Getting your diabetes under control is vital if you want to enjoy a normal life and live to a ripe old age because … if you don’t control your blood glucose levels you will probably end up with several awful health problems such as … heart disease, stroke, kidney disease, nerve damage, diabetic neuropathy, amputated feet, digestive problems, blindness, or a variety of infections.
You can control your diabetes through diet and some moderate exercise or by using drugs. Either way, your need to monitor your blood glucose levels to make sure they are within a healthful range. Without regular monitoring, control is impossible.
Type 2 diabetics should check their blood glucose levels first thing in the morning and two hours after each meal, ie about four times a day. Checking your glucose level is easy using a small portable tester and involves little more than a pin-prick on the tip of a finger.
If your after-meal blood sugar level is less than 7.0mmol/l (126 mg/dl), you probably have good control over your diabetes. If not, you are at risk of a wide range of dreadful medical conditions.
Should your blood glucose levels be persistently high, the outlook for your health will be extremely grim. You will be subject to heart attacks, strokes, disabilities, dialysis, transplants, infections, amputation and blindness. Your death will probably be messy and painful.
Most diabetics who do not control their blood glucose levels are killed by heart disease, one of the most common complications of diabetes. Diabetics usually also suffer from high blood pressure and high cholesterol levels. Together the three conditions increase the risk of heart disease.
Heart disease has serious consequences. At the ‘easy’ end of the scale, these include constant chronic fatigue, shortness of breath, and dizziness. You feel light-headed because your heart is no longer functioning properly and blood flow between your heart and brain is impaired.
Persons with heart disease are also likely to suffer angina, a severe pain in the chest which occurs when oxygen to the heart is limited due to blockages in the arteries. If an artery linked to the brain is so clogged up with fatty deposits that blood flow to the brain is interrupted, you’ll have a stroke.
Strokes are the leading cause of disability in adults the USA and Europe, and the number two cause of death worldwide. If you do have a stroke, you could be unable to move your arm or leg on one side of your body or unable to speak or understand what people are saying.
A common consequence of heart disease is a fatal heart attack. This happens when an artery becomes so narrowed that the blood flow to the heart is completely blocked. Mercifully, it is a fairly rapid form of death.
Your kidneys are made up of millions of extremely small filtration units that purify your blood and send the waste out into your urine. These tiny filters can be damaged by high blood glucose levels, high blood pressure, high cholesterol levels, and smoking.
If you fail to control your diabetes and allow damage to your kidneys to develop, you will end up needing kidney dialysis three times a week … a very inconvenient, extremely messy and highly uncomfortable procedure. In the end, you’ll probably need a kidney transplant.
Your nervous system consists of thousands of fibres that connect your brain and spinal cord to every part of your body. This system controls your blood pressure, temperature, breathing, pulse rate and digestive system, as well as your ability to move, listen and talk. If you are a man, it also controls your erectile function.
High blood glucose levels damage these nerve fibres … this is called diabetic neuropathy. This nerve damage is permanent. Once it’s happened, you cannot improve it by better control of your diabetes. But you can prevent diabetic neuropathy in the first place … by controlling your blood glucose levels through diet. And you can prevent the damage getting worse by improving your diet and exercising.
An early sign of diabetic neuropathy is a loss of feeling in your feet. This nerve damage is known as peripheral neuropathy. It can also occur in your hands.
As this neuropathy develops you experience numbness, tingling, pain or weakness in your feet or hands. At times you’ll feel as if your feet are on fire, at other times you’ll think they have been frozen solid. This happens because the nerves that allow you to feel things or move your muscles have been damaged.
Peripheral neuropathy can be very dangerous. The reduced sensation in your feet leaves you vulnerable to injuries you do not feel. You can easily overlook a small cut or scrape which may take a long time to heal (another consequence of diabetes). This gives them plenty of time to become infected. If these infections fester, your foot may need to be amputated.
Diabetes is a common cause of amputations of the feet and lower limbs.
Having diabetes increases your risk of stomach problems, such as gastroparesis in which the vagus nerve that controls the muscles of the stomach and intestines is damaged and the movement of food through the digestive process is interrupted.
If you have gastroparesis, the length of time it takes for you to digest food will be unpredictable, making it very difficult to monitor your blood glucose and control the effects diabetes is having on your heart, kidneys, nerves, feet and hands, and eyes.
Gastroparesis has extremely unpleasant consequences. You may suffer from malnutrition due to the vomiting brought on by the condition. Because you will be deficient in calories, you will probably suffer severe fatigue and weight loss.
You could end up with solid masses of undigested food in your stomach which will block your intestines. You also have a pretty good chance of getting a bacterial infection due to the undigested food and high glucose levels.
Years of high blood glucose levels will lead to gastroparesis. To prevent it you have to gain control of your blood glucose levels before the condition starts developing.
Your eyes contain thousands of capillaries, minute hair-like blood vessels with very thin walls. Their tiny size and the thinness of the walls mean that they are very fragile. These tiny blood vessels can be damaged by persistently high blood glucose levels and high blood pressure. As a diabetic, you can develop three different diseases of the eye: glaucoma, cataracts and retinopathy.
Glaucoma: if you have glaucoma your vision will have deteriorated due to damage to the optic nerve from pressure that builds up in the anterior chamber (the front of the eye) and pinches the tiny blood vessels in the retina. This damages both the retina and the optic nerve.
If glaucoma is discovered early, treatment can be effective. Because it begins without symptoms, you can only catch it in time if you have your eyes examined by an ophthalmologist at least once a year. If left untreated, glaucoma will make you blind.
Both high glucose levels and high blood pressure increase the risk of getting glaucoma. The best defence against its development is to keep these under control.
Cataracts: a cataract is a painless clouding of the lens of the eye. These generally develop over a long period of time, causing eyesight to gradually get worse.
If you are starting to develop cataracts, you may notice difficulty with your distance vision, blurred or double vision, a halo effect around lights, excessive glare in bright sunlight or too much glare while driving at night.
Cataracts are age-related and avoiding them is probably impossible. But cataracts are also caused by diabetes and high blood pressure. You can retard the development of cataracts by protecting your eyes from harsh sunlight, avoiding tobacco, fatty foods, alcohol, and dairy products.
Person who avoid dairy products have a lower risk of developing cataracts. This is because during digestion the lactose in milk releases galactose, a simple sugar, which can enter the lens of your eye and damage its tiny blood vessels.
Retinopathy: your retinas consist of millions of tiny nerves that pick up images, convert them into electrical signals and send them to the brain. These tiny nerves can be damaged by high blood glucose, high blood pressure and high cholesterol levels. This damage is known as retinopathy.
Retinopathy has extremely serious consequences: it makes you go blind. Indeed diabetic retinopathy is the most frequent cause of blindness among adults up to 74 years of age. More than 60% of patients with type 2 diabetes eventually develop retinopathy. However, a long-term study in the UK has shown that improved blood glucose control reduces the risk of developing retinopathy.
Retinopathy does not have any symptoms when it starts. Therefore it is essential to have your eyes checked regularly — at least once a year — by an ophthalmologist, who will dilate your eyes so that he can see into the retina at the back of the eye.
Protecting your eyes means keeping your blood glucose, blood pressure and cholesterol levels under control. Only a diet that reduces these levels and helps to clean out your arteries will be kind to the tiny blood vessels in your eyes.
Researchers have discovered that some of the changes in the eyes due to diabetes start to improve when a person switches to a plant-focused, minimal-fat diet.
Diabetes affects your immune system and reduces your body’s ability to fight infection. At the same time, high blood glucose leads to high levels of sugar in the tissues of your body.
Your weakened immunity and the presence of sugar allow bacteria and fungi to grow and infections to develop more quickly. These infections can affect your bladder, kidneys, vagina, gums, feet and skin. It is therefore vital that you control your blood glucose levels.
About one-third of people who are diabetic will get a skin infection related to their disease at some time in their lives. If you do not take care, a minor skin condition can turn into a severe problem. For diabetics, the early treatment of all infections is vital to prevent serious complications.
Monitoring is crucial
So there you are … angina, heart attacks, strokes, kidney disease (dialysis and transplants), damaged feet and amputations, stomach problems, impaired vision and blindness, and chronic infections … if you don’t control your blood glucose levels.
Of course you cannot control these levels if you don’t know what they are; hence the importance of monitoring.
So why do so few people monitor their glucose sufficiently to provide the basis for good control of their diabetes?
I don’t know. But I do know that the results of a recent pan-European survey (reported in the Irish Times, a fairly reliable Irish newspaper) indicate that 67 percent (two-thirds) of type 2 diabetics do not monitor their blood glucose the recommended number of times each day.
Respondents to the survey gave a variety of reasons for not doing so … forgetfulness (40%) … pain (16%) … inconvenience (21%) … tired of testing (33%).
None of these reasons are valid excuses. You can overcome forgetfulness easily using the reminder function in your mobile phone. The slight discomfort involved in pricking your finger is nothing compared to the pain that awaits you down the road if you don’t get your diabetes under control.
Surely there is nothing more inconvenient than going blind or having a foot amputated?
Monitoring your glucose levels is vital for your health no matter how tiresome it may be.