Type 2 Diabetes: Living With Complications (cont.)
IN THIS ARTICLE
Treatment of your complications of type 2 diabetes depends on the stage of the disease.
In general, keeping your blood sugar levels in your target range can prevent or slow the worsening of your complication and reduce the risk of developing new ones. Keeping blood sugar under control can help protect your vision and kidney function even before you develop any symptoms of eye or kidney complications.
You should see your doctor regularly to review your treatment and to have screening exams and tests for complications.
Talk to your doctor about whether you should take low-dose aspirin. Daily low-dose aspirin (81 milligrams) may help prevent heart problems if you are at risk for heart attack or stroke. People with diabetes are 2 to 4 times more likely than people who don't have diabetes to die from heart and blood vessel diseases.6
Effective treatment of high blood pressure and high cholesterol can help decrease your risk for worsening of complications. Stopping smoking and limiting alcohol to one drink a day for women and two drinks a day for men also can help.
For eye disease (diabetic retinopathy)
Keep all appointments with your eye specialist, and call if you notice any changes in your vision. Early detection and treatment of any changes can help prevent vision loss.
If you have severe vision loss, use vision aids to help you do as much of your diabetes care and remain as active as possible. Your local or state organization for the visually impaired can help you find vision aids that are right for you.
For more information, see the topic Diabetic Retinopathy.
For heart and large blood vessel disease
Don't smoke. Smoking increases your risk for heart attack.
Control your blood pressure. Keep it at 130/80 millimeters of mercury (mm Hg) or lower. Often, more than one blood pressure medicine will be needed in addition to lifestyle changes. Blood pressure medicines that can be useful include:
If your systolic blood pressure is between 130 mm Hg and 139 mm Hg or your diastolic blood pressure is between 80 mm Hg and 89 mm Hg, you may try some lifestyle or behavioral therapy for 3 months before starting medicine.5 For more information, see the topic High Blood Pressure (Hypertension).
Lower high cholesterol. Strive for a goal of less than 100 milligrams per deciliter (mg/dL) or aim for keeping it at 70 mg/dL for low-density lipoprotein (LDL), or "bad," cholesterol. High-density lipoprotein (HDL)—the "good" cholesterol—should be more than 40 mg/dL for men and more than 50 mg/dL for women. Triglycerides should be less than 150 mg/dL. A low-fat diet, exercise, and weight loss can lower your cholesterol. But you may need to take lipid-lowering medicines, such as statins, to reach your goals. Statins reduce LDL levels and the risk of heart disease in people who have diabetes.7 They also have been shown to reduce the risk of heart attack and stroke by one-third in people who have diabetes, even those who do not have high LDL levels or existing heart disease.8 For more information, see the topic High Cholesterol.
For nerve disease (diabetic neuropathy)
Keeping your blood sugar levels within your target range is the only way to stop or slow the progression of neuropathy.
If you have peripheral neuropathy, you may take medicines (such as nonprescription pain relievers, creams, or prescription oral or injection medicines) to relieve pain. You also may try physical therapy or acupuncture to relieve pain and improve your physical functioning, mood, and mental well-being.
You also can make changes in your home to reduce the risk of hurting yourself because of diminished sensation. These include lowering the water temperature in your home, using pot holders to avoid burns, and removing clutter that can cause falls. For more information on making life easier when you have neuropathy, see the Home Treatment section of this topic. Also, see the topic Diabetic Neuropathy for more on this complication.
For kidney disease (diabetic nephropathy)
Early detection and treatment of kidney disease can help prevent your kidney function from getting worse. Treatment involves taking medicines that can lower blood pressure (and can protect your kidneys even if you do not have high blood pressure), keeping your blood sugar under control, and possibly limiting the amount of protein in your diet.
For foot problems
Foot care is important for people with diabetes. You need to inspect your feet every day and protect them from injury. If you have poor eyesight, have someone else check your feet. If you develop serious infections or bone and joint deformities, you may need surgery (even amputation) to treat those problems.
To protect your feet:
For more information on protecting your feet, see:
What to Think About
Make every effort to keep your blood sugar levels within your target range to slow the progression of your complication and reduce your risk for developing others. Eat a balanced diet with the calories you need to help you stay at a healthy weight. Or if you are overweight, eat a balanced diet and reduce your calories to help you lose some weight. Get regular physical exercise, and take your prescribed diabetes medicine or insulin. For more information, see the Home Treatment section of the topic Type 2 Diabetes: Living With the Disease.
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