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Surprising consequences of uncontrolled diabetes

February 20, 2020 | UCI Health
woman with diabetes checking her blood glucose levels

Diabetes is a serious disease that can lead to heart disease, blindness, kidney failure and more. But when it is well controlled — through diet, exercise and medication — diabetics can avoid the most debilitating conditions.

According to the American Diabetes Association, the disease affects more than 30 million U.S. adults and children, or 9.4% of the population. It is the seventh leading cause of American deaths. An estimated 84 million more people have prediabetes, but many of them don’t realize it.

Endocrinologist Dr. Ping H. Wang, medical director of the UCI Health Diabetes Center, says diabetic patients need to take their diagnosis very seriously and change their lifestyle accordingly.

What is diabetes?

Diabetes occurs when the pancreas doesn’t make insulin or enough of it to regulate levels of blood glucose, also called blood sugar, which is the body’s primary source of energy, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Without sufficient insulin to help deliver the energy source to the body’s cells, the glucose stays in the blood. Over time, this can cause a variety of severe health problems.

Common diabetes complications

Wang explains how diabetes affects the body how to avert the most common health consequences.

Eye complications

High blood sugar can damage blood vessels in the eyes, which can cause diabetic retinopathy. “It can eventually cause blindness,” he says.

In fact, diabetic retinopathy is the leading cause of blindness in adults age 20-74 according to the National Eye Institute. Uncontrolled diabetes also can lead to glaucoma and cataracts.

“We recommend that our patients get routine eye exams and screenings so we can identify problems in the early stages,” he adds. “Ophthalmologists may also prescribe medications that can help prevent eye deterioration.”

Nerve complications

“High blood sugar leads to nerve damage, especially in the hands and feet,” Wang says. “Patients become unable to sense skin damage, which then can develop into ulcers or infections. In severe cases, this can lead to amputation.

“Blood sugar levels that are too high or too low may also cause chronic brain damage, leading to memory loss.”

In addition to controlling blood sugar levels, people with diabetes should inspect their feet daily to check for ulcers or infections.

Heart disease

“Cardiovascular disease is a major cause of mortality among diabetics,” Wang says.

Two out of every three diabetics have high blood pressure, which increases the risk of heart disease and stroke. Very low blood pressure (hypotension) is also dangerous because it can trigger heart attacks.

He urges patients to get screened for additional risk factors for heart disease, including high cholesterol and high blood pressure.

Kidney disease

Uncontrolled blood glucose puts tremendous stress on the kidneys and can cause them to lose their filtering ability. This, in turn, causes kidney failure.

“Diabetes is a major cause of kidney failure, which requires dialysis or kidney transplantation,” says Dr. Wang.

Just as with the other complications, keeping blood sugar levels within a normal range is key to preventing kidney problems.

Controlling blood sugar

To prevent these serious complications from diabetes, Wang says action is imperative to control blood glucose in the body.

“When there is enough damage, it might be too late to reverse course. Patients need to control blood sugar early to prevent complications,” he says.

Along with regular health screenings, diabetic patients need to adopt the following lifestyle changes:

  • Diet: A healthy diet includes protein and fiber from non-starchy vegetables, whole grains, beans and legumes. Foods containing sugar and refined carbohydrates can raise blood sugar levels and should be avoided.
  • Exercise: In consultation with their healthcare providers, people with diabetes (as even those without the condition) should aim for 30 to 60 minutes of daily physical activity. Regular exercise not only lowers blood sugar and blood pressure, it also improves blood flow.
  • Medication: When diet and exercise cannot keep blood sugar levels sufficiently low, medication, typically insulin, may be prescribed. Patients who take medication as directed can keep their blood sugar at healthier levels.

'It's not always easy'

By eating differently, exercising and taking prescribed medications, Wang says it’s possible for diabetics to live a life healthy life. But he recognizes that it isn’t always easy for some people to stay the course.

“When patients don’t follow these steps, I try to find out why and then address the reason,” he says. “For example, maybe a particular medication is too expensive or maybe the patient doesn’t realize what it means to follow a healthy diet.”

Wang recommends that his patients work with UCI Health certified diabetes educators, who can help them optimize their diet and exercise regimens and achieve better glucose control.

“It’s important to work with your physician and your diabetes educator to optimize your blood sugar control,” he says. “That’s the best way to avoid severe health consequences.”

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