Dealing with Complications

Despite your best efforts, you may some day develop complications from diabetes. Factors you can't control - your age, race, and genetic makeup - can affect your risk of developing complications.

If you have been taking steps to prevent complications, you may feel cheated if you develop a diabetes-related health problem. You may have many of the same feelings you had when you were first diagnosed with diabetes - anger, fear, guilt, or denial. You may feel overwhelmed that on top of dealing with diabetes and the ordinary stresses of everyday life, you now have new health problems to contend with. You may feel tired of having worked so hard to prevent complications, only to have them develop anyhow.

But there are treatments for diabetes complications, and they are getting better all the time. The earlier the signs of complications are found, the more effective these treatments can be.

So be sure you are getting up-to-date information on treatments and prevention (see p. 86 for a complete diabetes care schedule). Read all you can and ask your diabetes care provider and other members of your health care team - don't rely on hearsay from friends and relatives who may not be up on the latest research.

"I give up. It's just not worth the trouble. No matter what I do, I'll get diabetes complications."

Unless you've been dealt an incredibly poor genetic hand, this is a diabetes myth. Blood glucose levels are at the root of this disease, so it makes sense that keeping blood glucose levels as close to normal as possible will stop or slow down diabetes complications from occurring. People studying diabetes and seeing patients with diabetes have suspected this connection for decades. But it took the DCCT and the UKPDS to prove it.

You are not predestined to get diabetes complications. It's true that one study found that, after 20 years of diabetes, 95 percent of the people in the study had some evidence of retinopathy. But early retinopathy can be successfully treated without impairing vision. Like diabetes, heart disease and high blood pressure run in families. If you have genes that make you more susceptible to, for instance, poor circulation, your body might react more to the effects of high blood glucose. Do high blood pressure, obesity, or cardiovascular problems occur in your family? These are health conditions that are worsened by high blood glucose levels. If health problems that are aggravated by the effects of diabetes are in your family gene pool, you have even more reason to work hard to lower your blood glucose levels.

The remainder of this section is in sections that explain some of the most common complications of diabetes, with emphasis on ways to detect, prevent, and treat them:

• cardiovascular disease
• retinopathy (eye disease)
• nephropathy (kidney disease)