WHEN SHOULD I WORRY ABOUT...

7 Reasons to Stop Type 2 Diabetes in Its Tracks

July 20, 2021 - Sheshe Giddens

If you have been diagnosed with type 2 diabetes, managing your disease effectively is one of the most important things you can do. When uncontrolled, this progressive disease devastates most of the body's systems as time goes on. If it's left unchecked or poorly managed, type 2 diabetes will not only negatively impact your health but significantly reduce your quality of life and life expectancy.

Is type 2 diabetes common?

Type 2 diabetes is an incurable disease that's mostly preventable, yet the number of people getting it is on the rise. More than 1 in 10, or 34.2 million, Americans have diabetes, of which type 2 diabetes makes up approximately 90-95% of diabetes cases.

Currently, 1 in 3, or 88 million American adults, have prediabetes — and many of them, 4 in 5, don't know they have it. According to the Centers for Disease Control and Prevention, if we don't reverse this trend, 1 in 5 Americans will have diabetes by 2025.

Two of the most common contributors to the rise in type 2 diabetes are being overweight and inactive. As of 2017-2018, 42.4% of U.S. adults were obese.

Does type 2 diabetes require lifestyle changes?

It should be no surprise that lifestyle changes are one of the most important ways to improve your health and to prevent or delay the development of diabetic complications. Doctors often recommend that diabetic patients change their diets and encourage them to get enough exercise as well as monitor their blood sugar and take their medications.

Your inner cynic may tell you to ignore this advice. Don't let it. This is too important. You may be dealing with symptoms like frequent urination, being thirsty and nerve pain, but these symptoms are just the tip of the iceberg — especially since the effects of diabetes become more pronounced the longer you have it.

Type 2 diabetes — a vicious cycle

As the disease progresses, your cells become more resistant to the insulin your pancreas tries desperately to continue producing. As the pancreas cranks out more insulin, which helps the cells access the sugar in the bloodstream, those cells are becoming more and more insulin resistant, so sugar levels become higher and higher. Without medical intervention, the pancreas eventually gets tired and begins making less insulin before practically stopping completely.

"When people get type 2 diabetes, initially, they have insulin resistance, plus their pancreas is probably only making 50-70% of insulin that a normal pancreas would make," says Dr. Vidhya Subramanian, an endocrinologist with Houston Methodist Endocrinology Associates at Sugar Land.

"Unfortunately, it's how the disease develops. It continues to get worse because the insulin supply keeps diminishing as insulin resistance increases," Dr. Subramanan explains. "Often people take two to four medications and then eventually they have to start taking insulin."

Tackling diabetes head-on

There's no point in sugar-coating it. Diabetes, as it advances, become even more difficult to manage. Whether you have prediabetes, have just been diagnosed with type 2 diabetes or if your diabetes has been out of control for a long time, it's never too late to stop diabetes in its tracks.

"A primary care physician can diagnose and manage diabetes. But when patients' blood sugars still aren't under control, even if they are taking three or four medications, and their A1C remains above 8, it's time to see an endocrinologist," says Dr. Subramanian.

An endocrinologist is a specialist in treating endocrine disorders, such as diabetes and hormone issues. This specialist can reassess your current medications, as well as take into account any additional conditions and complications that need to be factored into your treatment plan.

"When treating diabetes, some of the more common complications are kidney disease, cardiovascular disease and wound issues. Diabetes can become more difficult to treat when patients have multiple complications, such as kidney issues, because you cannot prescribe certain medications and the amount of medicine the patient can take probably is also restricted," says Dr. Subramanian.

Fortunately, there are medications to address some of these multiple complications. "There are oral medications that can reduce heart failure risk or offer kidney protection, or injectables that can also help with weight loss while bringing bring down the blood glucose," adds Dr. Subramanian.

"Along with newer medications, now continuous glucose monitoring devices are available that continuously monitor your glucose and alert you if the glucose level is high or low, which helps you monitor your glucose closely and adjust your diet and medications to achieve better control of diabetes while avoiding hypoglycemia (low blood sugar)."

7 major diabetes complications

Diabetes complications are mainly caused by excess sugar in your bloodstream, which can damage your body. Dr. Subramanian recommends that diabetic patients regularly monitor their blood sugar and blood pressure, take medications as prescribed, control their diet, lose weight, exercise, and have regular follow-ups with their doctor — all of which are essential for stopping or delaying the damage caused by diabetes.

Here are some other things you can do to regain control:

1. Cardiovascular disease

The problem: According to the Centers for Disease Control and Prevention (CDC), diabetes doubles your risk of heart disease and stroke by damaging blood vessels and nerves that control the heart, which increases blood pressure. It also lowers your good cholesterol (HDL) and raises the bad cholesterol (LDL) and triglycerides (fat in the bloodstream). It also increases your risk for congestive heart failure, in which the heart is unable to pump enough blood. The risk of stroke increases 1.5 times for diabetics. This disease also affects blood circulation with patients suffering from poor circulation, particularly in the legs and feet, potentially resulting in gangrene and amputation.

What you can do about it: On top of controlling your blood sugar, watch your weight and see your primary care physician to monitor your blood pressure, cholesterol and triglycerides. If any of these are elevated, your doctor may recommend changes in diet and exercise, and prescribe medication.

2. Foot problems and amputation

The problem: Diabetic neuropathy results from nerve damage caused by diabetes. It causes pain, numbness and tingling, especially in the legs and feet. Also, because diabetes damages blood vessels, it can cause reduced blood flow to the legs and feet. The resulting loss of feeling from nerve damage can be dangerous for diabetics because they are also more susceptible to infections, nonhealing wounds, sores and ulcers. Without "feeling" the warning from pain, these conditions and accidental cuts can go unnoticed and worsen. This can lead to tissue damage or tissue death, resulting in the need for amputation. Diabetes increases a person's risk of amputation by 30 times.

What you can do about it: Check and wash your feet daily. Be careful when cutting your toenails, which should be cut straight across. Also, protect your feet from injury by wearing shoes and socks. If you notice any sores, wounds or infections that aren't healing properly, contact your doctor immediately.

3. Hearing loss

The problem: According to the CDC, hearing loss can be caused over time by high blood sugar, which can damage the nerves in the inner ear, while low blood sugar can damage how the nerve signal travels to the brain.

What you can do about it: According to the American Diabetes Association, diabetics experience hearing loss at double the rate of their healthy counterparts. Talk to your doctor about getting your hearing checked if you have trouble understanding conversations or if your loved ones have commented on your hearing.

4. Kidney disease

The problem: Diabetes commonly affects the kidneys, with 1 in 3 adult diabetics having chronic kidney disease (CKD). According to the National Kidney Foundation, up to 40% of patients with type 2 diabetes will experience kidney failure. Late-stage kidney failure may necessitate dialysis or kidney transplant. The kidneys filter the blood to remove waste. Dialysis will clean the blood by removing waste, excess fluid and salt, and control blood pressure.

What you can do about it: Control your blood pressure as well as your blood sugar. High blood pressure damages your blood vessels, including the ones in the kidneys, which can lead to the kidney not removing waste properly. Also, look for signs of kidney disease, which includes frequent urination, leg and ankle swelling, itching, and needing less diabetes medicine to control your blood sugar. Go to your regular doctor visits so that your doctor can monitor your levels of blood urea nitrogen (BUN) and creatinine in the blood.

5. Nerve damage

The problem: Diabetic neuropathy (nerve damage from high blood sugar) commonly affects diabetics by causing painful numbness and tingling, notably in areas such as the legs and feet, known as peripheral neuropathy. This affects between one-third to one-half of diabetics. Diabetes also causes damage to the other nerves throughout the body, such as internal organs (autonomic neuropathy), which cause problems ranging from heart arrhythmia to sexual dysfunction.

What you can do about it: Talk to your doctor about treatment options for your nerve pain or other symptoms caused by diabetic neuropathy. Also, check your feet regularly, because peripheral neuropathy increases the risk for foot issues and infection from slow or nonhealing sores, cuts, blisters, etc.

6. Vision loss

The problem: Diabetes can lead to vision loss. It is the leading cause of blindness in working-age adults, according to the CDC. High blood sugar causes scarring in the blood vessels in the retina of the eyes (diabetic retinopathy), which can lead to permanent vision loss, including blindness. Diabetes also significantly increases the risk of developing cataracts and glaucoma.

What you can do about it: See your eye doctor regularly for a comprehensive diabetic eye exam. This should include getting your eyes dilated to look for early signs of diabetic retinopathy before symptoms occur to prevent or delay vision loss.

7. Wounds

The problem: Nonhealing and slow-healing wounds are a common challenge for people with diabetes, especially those experiencing peripheral neuropathy and poor blood circulation. Open wounds can lead to infection and gangrene. They also increase the risk of amputation.

What you can do about it: If you suffer from neuropathy that has affected your ability to feel sores and cuts, you must protect your feet and check them daily. Contact your doctor immediately if you notice signs of skin infection or if a wound is taking a long time to heal.

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