Chronic or long-term complications require careful watching and ongoing maintenance. Here you can educate yourself about these complications and to know what precautions to take. As always, your Medicine Shoppe® pharmacist is there to help answer any additional questions you may have.

Heart Disease and Stroke

Diabetes carries an increased risk for heart attack, stroke and complications related to poor circulation. According to the American Diabetes Association (ADA), two out of three people with diabetes die from heart disease and stroke. Heart disease and stroke account for about 65 percent of deaths in people with diabetes.

Although frightening statistics, the good news is that steps can be taken to help your patients prevent heart disease. Selecting healthy foods, staying active, taking the proper medications, along with other lifestyle changes, can successfully minimize these complications.

Improved control of cholesterol or blood lipids (for example, HDL, LDL and triglycerides) can also reduce cardiovascular complications by 20 to 50 percent. Blood pressure control reduces the risk of cardiovascular disease (heart disease or stroke) among persons with diabetes by 33 to 50 percent, and the risk of microvascular complications (eye, kidney and nerve diseases) by approximately 33 percent. In general, for every 10 mm Hg reduction in systolic blood pressure, the risk for any complication related to diabetes is reduced by 12 percent.

Kidney Disease

Diabetes often takes a significant toll on the kidneys, causing them to lose their ability to filter out waste products and/or fail. Diabetes is the leading cause of kidney failure, accounting for 44 percent of new cases in 2002.

Some signs of kidney disease in patients with diabetes include albumin/protein in the urine, high blood pressure, ankle and leg swelling, leg cramps, lessened need for insulin or anti-diabetic medications, weakness, paleness and anemia.

Treatments for kidney disease often include closely monitored control of blood glucose and blood pressure. According to the ADA, four ways to lower your blood pressure are losing weight, eating less salt, avoiding alcohol and tobacco, and getting regular exercise. Detecting and treating early diabetic kidney disease by lowering blood pressure can reduce the decline in kidney function by 30 to 70 percent.

Eye Complications

Diabetes can cause eye problems that may lead to potential blindness. Diabetic retinopathy causes 12,000 to 24,000 new cases of blindness each year making diabetes the leading cause of new cases of blindness in adults 20 to 74 years of age according to the ADA.

Early detection and treatment of eye problems help minimize this complication.

Diabetic Neuropathy and Nerve Damage

Diabetes is the leading known cause of neuropathy in developed countries, and neuropathy is the most common complication and greatest source of morbidity in diabetes patients.

It is estimated that the prevalence of neuropathy in diabetes patients is approximately 20 percent. Diabetic neuropathy is implicated in 50-75 percent of non-traumatic amputations. About half of all people with diabetes have some form of nerve damage.

Keeping your blood glucose levels in check can help prevent or delay nerve damage.

Foot Complications

People with diabetes can develop many different foot problems sometimes resulting in the need for eventual amputation. In fact, according to the ADA, the rate of amputation for people with diabetes is 10 times higher than for people without diabetes.

It’s important to be aware of even ordinary foot problems because even simple problems get lead to further complications.

Skin Complications

According to the ADA, as many as one-third of people with diabetes will have a skin disorder caused or affected by diabetes at some time in their lives. In fact, such problems are sometimes the first sign that a person has diabetes.

Most skin conditions can be prevented or easily treated if caught early.

Sexual Dysfunction

Diabetes can impact sexual function in both men and women. Diabetes may also influence decisions about having children for both men and women.

It is also important to remember that sexual activity is a physical activity. Therefore, hypoglycemia (low blood sugar) may occur during sexual activity. Eat one carbohydrate exchange before sexual activity to prevent hypoglycemia.

Sexual dysfunction in women with diabetes seems to develop slowly. The autonomic nerves may be damaged leading to diminished orgasms or the inability to have an orgasm. If intercourse is painful for the women, it may be related to inflammation of the vagina (vaginitis) or lack of lubrication.

Specific types of treatment may include: Medications for vaginitis, use of water-soluble lubricating gels, use of estrogen-based lubricating gels and/or hormone replacement therapy (HRT).

In men, autonomic nerve damage may result in erectile dysfunction (impotence). This occurs in 40 to 60 percent of all males with diabetes. Erectile dysfunction can also be caused by other reasons: medications, including some blood pressure medications, decreased testosterone levels, alcohol, psychological factors or smoking. Younger men with diabetes may experience a delayed onset of puberty or sexual maturity.

No single therapy option is effective for everyone. Some of the current treatment options include: smoking cessation, avoidance of alcohol, change in drug therapy, psychological counseling, hormonal treatment, medication therapies or surgery.

There is help available for both men and women, and the first step is to talk with a health care professional and pharmacist about your concerns.

Gastroparesis

Gastroparesis can make diabetes worse by adding to the difficulty of controlling blood glucose. Gastroparesis is a disorder that affects people with both Type 1 and Type 2 diabetes, where the stomach takes too long to empty its contents. It happens when nerves in the stomach are damaged or stop working causing the movement of food to be slowed or stopped.

When food that has been delayed in the stomach finally enters the small intestine and is absorbed, blood glucose levels rise. Since gastroparesis makes stomach emptying unpredictable, a person's blood glucose levels can be erratic and difficult to control.