TMH Living Well: Preventing complications from diabetes, including eye disease
November is Diabetic Eye Disease Month
When diabetes goes uncontrolled, organs can suffer. With proper management, complications from diabetes can be held at bay. It’s critical to keep blood sugar levels under control over the long term.
“Diabetes has so many ramifications. As it advances, it can affect several internal organs, including the kidneys, coronary arteries and peripheral nerves. When these organs are compromised, renal failure, heart attacks and nerve pain in the feet and hands can ensue,” said Dr. Gerald Myers, internal medicine physician and cardiologist with The Memorial Hospital Medical Clinic.
One organ in particular is commonly affected by longstanding diabetes — the eye. According to the National Institutes of Health (NIH), between 40 and 45 percent of Americans with diabetes have some stage of diabetic retinopathy or diabetic macular edema (DME), which cause leaking blood vessels, swelling of the macula, nerve damage and changes to your lens.
Often, people don’t know they have one of these conditions at the start. That’s because they don’t create symptoms until later on when they are more advanced. Symptoms include floating spots, bleeding and blurred vision.
The good news is that early detection and treatment reduce the risk of blindness by nearly 95 percent. It’s important to have your eyes checked every year with a comprehensive dilated eye exam if you have diabetes. Also, by controlling your blood glucose levels, NIH studies show you are significantly less likely than those without optimal glucose control to develop eye problems with diabetes.
Preventing complications from diabetes
The focus in diabetes management is shifting from maintaining daily sugar levels to preventing complications caused by the disease. This shift in approach, coupled with new treatment options, makes for a promising new future for patients with diabetes.
Rather than relying solely on daily blood sugar checks, physicians are relying more and more on the hemoglobin A1C to regulate blood glucose levels. This blood test reflects your glucose levels over several weeks.
“In my patients with diabetes, I want to see test numbers consistently under 7, or trending down to avoid problems with vital organs. The higher the hemoglobin A1C number, the higher the risk of complications due to the disease,” Myers said.
The new trend is part of the American Diabetes Association’s “ABC” guidelines. Besides “A” for A1C levels lower than 7, the guidelines call for “B” — blood pressure readings below 130/80 mm/Hg and “C” — LDL cholesterol levels below 100 mg/dL.
When blood sugar levels are poorly controlled, plaque builds up in the coronary arteries over time. Results can mean organ disease in the eyes, kidneys, nerves, blood vessels or the heart.
“An unfortunate complication of diabetes is that diabetics don’t experience the early warning signs as others do with heart attacks. Instead of chest pain, they may experience indigestion or no symptoms at all — yet when we check their electrocardiogram or echocardiogram we see evidence that they’ve had a heart attack. These heart attacks are considered “silent” heart attacks and they damage the heart each time it happens,” Myers said.
Dr. Myers serves as a full-time physician at TMH Medical Clinic, splitting his time between internal medicine and cardiology. As an internist he sees several patients for diabetes and helps them manage their disease. He is accepting new patients in both areas. For an appointment, call 970-826-2400.
“Diabetes is a life changer and learning to manage it takes time. It’s important to get good glucose control to avoid complications down the road,” Myers said.
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