complication of Diabetes in brief & how you prevent????

Diabetic Nephropathy
What is diabetic nephropathy?

Diabetes can affect many parts of the body, including the kidneys. In healthy kidneys, many tiny blood vessels remove waste products from your body. These vessels can be damaged if diabetes is not controlled. This damage can cause kidney disease, which is also called nephropathy (say: nef-rah-puh-thee). If the damage is bad enough, your kidneys could stop working.

complication of Diabetes in brief & how you prevent???? Diabetes%20diabetic

complication of Diabetes in brief & how you prevent???? Diabetes%20diabetic

How do I know if diabetes has hurt my kidneys?

Your doctor will test your urine for protein. This test will tell your doctor if there is a problem with the way your kidneys are working. Your doctor may also want to do a blood test to see how much damage has been done to the kidneys. Your doctor will find out if it is diabetes or something else that is hurting your kidneys.

Unless the damage is severe, you probably will not have any symptoms. If your kidneys stop working, your feet and ankles may swell. You also might feel weak or not want to eat.

What can I do to slow down the damage?

The following are some of the most important things you can do to protect your kidneys:

Keep your blood pressure lower than 130 over 80. Your doctor may give you medicine to help lower your blood pressure.
Control your blood sugar level. Your doctor may give you medicine to help lower your blood sugar level.
Stick to your diet. Ask your doctor how many calories and carbohydrates and how much protein you should eat.
Be physically active every day.
Take the medicines your doctor prescribes for you. Check with your doctor before taking any new medicines. This includes vitamins, herbal medicines and over-the-counter medicines.
Keep all of your doctor appointments.
Stop smoking.

What happens if my kidneys stop working?

Even with the right treatments, diabetic nephropathy can get worse over time. Your kidneys could stop working. This is called kidney failure. If this happens, waste products build up in your body. This can cause vomiting, weakness, confusion and coma.

If you have kidney failure, your doctor will refer you for dialysis (say: die-al-uh-sis). In dialysis, a machine is used to take waste products out of the blood. One kind of dialysis has to be done in a clinic. For another kind of dialysis, the machine is so small it can be strapped to your body while you go about your daily activities.

Diabetes and Heart Disease

What does diabetes have to do with heart disease?

People with diabetes are more likely to get heart disease. When you have diabetes, your blood sugar level is often much higher than it should be. Too much sugar in the blood can cause damage to many parts of the body, including blood vessels. Some lifestyle habits may also raise the risk of heart disease. Here are some things you can do to lower your risk:

1. Keep your blood sugar level under control.

Keeping your blood sugar level under control will lower your risk of heart disease. Many people with diabetes check their blood sugar level every day to make sure that their medicines and diet and exercise are working to keep blood sugar in a normal range.

By exercising often and eating a healthy diet, many people with type 2 diabetes (the kind of diabetes you're not born with) can keep their blood sugar level nearly normal. Some people have to take medicines to control their blood sugar level.

2. Lose weight--and keep it off.

Diabetes, being overweight and heart disease often go together. Losing weight helps a lot of health problems. For example, if you have been told that your blood pressure is too high, losing weight can bring it down. If your blood sugar level has been hard to control, losing weight can help.

Weight loss is important if you have a lot of extra weight around your waist and tummy. People who have "spare-tire" or fat around their waist are more at risk for heart disease than people who have extra weight around the hips or thighs.

You don't have to lose a huge amount to lower your risk for heart disease. Losing even 10 pounds can help.

3. Lower your cholesterol level.

Cholesterol is in many fats and oils, but it is not a fat. It is a part of many important body substances (like hormones) and body structures (including the brain and nerves). But, too much cholesterol in your blood can clog your arteries.

You've probably heard about "good" and "bad" cholesterol. Bad cholesterol or LDL cholesterol, which stands for low-density lipoprotein, can clog your arteries and lead to heart disease. Good cholesterol or HDL cholesterol, which stands for high-density lipoprotein, carries unneeded cholesterol away from body tissues, so it lowers your risk of heart disease.

If your doctor says your cholesterol level is too high, what can you do about it? It helps to lose weight and eat a healthy diet. Your diet should limit the amount of fatty and cholesterol-rich foods you eat.

There are many cookbooks available that contain low-fat, heart-healthy recipes and meal suggestions. If you need help figuring out how to change your diet, your doctor might refer you to a dietitian. A dietitian has special training in planning healthy diets.

If diet alone doesn't lower your cholesterol , medicines can help do that. You and your doctor can talk about these medicines. The medicine that is best for you depends on your special needs and medical condition.

4. Increase your physical activity.

Along with diet, exercise is very important for people with diabetes. Diet and exercise work together to help your body work properly. If you have changed your diet to lose weight, exercising can help you lose weight faster.

You and your doctor can plan exercises that will work for you and be safe. You don't need a gym or expensive equipment to get good exercise. Brisk walking is great exercise. Climbing stairs instead of taking an elevator is another good thing to do.

Like eating a healthy diet, exercise will also help keep your blood sugar level normal and can lower your risk of heart disease.

5. Control your blood pressure.

People with diabetes often have high blood pressure too. High blood pressure is a big risk factor for stroke. It also increases your risk for heart disease and kidney disease.

The same lifestyle changes that control blood sugar levels and lower your risk of heart disease may also keep your blood pressure at safe levels. Weight loss and exercise are important. The more weight you lose, the more you lower your blood pressure. It is also important not to drink very much alcohol.

If your blood pressure doesn't come down enough with diet and exercise, your doctor might have you take medicines that will help.

6. If you smoke, stop smoking.

Smoking is bad for everyone but it's even worse for people with diabetes because it damages the blood vessels. If you have diabetes and you also smoke, you double your risk of getting heart disease. Worse still, if you keep smoking while you try to reduce other risks (like losing extra weight), you won't be able to exercise as much and you probably won't lose the weight you need to.

Remember:

Diabetes and heart disease are related. Diabetes, being overweight and having high blood pressure are related. Diet and exercise are good ways to control your blood sugar level, lower your blood pressure and cut your risk of getting heart disease. When diet and exercise don't help enough, medicines can help control blood sugar levels, lower cholesterol levels and control blood pressure. You can do a lot to help by your own efforts.

Where can I get more information?

The American Diabetes Association can help you choose the right foods, plan healthy meals and get good nutrition while keeping your calories down.

The American Heart Association is a good source for diets that are low in fat and cholesterol.

Diabetic Neuropathy: What You Can Do About It

What is diabetic neuropathy?

Diabetic neuropathy is a type of nerve damage that happens in people who have diabetes. This damage makes it hard for their nerves to carry messages to the brain and other parts of the body. It can cause numbness (loss of feeling) or painful tingling in parts of the body. Diabetic neuropathy can also cause changes in:

Strength and feeling in different body parts
Ability of the heart to keep up with the body's needs
Ability to digest food
Ability to have an erection (in men)

What causes diabetic neuropathy?

Nerve damage occurs in people who have had diabetes because their blood sugar level is higher than normal. Over time, high blood sugar levels damage the blood vessels and nerves. That's why people who don't control (or can't control) their blood sugar very well seem more likely to get diabetic neuropathy. Men have diabetic neuropathy more often than women.

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complication of Diabetes in brief & how you prevent???? Clip_image006

What can I do to avoid diabetic neuropathy?

The most important thing is to keep your blood sugar under control. Take your medicines just the way your doctor tells you to. Eat a variety of healthy foods and avoid foods that are high in fat and sugar. If you are overweight, ask your doctor to help you lose weight. Exercise 4 to 6 times a week for 30 to 60 minutes at a time. Before starting an exercise program, talk to your doctor.

How do I know if I have diabetic neuropathy?

If you have numbness in your feet and toes, you may have diabetic neuropathy. You may notice that cuts and sores on your feet don't hurt as much as you would expect them to. The following are also symptoms of diabetic neuropathy:

Pain or a burning feeling in your legs
A feeling of lightheadedness that causes you to fall
Diarrhea and constipation
Failure to get an erection (in men)

What will happen if the nerves in my legs and feet are damaged?

If diabetic neuropathy has damaged the nerves in your legs and feet, you may not be able to feel pain in those parts of your body. This is a problem because pain can be a useful signal. If you have no feeling in your feet, you could have an injury and not know it. In addition, your muscles might atrophy (decrease in size), causing you to have trouble walking. The skin on your feet might crack and develop sores. If these sores get much worse and become infected, you might have to go to the hospital, or possibly have your foot amputated (removed). Because diabetes makes it harder for an injury to heal, it's important to take good care of your feet.

What can I do to prevent foot problems from diabetic neuropathy?

Keep your feet healthy by following these tips:

Check your feet every day.You may need to use a mirror to to check the bottoms of your feet. Call your doctor at the very first sign of redness, swelling, infection, pain, numbness or tingling in any part of your foot.
Check inside your shoes every day for things like gravel or a torn lining. These things could hurt your feet.
Have your doctor look at your feet during every office visit (at least once a year) or whenever you notice anything that seems wrong.
Choose the right shoes. The most common cause of foot sores is shoes that are new or don't fit properly. Buy shoes that fit properly and have good arch support. Choose shoes made of soft leather. They should not fit tightly anywhere. To get the best fit, try on shoes at the end of the day when your feet are a little swollen. If you've had problems before with shoes that didn't fit well, you may want to be fitted for a custom-molded shoe with plenty of room for your toes.
Break in new shoes slowly. Wear the shoes for 1 to 2 hours. Then check your feet for red spots. If you have red spots, do not wear the shoes again until the red spots are gone. Slowly break in new shoes by wearing them one hour longer each day every 3 days.
Wear white socks and check when you take them off to see if there is any blood or fluid from a sore on them.
Wash your feet daily in lukewarm water. Dry them well, especially between the toes. Use a soft towel and blot gently; don't rub. Keep the skin of your feet smooth by applying a cream or lanolin lotion, especially on your heels. If your feet sweat easily, keep them dry by dusting them with nonmedicated powder before putting on your socks, nylons and shoes.
Avoid things that are bad for your feet. Do not walk barefoot. Do not wear stretch socks, nylon socks, socks with inside seams, or socks with an elastic band or garter at the top. Do not put hot water, electric blankets, or heating pads on your feet. Do not use hydrogen peroxide, iodine, or astringents (such as rubbing alcohol or witch hazel) on your feet.

Diabetic Ketoacidosis: What It Is and How To Prevent It
What is diabetic ketoacidosis?
Diabetic ketoacidosis (say: key-toe-acid-oh-sis), or DKA, happens when you have high blood sugar (also called glucose) levels and a build-up of acids called ketones. If it isn't treated, it can lead to coma and even death. It mainly affects people who have type 1 diabetes. However, it can also happen with other types of diabetes, including type 2 diabetes and gestational diabetes (during pregnancy).

What causes DKA?
The main cause of DKA is not enough insulin. This causes your body's glucose levels to rise, but stops the body from using the glucose for energy. To get energy, the body starts to burn fat. This causes ketones to build up. Ketones can poison the body. High blood glucose levels can also cause you to urinate often, which leads to a lack of fluids in the body (dehydration).

For some people, DKA may be the first sign that they have diabetes. For others, DKA can be caused by missing an insulin dose, eating poorly or feeling stressed. Infections can also lead to DKA. If you have signs of infection, such as fever, cough, sore throat, or pain when you go to the bathroom, contact your doctor to make sure you are getting the right treatment.

What are the warning signs of DKA?

DKA is a very serious condition. People with diabetes should contact their doctor right away if they have any of the following:

Vomiting more than once
Stomach pain
Diarrhea 5 or more times in 6 hours
2 blood glucose level tests higher than 300 mg per dL
A blood glucose level less than 70 mg per dL more than once, or symptoms of low blood sugar
Trouble breathing
Moderate or high ketones if you are using urine test strips
High beta-hydroxybutyrate levels if you are using blood test strips

How can I prevent DKA?
When you are sick, you need to watch your blood glucose very closely so that it doesn't get too high or too low. Ask your doctor what your critical blood glucose level is. Most patients should watch their glucose levels closely when they are higher than 250 mg per dL.
When you're sick, you should check your blood glucose level every 3 to 4 hours. If your blood glucose reaches a critical level, check it every 1 to 2 hours. Test your blood glucose levels at least every 4 hours during the night.

You should talk to your doctor to develop a plan if your blood glucose level gets too high. Make sure that you know how to reach your doctor in an emergency.

You should also test your urine for ketones or your blood for beta-hydroxybutyrate every 4 hours or if your blood glucose is over 250 mg per dL.

Should I keep taking insulin when I'm sick?

Yes, you should keep taking your insulin, even if you are too sick to eat. Your body needs insulin even if you are not eating. Ask your doctor whether it is necessary to adjust your dose or take extra insulin.

If you are on an insulin pump, make sure that you have short-acting insulin, long-acting insulin and needles in case your pump is not working right. You also should have an emergency phone number to call for help with your pump.

What else should I do?

When you're sick, drink lots of sugar-free, caffeine-free liquids. Sip small amounts every few minutes if you are feeling sick to your stomach.

If your blood glucose is more than 250 mg per dL, do not eat or drink foods that are high in carbohydrates.

Preventing Diabetic Complications

What are diabetic complications?

Diabetic complications are health problems caused by diabetes. Diabetes causes your blood sugar level to be higher than normal. Over time, high blood sugar levels can damage your blood vessels and nerves. This damage can cause problems in many areas of the body. This handout explains common diabetic complications and how to prevent them.

Nerve damage

Nerve damage (also called diabetic neuropathy) makes it hard for your nerves to send messages to the brain and other parts of the body. If you have nerve damage, you may lose feeling in parts of your body or have a painful tingling feeling.

Neuropathy most often affects the feet and legs. If you have neuropathy, you may not be able to feel a sore on your foot. The sore can become infected and, in serious cases, the foot may have to be amputated (removed). People who have neuropathy may continue walking on a foot that has damaged joints or bones. This can lead to a condition called Charcot foot that causes the injured foot to become deformed. However, this problem can often be avoided.

If you have diabetes, check your feet every day. If you see swelling and redness and feel warmth in your foot, see your doctor immediately. These can be signs of Charcot foot. Your doctor should also check your feet at least once a year.

Warning signs of nerve damage

Call your doctor if you have:
Loss of feeling (numbness)
Sharp pain or tingling feeling
Sores on your feet
Muscle weakness
Burning feeling
Inability to get an erection (in men)

Eye problems

The retina is the part of the eye that is sensitive to light and helps you see. Diabetes can damage and weaken the small blood vessels in the retina. This damage is called diabetic retinopathy.

When the blood vessels are weak, they can leak fluid. This causes swelling in the eye that blurs your vision. If retinopathy gets worse, it may lead to blindness by causing your retina to break away from the back of the eye.

Laser surgery can often be used to treat or slow down retinopathy, especially if the problem is found early. People who have diabetes should have an eye exam once a year.

Warning signs of eye problems

Call your doctor if you have:

Blurred vision for more than 2 days
Sudden loss of vision in 1 or both eyes
Black spots, cobwebs or flashing lights in your vision
Redness in your eye
Pain or pressure in your eye
Kidney damage

Diabetes can also damage the blood vessels in your kidneys so they can't filter out waste. This damage is called diabetic nephropathy. Some people who have nephropathy will eventually need dialysis (a treatment that eliminates waste from the blood) or kidney transplant.

The risk for nephropathy is increased if you have both diabetes and high blood pressure, so it is important to control both of these conditions.

Protein in the urine is usually the first sign of nephropathy. This should be checked yearly. If your doctor notices early signs of this, he or she can put you on medicine that helps protect your kidneys from damage.

Heart disease and stroke

People with diabetes are at greater risk for heart disease and stroke, The risk is even greater for people who have diabetes and smoke, have high blood pressure, have a family history of heart disease or are overweight.

Heart disease is easiest to treat when it is caught early. It is very important to see your doctor on a regular basis. He or she can test for early signs of heart disease or stroke.

The recommended cholesterol level for a person with diabetes is the same as for someone with heart disease. If your cholesterol is higher than the recommended level, your doctor will talk to you about lifestyle changes and medication to help get your cholesterol under control.

What can I do to prevent or delay diabetic complications?

To prevent problems, keep your blood sugar level as close to normal as possible and follow your doctor's instructions. The following are some other tips:

Eat a variety of healthy foods. Avoid foods that are high in fat and sugar.
Maintain a healthy weight. If you're overweight, your doctor can give you advice on how to lose weight safely.
Control your blood pressure and cholesterol levels.
Be physically active on a regular basis.
Quit smoking.
See your doctor regularly, even when you feel fine. Your doctor will check for early signs of complications.

Call your doctor right away if you have any of the warning signs listed in this handout

with my best wishes Dr. Abdul Hadi Al- juraisy

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خالص شكري وتقديري د-عبد الهادي الجريصي </p>
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