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10 Tips to avoid diabetes complications

diabetes complications
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Diabetes affects more than two and a half million people every year. It is a disease for which there is no cure, but whose complications can be avoided. Dr. Dominique Huet, head of the Diabetology Service of the Paris Saint Joseph hospital group (France), tells us how.

The complications linked to diabetes are of two types:

– Microvascular complications (affecting the blood vessels) can affect the retina (blindness), kidneys and nerves, and are directly related to the blood sugar index.
– Macrovascular complications (affecting the arteries) can affect the carotid (CVA), the coronary arteries (myocardial infarction) or the arteries of the legs (arteritis); they are related to glycemia and other factors.

It is important that patients receive the message that diabetes does not have to be a fatality, insists Huet, for which it is essential to know how to avoid complications.

1. Commit to control the disease

It is the first thing that must be done to avoid complications. “The objective in the first instance is to always control blood sugar levels,” recommends the expert. Beyond the daily monitoring of blood glucose, which is done at home autonomously, patients should see a doctor every three or four months to have their level of glycosylated hemoglobin checked. “It is a much more reliable indicator than the simple concentration of blood glucose and allows controlling the concentration in the long term and not only in a timely manner,” explains Huet. “If the rate of glycosylated hemoglobin is less than 7%, the risk of microvascular complications is almost zero.”

2. Monitor blood pressure and blood lipid levels

These two factors are very important in the prevention of macrovascular complications. “Diabetic patients must maintain a blood pressure lower than 14 / 8.5 mmHg, ” explains Huet.

When it comes to blood lipids (cholesterol and triglycerides), the controls are aimed at detecting LDL (the so-called bad cholesterol). “LDL should be less than 1.30 g / L in diabetic patients. But these figures vary if other risk factors come into play. LDL should be less than 1g / L in diabetics who smoke and even less than 0.7 g / L if there is also a history of cardiovascular disease. ”

3. Stop smoking (or avoid starting)

Tobacco does not influence diabetes directly. However, it does constitute a known risk factor in vascular problems. Diabetic people who smoke are more likely to develop severe macrovascular complications, which can lead to stroke, myocardial infarction, or lower limb arteritis. The diabetes factor can not be suppressed, but the factor snuff, yes: it is enough to stop smoking.

When it comes to blood lipids (cholesterol and triglycerides), the controls are aimed at detecting LDL (the so-called bad cholesterol). “LDL should be less than 1.30 g / L in diabetic patients. But these figures vary if other risk factors come into play. LDL should be less than 1g / L in diabetics who smoke and even less than 0.7 g / L if there is also a history of cardiovascular disease. ”

4. Eat in a balanced way

“Among the rights of diabetics is not having to suffer complications from the disease,” says Huet. “But along with the rights are the duties, and the first of these is to monitor the diet to control diabetes.” It is known that diabetics can not neglect their diet. Therefore, a healthy and varied diet is essential (“as for the whole population”), recalls the specialist. “Diabetic patients can eat everything, but in a balanced way. You just have to be careful with the fast sugars, which should not be consumed too often. ” There is nothing that is forbidden, not even alcohol, but it is necessary to moderate.

5. Control your weight

6. Exercise regularly

There is nothing new. “Diabetic people should commit to their illness and practice a minimum of physical exercise, as well as healthy people,” advises Huet.

Diabetics who do intense sports should, however, learn to control their blood glucose levels during activity peaks, thus avoiding hypoglycemia.

Sport helps prevent many chronic and cardiovascular diseases, as well as being overweight; It also improves the feeling of general well-being and decreases stress.

7. Get an annual medical check-up

“There are mandatory medical checks that must be done at least once a year to avoid the complications derived from diabetes,” explains Dr. Huet. These are:

– An electrocardiogram to check the health of the heart

– An eye fundus to monitor the state of the retina

– A check of kidney functions

– The search for nerve complications

– A dental review

– A review of the feet

These tests, performed on a regular basis, detect the least sign of a possible complication.

8. Keep your vaccines up to date

“It is not an obligation, nor is it for the majority of the population. But updating vaccines is especially recommended for diabetics, in particular, to prevent some infectious diseases, “Huet recalls. Diseases can unbalance perfectly controlled diabetes, even if the imbalance is far from being systematic. Influenza, for example, can cause problems for diabetics.

9. Monitor the health of your feet

Feet are of great concern to patients, who fear suffering from one of the most common complications of diabetes: gangrene and, therefore, amputation. But daily monitoring is not justified in all cases. “It is only recommended for those patients who suffer a neuropathy, a disease of the nerves,” says Huet. “These people lose sensitivity, they do not feel pain. It can happen that they suffer injuries without realizing it and that they cause complications. ”

However, patients who do not suffer from nervous diseases do not have to worry about their feet. According to the diabetologist, “we have to de-dramatize this complication. A review during regular medical check-ups is enough. ” Make sure however that the check is done correctly, not all professionals do it in a rigorous manner.

10. Relax

“Stress does not trigger diabetes, but it can unbalance it,” explains Huet. Since stress hormones increase blood glucose, diabetics should monitor this aspect. Sleep problems can also have a deleterious effect on glycemic control.

“The first thing we ask patients in the consultation is how they are. It is not a routine question, but a way to verify that they are not subjected to a level of stress that may hinder the control of the disease, “concludes the specialist.

Risk factor capable of causing complications in diabetic patients, stress should not be taken lightly. Talk to your doctor about everything that worries you (grief, separation, dismissal, etc.), that way you can make sure the stress does not have dire consequences for your illness.

Source:
Interview with Dr. Dominique Huet, Head of the Diabetes and Endocrinology Service of the Paris Saint-Joseph Hospital Group.

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