Why Taking Care of Your Diabetes Is Important Chapter 4 of 6 On this page: Diabetes and Your Heart and Blood Vessels Diabetes and Your Eyes Diabetes and Your Kidneys Diabetes and Your Nerves Diabetes and Your Gums and Teeth Taking care of your diabetes every day will help keep your blood glucose in your target range and help prevent other health problems that diabetes can cause over the years. This part of the guide describes those problems. We tell you about them not to scare you, but to help you understand what you can do to keep them from happening. Do what you can every day to keep your blood glucose in the range that’s best for you. Follow your meal plan every day. Be physically active every day. Take your diabetes medicine every day. Check your blood glucose as recommended. [Top] Diabetes and Your Heart and Blood Vessels The biggest problem for people with diabetes is heart and blood vessel disease. Heart and blood vessel disease can lead to heart attacks and strokes. It also causes poor blood flow (circulation) in the legs and feet. To check for heart and blood vessel disease, your health care team will do some tests. At least once a year, have a blood test to see how much cholesterol is in your blood. Your health care provider should take your blood pressure at every visit. Your provider may also check the circulation in your legs, feet, and neck. The best way to prevent heart and blood vessel disease is to take good care of yourself and your diabetes. Eat foods that are low in fat and salt. Keep your blood glucose on track. Know your A1C. The target for most people is under 7. If you smoke, quit. Be physically active. Lose weight if you need to. Ask your health care team whether you should take an aspirin every day. Keep your blood pressure on track. The target for most people is under 130/80. If needed, take medicine to control your blood pressure. Keep your cholesterol level on track. The target for LDL cholesterol for most people is under 100. If needed, take medicine to control your blood fat levels. What’s a desirable blood pressure level? Blood pressure levels tell how hard your blood is pushing against the walls of your blood vessels. Your pressure is given as two numbers: The first is the pressure as your heart beats and the second is the pressure as your heart relaxes. If your blood pressure is higher than your target, talk with your health care team about changing your meal plan, exercising, or taking medicine. Blood pressure results Target for most people with diabetes under 130/80 My last result _______ My target _______ printer-friendly version of blood pressure results form What are desirable blood fat levels? Cholesterol, a fat found in the body, appears in different forms. If your LDL cholesterol (“bad” cholesterol) is 100 or above, you are at increased risk of heart disease and may need treatment. A high level of total cholesterol also means a greater risk of heart disease. But HDL cholesterol (“good” cholesterol) protects you from heart disease, so the higher it is, the better. It’s best to keep triglyceride (another type of fat) levels under 150. All of these target numbers are important for preventing heart disease. Target blood fat levels for people with diabetes Total cholesterol	under 200	My last result_____	My target_____
LDL cholesterol	under 100	My last result_____	My target_____
HDL cholesterol	above 40 (men)	My last result_____	My target_____
	above 50 (women)	My last result_____	My target_____
Triglycerides	under 150	My last result_____	My target_____

printer-friendly version of target blood fat levels form

Rose is 55 years old and teaches at a junior high school on an American Indian reservation in New Mexico. Rose has had type 2 diabetes for almost 10 years. When she first found out she had diabetes, she weighed too much and didn’t get much exercise. After talking it over with her doctor, Rose began an exercise program. She lost weight, and her blood glucose began to come down. She felt better too. Now Rose teaches an exercise class in her spare time.

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Diabetes and Your Eyes

Have your eyes checked once a year. You could have eye problems that you haven’t noticed yet. It is important to catch eye problems early when they can be treated. Treating eye problems early can help prevent blindness.

High blood glucose can make the blood vessels in the eyes bleed. This bleeding can lead to blindness. You can help prevent eye damage by keeping your blood glucose as close to normal as possible. If your eyes are already damaged, an eye doctor may be able to save your sight with laser treatments or surgery.

The best way to prevent eye disease is to have a yearly eye exam. In this exam, the eye doctor puts drops in your eyes to dilate your pupils. When the pupils are dilated, or big, the doctor can see into the back of the eye. This is called a dilated eye exam and it doesn’t hurt. If you’ve never had this kind of eye exam before, you should have one now, even if you haven’t had any trouble with your eyes. Be sure to tell your eye doctor that you have diabetes.

Here are some tips for taking care of your eyes:

• For adults and adolescents (10 years old and older) with type 1 diabetes: Have your eyes examined within 3 to 5 years of being diagnosed with diabetes. Then have an exam every year.

• For people with type 2 diabetes: Have an eye exam every year.

• For women planning to have a baby: Have an eye exam before becoming pregnant.

• If you smoke, quit.

• Keep your blood glucose and blood pressure as close to normal as possible.

Tell your eye doctor right away if you have any problems like blurry vision or seeing dark spots, flashing lights, or rings around lights.

See your eye doctor for an eye exam with dilated pupils every year. Early treatment of eye problems can help save your sight.

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Diabetes and Your Kidneys

Your kidneys help clean waste products from your blood. They also work to keep the right balance of salt and fluid in your body.

Too much glucose in your blood is very hard on your kidneys. After a number of years, high blood glucose can cause the kidneys to stop working. This condition is called kidney failure. If your kidneys stop working, you’ll need dialysis (using a machine or special fluids to clean your blood) or a kidney transplant.

Make sure you have the following tests at least once a year to make sure your kidneys are working well:

• a urine test for protein, called the microalbumin test

• a blood test for creatinine

Some types of blood pressure medicines can help prevent kidney damage. Ask your doctor whether these medicines could help you. You can also help prevent kidney problems by doing the following:

• Take your medicine if you have high blood pressure.

• Ask your doctor or your dietitian whether you should eat less protein (meat, poultry, cheese, milk, fish, and eggs).

• See your doctor right away if you get a bladder or kidney infection. Signs of bladder or kidney infections are cloudy or bloody urine, pain or burning when you urinate, and having to urinate often or in a hurry. Back pain, chills, and fever are also signs of kidney infection.

• Keep your blood glucose and blood pressure as close to normal as possible.

• If you smoke, quit.

Mike is a migrant farm worker with type 2 diabetes and high blood pressure. Mike, 47, is married, and he and his wife have three children. The family is often on the move, depending on where the work is. Mike has his blood pressure and kidneys checked at clinics in migrant worker camps. Some of the clinics also offer diabetes classes. Whenever they can, Mike and his wife attend these classes. They especially like the cooking classes because they learn how to prepare low-cost, healthy meals for the whole family.

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Diabetes and Your Nerves

Over time, high blood glucose can harm the nerves in your body. Nerve damage can cause you to lose the feeling in your feet or to have painful, burning feet. It can also cause pain in your legs, arms, or hands or cause problems with eating, going to the bathroom, or having sex.

Nerve damage can happen slowly. You may not even realize you have nerve problems. Your doctor should check your nerves at least once a year. Part of this exam should include tests to check your sense of feeling and the pulses in your feet.

Tell the doctor about any problems with your feet, legs, hands, or arms. Also, tell the doctor if you have trouble digesting food, going to the bathroom, or having sex, or if you feel dizzy sometimes.

Nerve damage to the feet can lead to amputations. You may not feel pain from injuries or sore spots on your feet. If you have poor circulation because of blood vessel problems in your legs, the sores on your feet can’t heal and might become infected. If the infection isn’t treated, it could lead to amputation.

Ask your doctor whether you already have nerve damage in your feet. If you do, it is especially important to take good care of your feet. To help prevent complications from nerve damage, check your feet every day (see foot care tips below).

Joe is a 65-year-old retired letter carrier with type 2 diabetes. Every time he visits his doctor, he takes his shoes and socks off so the doctor can check his feet for sores, ulcers, and wounds. The doctor also checks the sense of feeling in Joe’s feet. Joe and his doctor talk about ways to prevent foot and nerve problems. Since Joe has lost some feeling in his toes, the doctor also talks to him about the importance of good foot care and keeping his blood glucose in a good range.

Here are some ways to take care of your nerves:

• Keep your blood glucose and blood pressure as close to normal as possible.

• Limit the amount of alcohol you drink.

• Check your feet every day.

• If you smoke, quit.

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Diabetes and Your Gums and Teeth

Diabetes can lead to infections in your gums and the bones that hold your teeth in place. Like all infections, gum infections can cause blood glucose to rise. Without treatment, teeth may become loose and fall out.

Help prevent damage to your gums and teeth by doing the following:

• See your dentist twice a year. Tell your dentist that you have diabetes.

• Brush and floss your teeth at least twice a day.

• If you smoke, quit.

• Keep your blood glucose as close to normal as possible.

Keeping your blood glucose in your target range, brushing and flossing your teeth every day, and having regular dental checkups are the best ways to prevent gum and teeth problems when you have diabetes.

James runs a bookstore in California. He’s 35 years old and has had type 1 diabetes for 15 years. James takes good care of his teeth and sees his dentist twice a year. He makes his appointments in the morning, after breakfast, so he won’t get hypoglycemia while at the dentist. He also carries glucose tablets and wears an identification bracelet that has the name and the telephone number of his doctor on it.

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