Diabetes: When it gets complicated



Diabetes is a progressive disease. It is a risk factor for many diseases. Even if your diabetes is in total control, you can still experience complications. But the good news is that with correct treatment and the recommended lifestyle changes, many people with diabetes are able to prevent or delay the onset of these complications.

Often, these complications can begin without noticeable symptoms. Regular check-ups and screening are important to detect complications early. Therefore, it’s imperative to go for regular check-ups to make sure that all systems are OK.

Hemoglobin A1c

1. The A1c test will tell you your average blood glucose level for the previous three months.

2. Making sure that your A1c is in your target range helps you keep your risk for complications lower.

3. The American Diabetes Association (ADA) recommends an A1c of less than 7%.

4. While the American Association of Clinical Endocrinologists (AACE) advises an A1c of less than 6.5%.

5. The normal range for people without diabetes is between 4% and 6%.

Creatinine and Blood Urea Nitrogen (BUN) levels

1. Kidney failure is a complication of diabetes.

2. BUN (blood urea nitrogen) is a marker of kidney function.

3. Creatinine and BUN are waste substances that are dumped into the blood stream, to be excreted by the kidneys.

4. When the kidneys aren’t working as well, these can build up in the blood, forcing levels to rise.

5. A BUN of over 20 mg/dl is an indicator of decreased kidney function.

Blood Pressure

1. High blood pressure is known as the “silent killer.”

2. People with diabetes tend to have trouble with high blood pressure, too.

3. Having both diabetes and high blood pressure can cause an increase in the risk of heart disease, stroke, and eye, kidney and nerve complications.

4. Blood pressure medications keep the risks down.

Cholesterol Levels: HDL, LDL and Triglycerides

1. Diabetes dramatically increases the risk of various cardiovascular problems like coronary artery disease with chest pain (angina), heart attack, stroke and narrowing of arteries (atherosclerosis).

2. People with diabetes are twice as likely to develop heart disease.

3. Glucose in the blood can slow down the LDLs (“bad” cholesterol) which makes them sticky.

4. This causes cholesterol to build up much faster on blood vessel walls.

5. Cholesterol-lowering medications are usually prescribed earlier for people with diabetes to prevent complications of heart disease.

Feet and Lower Extremities

1. Excess sugar in the blood can injure the walls of the tiny blood vessels (capillaries) that nourish the nerves, especially in your legs.

2. This leads to decreased circulation and changes in the blood vessels of your feet and lower legs.

3. Symptoms include tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward.

4. Left untreated, you could lose all sense of feeling in the affected limbs.

5. Check your feet daily for cuts, sores, or infections.

6. Make sure to get yourself feet checked by a professional on your routine check-up visits.

7. A microfilament exam can detect decreased sensation.

8. If cuts and sores become infected, the complications can be devastating.

9. The risk of gangrene increases as circulation becomes compromised and the body can’t fight off infection.

10. Amputation of the affected limb is often the result.


1. When blood glucose levels remain too high for a long period of time, changes can occur in the tiny blood vessels that supply the retina of the eye. This is called retinopathy. (Retinopathy is a serious complication of diabetes)

2. Damage isn’t always easy to detect, so getting your eyes checked regularly can help spot trouble before it gets out of hand.

3. If retinopathy is not treated, it can lead to blindness.

4. Anytime that you notice strange blotches, blurriness, or dark spots in your vision, you should make an appointment with an eye doctor immediately.

5. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma.


1. Diabetes raises your risk of nonalcoholic fatty liver disease, a condition in which excess fat builds up in your liver even if you drink little or no alcohol.

2. Fatty liver disease has no symptoms. But it increases the risk of developing liver cirrhosis, liver cancer and heart disease.

3. Ultrasound examination of your liver when you’re first diagnosed and regular follow-up blood tests to monitor your liver function test, both, are a must.

Skin problems

1. High blood glucose levels over time can affect the health of the skin.

2. People with diabetes may experience very dry skin due to damage to the small blood vessels and nerves.

3. As the skin acts as a barrier to protect our bodies from invading organisms it is important that it is kept as healthy as possible.

4. If the skin becomes dry it can lead to cracks and potential entry of harmful organisms.

5. If you notice you have a skin problem, see your doctor.

Oral health

1. People with poorly managed diabetes are at increased risk of tooth decay and gum infections.

2. Dental and gum infections can also lead to high blood glucose levels.

3. Poor oral care is also strongly linked with an increased risk of heart disease.

4. Brush your teeth at least twice a day and floss once a day.

5. Regular dental visit are a must.


1. Our Immune system helps to prevent and fight infection.

2. High blood glucose levels slow down the action of infection-fighting white blood cells.

3. This makes it more difficult for the immune system to do its job.

Thyroid problems

1. People with diabetes are at increased risk of thyroid disease.

2. This includes both overactive and underactive thyroid.

3. Get yourself screened regularly.


1. Diabetes can lead to stress, anxiety and depression.

Diabetes can be controlled by following a few strict guidelines:

1. Control of your blood sugar

2. Maintain a healthy weight

3. Take steps to reduce high blood pressure

4. Keep your low-density lipoprotein (LDL, or “bad”) cholesterol and triglycerides in control.

5. Avoid alcohol and smoking

6. Regular checkups are a necessity of your life

Good Health Depends on Good Care

Read the previous posts here and here.

About the author
I am a freelance dietitian based in Dubai. I strongly believe that health is the highest form of self-respect that we can gift ourselves. Besides being a dietitian I am also a NLP certified life coach. In my opinion Health is a state of mind, for most of us are emotional eaters. Our diet is influence by the emotional patterns that our mind has created over a period of time. And if we are to keep ourselves healthy we need to create new healthy neuro-connections in our brain. I strongly endorse a lifestyle change rather than just the usual diet change. A practical and sound nutritional guidance backed by logic and scientific research is a guaranteed way to good health. Read my posts to create healthy neuro-connection. Leaving you with a thought to ponder upon….. Life’s not about expecting, hoping, and wishing. It’s about doing, being, and becoming. It’s about the choices you’ve just made, and the ones you’re about to make, It’s about the things you choose to say – today. It’s about what you’re gonna do after you finish reading this. -Mike Dooley

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