Taking extra good care of yourself is important when you have diabetes.
What do my heart and blood vessels do?
Your heart and blood vessels make up your circulatory system. Your heart is a muscle that pumps blood through your body. Your heart pumps blood carrying oxygen to large blood vessels, called arteries, and small blood vessels, called capillaries. Other blood vessels, called veins, carry blood back to the heart.
Who does heart disease affect?
Many people think that heart disease only affects the middle-aged and elderly. However, serious cardiovascular disease may develop in diabetics before the age of 30. Both type 1 and type 2 diabetics are at greater risk of developing heart disease.
What is the cause of heart disease amongst diabetics?
Diabetes can change the makeup of blood vessels, and this can lead to cardiovascular disease. The lining of the blood vessels may become thicker, and this in turn can impair blood flow. This problem is called atherosclerosis. Heart problems and the possibility of stroke can occur.
How are heart disease and diabetes linked?
People suffering from type 1 and type 2 Diabetes are more likely to be at risk of heart attack, stroke and high blood pressure. Vascular problems, such as poor circulation to the legs and feet, are also more likely to affect diabetes patients. Like diabetes itself, the symptoms of heart disease may go undetected for years.
What can I do to prevent heart disease and stroke?
You can do a lot to prevent heart disease and stroke.
- Keep your blood glucose under control: You can see if your blood glucose is under control by having an A1c test at least twice a year. The A1c test tells your average blood glucose for the past 2 to 3 months. The target for most people with diabetes is below 7. In some people with heart disease or other special circumstances, their doctor may recommend slightly higher levels of A1c.
- Keep your blood pressure under control: Have it checked at every doctor visit. The target for most people with diabetes is below 140/90.
- Keep your cholesterol under control: Have it checked at least once
a year. The targets for most people with diabetes are
- LDL(bad-cholesterol): below 100
- HDL(good-cholesterol): above 40 in men and above 50 in women
- Triglycerides(another type of fat in the blood): below 150
- Make physical activity a part of your daily routine: Aim for at least 30 minutes of exercise most days of the week. Check with your doctor to learn what activities are best for you. Take a half-hour walk every day. Or walk for 10 minutes after each meal. Use the stairs instead of the elevator. Park at the far end of the parking lot.
- Make sure the foods you eat are "heart-healthy": Include foods high in fiber, such as oat bran, oatmeal, whole-grain breads and cereals, fruits, and vegetables. Cut back on foods high in saturated fat or cholesterol, such as meats, butter, dairy products with fat, eggs, shortening, lard, and foods with palm oil or coconut oil. Limit foods with trans fat, such as snack foods and commercial baked goods.
- Lose weight if you need to: If you are overweight, try to exercise most days of the week. See a registered dietitian for help in planning meals and lowering the fat and calorie content of your diet to reach and maintain a healthy weight.
- If you smoke, quit: Your doctor can tell you about ways to help you quit smoking.
- Take your medicines as directed.
What are the warning signs of a stroke?
A stroke happens when part of your brain is not getting enough blood and stops working. Depending on the part of the brain that is damaged, a stroke can cause
- Sudden weakness or numbness of your face, arm, or leg on one side of your body
- Sudden confusion, trouble talking, or trouble understanding
- Sudden dizziness, loss of balance, or trouble walking
- Sudden trouble seeing with one or both eyes or sudden double vision
- Sudden severe headache
Sometimes, one or more of these warning signs may happen and then disappear. You might be having a "mini-stroke," also called a TIA or a transient ischemic attack. If you have any of these warning signs, call your doctor right away. Getting care for a TIA may reduce or prevent a stroke. Getting prompt treatment for a stroke can reduce the damage to the brain and improve chances for recovery.
How can clogged blood vessels hurt my legs and feet?
Peripheral arterial disease, also called PAD, can happen when the openings in your blood vessels become narrow and your legs and feet don't get enough blood. You may feel pain in your legs when you walk or exercise. Some people also have numbness or tingling in their feet or legs or have sores that heal slowly.
Poor circulation, nerve damage, and trouble fighting infections can make foot problems very serious. Have your doctor or podiatrist (a foot doctor) test your feet at least once a year for loss of feeling. Visit a podiatrist regularly if you need help with routine nail or callus care. Here are some other things you can do to help keep your feet in top condition.
- Check your feet every day for redness, swelling, corns, calluses, ingrown toenails or breaks in the skin. Use a mirror if necessary. Report any problems to your doctor immediately.
- Cut your toenails straight across, not into the corner, and smooth with an emery board.
- Wear only comfortable, well fitting shoes. If your shoes are uncomfortable, get rid of them.
- Check inside your shoes for foreign objects or rough spots every time you put them on.
- Don't go barefoot, even indoors.
- Be especially careful with your feet when weather is very hot or very cold.
- Taking your shoes and socks off at every office visit will remind your doctor to check your feet.
Skin problems related to diabetes range from bothersome itching to painful infection, but there is a lot you can do to keep from having these problems. Basic skin care should include the following:
- Bathe every day with mild soap and lukewarm water, using a small amount of lotion afterward to keep skin soft.
- Take extra care to avoid scratches or bruises.
- Wear gloves when you do work that may cause injury.
- Use a sunscreen and common sense to avoid sunburn.
- Dress warmly and avoid long exposure in very cold weather.
- Wash cuts and scrapes with soap and water; then cover with a sterile bandage.
- Treat a skin injury quickly and call your doctor if it doesn't heal.
High blood sugars increase your risk for tooth and gum problems. To help prevent these problems, you should:
- Brush and floss every day
- See your dentist at least every 6 months
- Tell your dentist you have diabetes
Remember that the problems (Retinopathy) caused by diabetes have NO symptoms in the early, most treatable stages. Therefore, you should have a complete dilated eye examination every year.
A complete dilated eye exam must include eye drops that allow your doctor to see the blood vessels in your eyes more clearly. In addition you should visit your eye doctor at the first signs of any of following:
- Blurred or double vision
- Narrowed field of vision
- Seeing dark spots
- Feeling pressure or pain in the eyes
- Unusual difficulty seeing in dim light
To further reduce your risk of eye problems, you should have your blood pressure checked often and avoid smoking
How can diabetes hurt my kidneys?
When the kidneys are working well, the tiny filters in your kidneys, the glomeruli, keep protein inside your body. You need the protein to stay healthy.
High blood glucose and high blood pressure damage the kidneys' filters (diabetic nephropathy). When the kidneys are damaged, the protein leaks out of the kidneys into the urine. Damaged kidneys do not do a good job of cleaning out wastes and extra fluid. Wastes and fluid buildup in your blood instead of leaving the body in urine.
What are the causes of diabetic nephropathy?
Diabetic nephropathy is directly influenced by hypertension (high blood pressure), and in patients with hypertension acceleration through the stages of diabetic nephropathy may be more rapid.
Is it possible to prevent diabetic nephropathy?
It is possible to slow the progression of diabetic nephropathy through intensive management of the disease and its symptoms. This can include taking medication to lower blood pressure.
Taking medication to lower blood pressure may be necessary. When a patient initially reaches END STAGE RENAL DISEASE (ESRD) the blood is sometimes cleaned with dialysis, or in some cases the kidney may be transplanted.
How can I prevent diabetes kidney problems?
- Keep your blood glucose as close to normal as you can. Ask your doctor what blood glucose numbers are healthy for you.
- Keep your blood pressure below 130/80 to help prevent kidney damage. Ask your doctor what numbers are best for you. If you take blood pressure pills every day, take them as your doctor tells you.
- Ask your doctor if you should take pills to slow down kidney damage.
- Follow the healthy eating plan you work out with your doctor or dietitian. If you already have kidney problems, your dietitian may suggest you cut back on protein, such as meat.
- Have your kidneys checked at least once a year by having your urine tested for small amounts of protein. The result of this test should be used to estimate kidney function
- Have any other kidney tests your doctor thinks you need.
- "Avoid taking painkillers regularly". Taking a single dose of aspirin every day to protect the heart, however, should be safe. Taking acetaminophen for occasional pain should also be safe. But if you are dealing with chronic pain, such as arthritis, work with your doctor to find a way to control your pain without putting your kidneys at risk.
- See a doctor right away for bladder or kidney infections. You may have an infection
if you have these symptoms:
- Pain or burning when you urinate
- A frequent urge to go to the bathroom
- Urine that looks cloudy or reddish
- Fever or a shaky feeling
- Pain in your back or on your side below the ribs
Standards of Medical Care in Diabetes2015. DIABETES Care 2015;3 (Suppl. 1)
Harrison’s Principles of Internal Medicine, edition 18, chapters 35, 94, 218, 21, 344
ISPAD Clinical Practice Consensus Guidelines 2014
Uptodate: Overview of medical care in adults with diabetes mellitus Author David K McCulloch, MD, Mar 18-2015
Uptodate: Glycemic control and vascular complication in type 2 diabetes mellitus, Author David K McCulloch, MD, Jun 2015