Diabetes Related Health Problems

A blogger asks an excellent question, " my dad has diabetes. His GP told him that people with diabetes are three times more likely to die of or get heart disease. His doctor is of the belief that the moment you are dx then that's it - Diabetes by itself raises your chances threefold even if you keep your BSLs under good control or within normal range. My dad is quite fit (tons of exercise) and has a healthy weight (due to a very healthy diet and of course exercise). Why is he at more risk for heart disease than the next person?"

I'm sorry that this may not be comforting, but diabetes increases the risk for a variety of diseases.

• Heart disease and Stroke - Diabetics have a 2-4 times higher risk of heart disease than adults without diabetes. Other than sugar levels, there are changes in the vascular walls at the cellular level which may cause the higher risk. Certainly exercise and proper nutrition may help reduce the rate of heart attacks and stroke, but they may not eliminate the risk of heart disease completely because diabetes is a complex disease which impacts our health beyond what we measure in the sugar level. 65% of deaths among diabetics are due to heart disease and stroke. We do not know the cause of diabetes type 1 or type 2 and so we do not have a complete understanding of all of the pathological changes that occur as a result of having diabetes.
• High blood pressure - 70% of adults with diabetes have high blood pressure.
• Blindness - Diabetes is the leading cause of new cases of blindness in adults aged 20-74 years old in the US.
• Kidney disease - Diabetes is also the leading cause of kidney failure in the U.S. High blood pressure is the second most common cause.
• Nervous system disorders - At least 60% of diabetic adults have nerve problems such as pain or numbness in feet or hands, or a delayed emptying of the stomach after eating.
• Amputations - Diabetes accounts for 60% of nontraumatic lower extremity applications.
• Dental disease - Almost 30% of diabetics have severe gum disease.
• pregnancy complications - Birth defects and miscarriages occur if blood sugar is not controlled in the first trimester.
• Infections - there is a higher susceptibility to infections such as pneumonia and influenza.

However, it is not all bad news in that many of these complications can be prevented or delayed with appropriate medical care, lifestyle changes, and by controlling blood glucose levels . Preventive services and education of the patients and health care workers are the keys to success in the management of this disease.

References: MMWR 2000. Annals of Internal Medicine 2004. CDC 2003. Heart disease and diabetes. Mayo Clinic.

Related links: Every 10 seconds. World diabetes day. Unite for diabetes. National Diabetes Education Program. Am I at risk for type 2 diabetes.