than in people without diabetes.
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Diabetes And The Heart |
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Heart attacks and strokes are unfortunately more likely to happen to you if you have diabetes. Stopping smoking is the most vital factor in reducing the risk. The other main risk factors for developing these problems are high blood pressure and high blood fats. Your blood pressure should be checked at least once per year and your blood fats (also known as lipids, one of which is cholesterol) will be measured from time to time with a blood test.
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Diabetes And The Eyes |
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Diabetic Retinopathy is the name given to the eye problems caused by diabetes. In simple terms, abnormal blood vessels develop at the back of the eyes and can eventually cause blindness. The good news is that it is uncommon now to go blind because of diabetes. Your eyes need to be checked at the hospital clinic or ophthalmic optician at least once a year. If problems develop you will be referred to an eye specialist (ophthalmologist) who will treat you with laser therapy if you need it.
Cataracts are also more common in people with diabetes and these too will be picked up at your annual eye test.
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Diabetes And The Feet |
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Circulation and feeling can be lost in the feet because of damage to the blood vessels and nerves. If this happens there may be no pain when the feet are damaged, for instance if you have a stone in your shoe or if your shoes are too tight. The skin will be fragile and will not be able to heal properly. The feet will then be at risk of developing ulcers, which are skin breaks that may be very slow to heal.
Your feet should be examined once a year to make sure that the circulation and feeling in the feet is normal. If problems are detected, we will give you extra help to avoid foot ulcers. Protecting your feet should be part of the daily routine for anyone with diabetes whether or not problems have developed.
Nerve damage in the feet can also cause pain and other unpleasant feelings (such as pins and needles or "electric shocks" through the feet and legs). There are several different types of tablets which may be given to control the pain.
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Diabetes And The Nerves |
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Diabetes can damage nerves all around the body, although the feet are usually affected first. Autonomic neuropathy is the name given to a condition in which the autonomic nerves are damaged. The autonomic nerves are those that control things we don't need to think about: the automatic functions of the body such as how fast the heart goes and how fast food is pushed through the stomach. Damage to these nerves can cause symptoms such as dizziness, vomiting or diarrhoea. There is unfortunately no cure once nerves are damaged, but many of the symptoms can be controlled with tablets.
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