Sickeningly Sweet

15

DON’T GAMBLE WITH GLUCOSE!

Avoiding the Complications

 

                Gambling may appeal to some people, but not to me! When I was doing my university studies in the USA, I worked part time in the university public relations office. One time my boss invited me to go along with him and several other students to put on a weekend program. It just happened that the venue was one of America’s best-known gambling cities.

                Although the gambling casinos were not supposed to be on our itinerary, we students persuaded Mr. C. to let us stop at one that Saturday night. Some of my friends were happy just to look, but that wasn’t enough for me. I had to try it myself! Oh, I wasn’t going to spend big money—just the smallest amount I could put into the slot machines.

                I dropped a coin into the machine. No luck. I tried another coin. Still no luck. Just one more. Hooray! Coins came pouring out of the machine.

                “Okay, Marilyn, you’ve won. Now let’s go,” one of my friends said.

                But by then I had gotten a case of “gambling fever”—I couldn’t quit when I had just started getting lucky. “Just a minute,” I answered as I dropped another coin into the slot machine. And another. And still another.

                For the next 15 minutes my schoolmates and even my boss tried to convince me it was time to leave, while I kept delaying, asking for just another minute. Meanwhile, I tried one machine after another, trying to get lucky again.

                When we finally left the gambling casino, I was several dollars poorer than when I had entered. Bad luck? No, I finally decided…just bad sense! With gambling, you usually loose. It really isn’t worth the risk.

                Since then, I’ve met quite a number of people who were hooked on gambling. Not one gambler that I’ve ever met considers himself a winner. Some have lost only money. Others have lost much more—wife and children, house, a reason to live. The list of losses is long and sad. No, gambling just doesn’t seem worthwhile to me.

                But, you may be thinking, all of life is a gamble. Life is full of risks. I don’t want to bother with carrying an umbrella when I can see only one or two little clouds in the sky. Yet if I leave home without my umbrella, I’m taking a risk—I may get soaking wet in a sudden rainstorm.

                Maybe you’ve heard the old saying, “Nothing ventured, nothing gained.” If I don’t take some risk, I’ll never accomplish my dreams. Like the young lady who really wants to get married. Yet she is so afraid of marrying the wrong man that she hesitates and delays until finally it is too late. She may have saved herself the sorrow of marrying the wrong person, but maybe she just missed out on all the happiness she might have had.

                It is true that many of the decisions you and I make in life do involve some risk. The important thing is to look at the possible results—good and bad—and then make a sensible choice.

 

Gambling With Diabetes

                With diabetes, life is even more of a gamble. Every day the diabetic has decisions to make. The ice cream would taste so nice—should I eat like everyone else is doing? I have so much work I need to get done today—do I really have to exercise now?

                Big decisions. Little decisions. But every one of them may make a difference in how well the diabetes is controlled. And every one of them may be making a difference in how well the diabetes is controlled. And every one of them may be making a difference in whether or not the diabetic will have any of the serious complications of diabetes later on.

                I wish I could guarantee that good control would always prevent complications. Unfortunately, I cannot. No one can. But with careful control, the odds are at a lot better.

                If you look at smoking and lung cancer, a nonsmoker may still get the deadly disease, while a heavy cigarette smoker may escape without ever getting cancer.

                So it is with a diabetic and all his efforts at maintaining good control. Even with the best efforts at regulating his life, he may still have complications. And a person who always seems careless about his diabetes may somehow escape without serious problems. Yet statistically speaking—looking at the laws of chance—the person who is careful about his diabetes control has a much better chance of escaping the complications so common to the diabetic.

                In the recently reported Diabetes Control and Complications Trial (DCCT), 29 research centers studied 1,441 diabetic volunteers for up to 15 years to see whether tight blood glucose control would help prevent or delay complications. The DCCT showed that people who carefully control their blood sugar levels do have fewer and less severe complications.

                What about the diabetic who has spent years working hard at keeping his diabetes under good control and then develops a serious complication anyway? He will likely become discouraged, depressed and angry. “Why did I waste all the effort?” he wonders. “Why did I miss out on all the foods I like? Now look at me—I’m no better off than if I had just enjoyed life!”  The truth is, however, that his complications might have come much sooner and may have been much worse if he had not been so careful. Throwing out all his good efforts would have been a bad gamble.

                Gambling with glucose levels is just not worth the risk! There are too many possible problems. It doesn’t matter whether a person has type I (insulin-dependent) or type II (non-insulin-dependent) diabetes—both have the same likelihood of developing long-term complications. A diabetic should not take chances with his health and his lifestyle.

                Diabetes is the most common cause of new blindness. It is one of the major causes of kidney disease. It more than doubles the risk of heart disease and stroke. Diabetes may lead to male impotence. It causes a person to have many more infections than normal, and it may make foot or leg amputations necessary.

                All of these are in addition to the usual out-of-control blood sugar level complications such a s hypoglycemia (insulin shock, or very low blood sugar), ketoacidosis, and hyperglycemia (diabetic coma) which we already looked at in the last chapter.

                Not every diabetic will develop such complications, but he must constantly be alert for the warning signs of problems. The diabetic must have medical checkups quite often. Most likely, he will need considerably more medical care than the average person.

                Let us look now at some of the complications of diabetes and why they happen. First, we will see what happens in the blood vessels because it is the changes in the blood vessels (both small and large) which cause many of the other complications of diabetes.

                When the blood glucose level stays high for a long period of time, the red blood cells become stiff and flexible. Because of this, it is more difficult for them to squeeze into the very small blood vessels—the capillaries.

                The capillaries have very thin walls so that oxygen and glucose can pass right through them into the cells of the body. However, high blood glucose levels weaken the capillary walls. When the stiffened red blood cells try to squeeze into the capillaries, they do even more damage to those capillary walls. After some time, these small vessels become so weakened that they may bleed or leak protein. Meanwhile, as nature tries to heal the damaged capillary walls by forming scar tissue, those once-thin walls become thicker. But the space inside the capillaries becomes narrower, thus slowing down the flow of blood.

                The large blood vessels—the arteries—may also be damaged by high blood glucose levels. There, too, stiffened red blood cells damage the inner lining of the arteries, causing scar tissue to form. The more scar tissue is formed inside the arteries, the stiffer and harder the blood vessels get. In addition, the scar tissue catches cholesterol which is in the bloodstream, forming a fatty layer of plaque. Gradually, more and more scar tissue and cholesterol deposits accumulate until the blood vessels become hard and narrow—what we often call “hardening of the arteries”, or atherosclerosis.

                As this happens, the heart is forced to work harder to pump the blood throughout the body. The blood pressure goes up. Heart attacks and strokes become more common. The blood circulates more poorly throughout the arms and legs. Many different parts of the body are affected—all from too much glucose in the blood.

 

Eye Complications

                One of the common complications of diabetes is an eye problem called retinopathy. The retina is like the body’s camera, forming the visual picture of what we see.

                In retinopathy, the tiny blood-carrying capillaries in the eyes become damaged. Because the capillary walls are weak, they bulge, they leak, and sometimes they even burst and bleed. This fluid may collect and cause swelling in the retina. This alone does not usually interfere with a person’s vision.

                In some people, however, the condition becomes much worse, as they get what is called proliferative retinopathy. As some capillaries become blocked, new capillaries begin to form in and around the retina. In proliferative retinopathy, the capillaries proliferate, or push into the vitreous—the fluid-filled center of the eye. There they may break and cause bleeding which could result in blindness.

                Fortunately, only about five percent of diabetics will have such an advanced case of retinopathy that they will actually have any real loss of vision. Even so, retinopathy is the greatest cause of new cases of blindness among adults between the ages of 20 and 74.

                Most diabetics will eventually develop some retinopathy. Researchers estimate that after 20 years of diabetes, almost all type I diabetics and at least 60 percent of type II diabetics will have some degree of retinopathy. After the DCCT, they estimate that by 15 years after the diagnosis of diabetes about 25 percent of type I diabetics and 10 percent of type II diabetics will have proliferative retinopathy.

                To prevent the blindness which can occur, a diabetic should have his eyes examined by a qualified eye specialist (an ophthalmologist) at least once a year. At first, retinopathy develops gradually and without warning or symptoms. If an eye doctor finds it early enough, he can usually treat it successfully without surgery by using a laser treatment called photocoagulation.

                Often diabetes is first diagnosed when a person goes to see a physician for eye troubles and finds that he already has retinopathy. By the time a doctor can see evidence of retinopathy, however, the person has likely had diabetes for several years already.

                There are other eye problems which also occur more commonly in diabetics than in nondiabetics. Glaucoma is one. In glaucoma, excess fluid collects in the eye and the pressure in the eyeball increases. This damages the tiny blood vessels that feed the optic nerve fibers, interfering with the person’s eyesight.

                Although cataracts occur in both diabetics and nondiabetics, they occur earlier in life for diabetics. A cataract is the clouding of the eye lens so that vision becomes more and more difficult.

                Sometimes diabetics may also have blurred vision. This occurs when the diabetes is out of control, and usually goes away when the diabetes is under control again. Blurred or double vision may also be a symptom of cataracts.

                Eye problems can be serious. We all value our eyesight and want to keep it safe. Remember, the best way for a diabetic to safeguard his eyesight is to maintain good diabetes control and to have his eyes checked regularly.

 

Kidney Complications

                Many of the complications of diabetes occur because of the weakening of the walls of the small blood vessels. Kidney disease—called diabetic nephropathy—is another one of those diseases.

                The kidneys are the “policemen” on round-the-clock duty, ready to remove any harmful wastes and chemicals from the blood. In the kidneys, there are millions of tiny blood vessels that act as filters. They produce the urine, which is made of the body’s extra water and all of the wastes.

                The kidneys should function as good filters throughout a person’s lifetime. However, high blood sugar levels, high blood pressure and infections can all damage the capillaries so that they are unable to filter as well as they should. Because diabetics are likely to develop blood vessel damage, they are 18 times more likely to have serious kidney damage than nondiabetics are. Put more simply, one diabetic in every 10 will likely develop kidney disease.

                The urine of a person with healthy kidneys does not usually contain protein except during an infection or a urinary tract infection. Once in a while, a healthy person may have a very small amount of protein in the urine—called albuminuria—but this should usually clear up after some time.

                However, when the capillaries of the kidneys become damaged, they begin to leak and let protein spill out into the urine. So, if a person has protein in his urine for quite some time but has no infection to blame, the doctor may consider the possibility of diabetes.

                As more and more of the filtering capillaries are damage, those which remain have to work harder to keep up. As they work more, they too will become damaged. As this happens, the kidneys become less and less efficient, until at last the person has kidney failure.

                Kidney failure can cause death, so it is extremely important to try to prevent it. Once the kidneys do fail, there are two methods of treatment: dialysis and kidney transplant.

                With dialysis, the blood is “cleaned” artificially—usually in a dialysis center. There are two types of dialysis. One is hemodialysis, in which the blood is circulated through a special machine two or three times a week. The machine filters out all the waste products then returns the blood to the body.

                In the other kind of dialysis—peritoneal dialysis—the blood does not have to go through a machine. Instead, a small tube is permanently placed through a tiny hole in the abdomen. Every day a special liquid is passed through the tube into the abdominal cavity. The fluid picks up wastes as it washes through the abdomen. Later this fluid is filtered to remove the wastes.

                There are various causes of kidney failure, but diabetes is one of the most common. Today, more than 25 percent of all kidney dialysis patients have diabetes.

                The other method of treating kidney failure is to have a kidney transplant. The damaged kidney is replaced with a healthy kidney from another person. The new kidney may be obtained from a relative whose kidney matches exactly. Or it may be taken from someone who has died accidentally.

                Kidney transplantation has quite a high success rate nowadays, although there are still some risks. Even though doctors do their best to match the tissue of the donor and the receiver of the kidney, there is a constant possibility that the body will reject the “foreign” tissue of another person. To try to prevent that rejection, the person will have to take powerful medicines called immunosuppressives for the rest of his life.

                Not everyone is a good candidate for transplant surgery. Age or other health problems may make it unwise. Transplantation is also quite expensive. For many people, however, transplantation gives the freedom from dialysis and allows for a much more normal life.

                What can be done to prevent kidney deterioration and failure? As with most of the complications of diabetes, careful control of blood sugar levels is very important.

                A diabetic should have his urine tested for protein whenever he goes to the doctor for his regular appointments. Then, if protein becomes evident, the doctor may order more tests for kidney damage.

                The diabetic can also watch for other warning signs such as a swelling of the feet and ankles, feeling extra tired, and paleness of the skin.

                All urinary tract infections should be treated promptly. The symptoms of kidney r bladder infections include back pain, cloudy or bloody urine, a burning feeling when passing urine, passing

urine more often than usual, or feeling the need to pass urine but not being able to.

                It is also extremely important that a diabetic keep his blood pressure under good control—especially if tests have shown protein in his urine. In a person whose kidneys already sufficiently damaged to allow protein leakage, high blood pressure may soon lead to kidney failure.

                The physician may prescribe medications to regulate the blood pressure. In addition, however, there are several things a diabetic can do to help keep his blood pressure under better control:

                *Use less salt and sodium-containing foods. Cook food with less salt, and don’t have salt on the table at mealtimes. Most people use 20 to 30 times as much salt as they really need. This is easy to do with all the salted meat, salted eggs, salted vegetables, soy sauce, and all the potato chips or other salty snacks which are so popular today. Also avoid all foods with monosodium glutamate—also known as ajinomoto or vetsin.

                *Stay assay from coffee, tea, the cola drinks, and other drinks which contain caffeine or other stimulants.

                *Avoid smoking cigarettes, pipes or cigars. Also avoid the smoke from other people’s cigarettes.

The nicotine in tobacco narrows the blood vessels and thus raises the blood pressure.

                Keep away from alcohol. Drinking may be another cause of high blood pressure. Besides, it contains a considerable amount of sugar, which the diabetic certainly does not need.

                Control stress and anger—the blood pressure automatically goes up when a person is angry, excited or frightened.

                Remember, your kidneys help to keep you alive. Whether or not you have diabetes, you should guard them well. Drink six to eight glasses of water each day to make their filtering work easier. Just as it would be next to impossible to get a dirty shirt washed clean in a half a liter of water, the body’s “laundry” also has a more difficult task if we fail to provide enough pure, clean water for its work.

 

Nerve Damage

                Another common complication of diabetes is neuropathy—damage to the nerves of the body.

                More than 70 percent of all people who have had diabetes for more than 15 years have some form of nerve damage. Young people do not usually have neuropathy, but may develop it later. Type II diabetics, who are diagnosed with diabetes later in life, may have nerve damage soon after diagnosis.

                Nerves in various parts of the body may be affected by diabetes. The autonomic nerves help to regulate the speed of your heartbeat, your blood pressure, your perspiration. They also help with the control of your bladder, your digestive system, and your sex organs.

                In the diabetic, damage to the autonomic nerves may result in diarrhea—or in constipation. It may make it difficult to pass all the urine stored in the bladder, which may result in urinary infection. It may also cause impotence, which we will look at later in this chapter. Autonomic neuropathy can lead to postural hypotension, which simply means that the blood pressure drops when you stand up quickly, making you feel dizzy or giddy.

                Neuropathy may also affect the motor nerves, which carry signals to the muscles telling them to move. In a person with diabetes, the most likely muscles to be affected are those which control eye movements. However, motor neuropathy may also cause a person to have a difficulty in walking.

                Of all kinds of nerve damage which a diabetic may experience, the most common is called peripheral neuropathy, which affects the nerves in the arms and legs.

                This nerve damage causes numbness and loss of feeling, especially in the feet, so the person no longer feels pain or other sensations such as hot and cold. Injuries may occur without the person’s knowledge. Then, with the poorer blood circulation which diabetics often have, serious infections and even gangrene can easily occur.

                Peripheral neuropathy causes at least half of all foot and leg amputations in the USA, in Singapore and Malaysia, and in many other countries. Because of the frequency and the seriousness of foot problems in the diabetic, we will devote the entire next chapter to these problems and their prevention. 

 

Heart and Blood Vessel Disease

                Earlier in this chapter we saw how diabetes may cause damage and narrowing of both the large and the small blood vessels of the body.

                When the arteries of the abdomen or the arms or legs are affected, we call it peripheral vascular diseases or peripheral arterial disease. We have already seen what can happen in the eyes or in the kidneys when the small blood capillaries get hard and narrow.

                We have mentioned briefly what happens in peripheral neuropathy, when the nerves of the feet and legs are damaged. If both the nerves and the blood vessels of the feet and legs become damaged, that spells double trouble! In the next chapter, we will also take a closer look at circulatory problems of the feet.

                When the body’s large blood vessels begin to narrow, the person may get what doctors call cardiovascular disease or coronary (heart) disease. When the arteries become narrow, the blood pressure rises, and high blood pressure may lead to heart attack. In fact, heart attack is the leading cause of death among diabetics. The narrowing of the arteries and the resulting high blood pressure may also affect the brain, causing what we know as cerebrovascular disease, or stroke.

                Compared to a nondiabetic, a diabetic has two to four times the danger of dying from a heart attack or a stroke. Worse yet, the diabetic may have his heart attack or stroke at an earlier age than the nondiabetic.

                Diabetes and heart disease share some of the same conditions and causes, including overweight and lack of exercise. In both heart disease and diabetes, high blood pressure and smoking also add to the risks of problems.

                Knowing the danger of heart attack, stroke and peripheral artery disease, the diabetic—and the nondiabetic as well—would be wise to take the following precautions:

                *Control blood pressure level—the blood pressure should be kept lower than 140/90. It is estimated that good control of blood pressure could prevent up to 50 percent of the heart attacks and 85 percent of the strokes which occur among diabetics.

                *Avoid smoking. Because smoking narrows and damages the blood vessels, getting rid of his tobacco may be the most important step a diabetic can take in preventing heart attack, stroke, or foot and leg problems. Diabetics who stop smoking will have far fewer heart attacks, strokes or amputations than those who keep smoking.

                *Control weight. Every extra pound a person weighs means extra miles of blood vessels that the heart has to pump blood through. This means an extra work load for the heart to cope with, resulting in higher blood pressure—and a greater risk of heart attack or stroke. If an overweight person loses weight, he may be able to lower his blood pressure also.

                *Avoid eating fatty, high-cholesterol foods. A person should certainly not get more than 30 percent of his calories from fat. Eggs, meat and fish should be greatly reduced or eliminated from the diet if a person has a high blood cholesterol level. A cholesterol level of approximately 145 mg/dl is considered normal, while 200-240 mg/dl is bordering the danger zone.

                *Eat more fruits and vegetables, but eat fewer refined foods. The natural fiber of the plant foods acts like a sponge, absorbing water and food particles—including fats and sugars. This benefits the diabetic in two ways.

                First of all, fiber speeds up the passage of foods through the digestive tract. Since fats and cholesterol are digested and absorbed more slowly than other foods, more of them will pass through the body without ever being absorbed. This helps in the control of weight and in keeping the blood cholesterol level lower.

                Fiber also helps to control the blood sugar level. Refined and sugary foods are absorbed into the bloodstream very quickly, causing the blood glucose level to rise rapidly. The body responds to the sudden rise in sugar by releasing insulin, which may end up causing a hypoglycemic reaction. With more fruits and vegetables in the diet, however, the digestive process is more steady and balanced. This helps to regulate the amount of time it takes for sugars to pass into the bloodstream, thus avoiding sudden high or low blood glucose levels.

                *Carefully control blood sugar levels. Doctors don’t fully understand the relationship between the hyperglycemia (high blood sugar levels) of diabetes and the atherosclerosis (narrowing and “hardening” of the arteries) of heart disease. Nevertheless, this narrowing of the blood vessels does occur in diabetics. And that narrowing of the arteries leads to higher blood pressure, which is one of the major risk factors for heart attack and stroke.

                *Exercise regularly—at least half an hour a day. Daily exercise can help with weight loss and in controlling the amount of cholesterol in the blood. Before beginning an active exercise program, however, a diabetic—especially if he is over 40 years of age—should consult with his doctor and possibly go through an exercise stress test.

                A person with peripheral artery disease should walk for 40 minutes every day. When the cramps begin, he should stop and stand still for two to five minutes—until the discomfort goes away. Then he can begin walking again. He should soon find that he can walk farther and farther without getting the cramps, and he may well be able to prevent the need for surgery or amputation by a regular walking program.

 

Impotence

                Another complication which men with diabetes may experience is impotence. With impotence, a man’s penis may not become erect—or hard enough—for sexual intercourse. Or it may become erect—or hard enough—for sexual intercourse. Or it may become erect at first but then soften before he can reach a sexual climax.

                Impotence may occur for psychological reasons, or it may be caused by physical problems such as accident, drug abuse, blood vessel or nerve disease, or by diabetes. In fact, diabetes is the second most frequent cause of impotence in men, affecting men at any age—from 20 to 70 or more. After the age of 45, approximately half of all diabetic men suffer from impotence.

                In a diabetic, there are two main causes of impotence. The nerves which are normally stimulated to cause an erection may be damaged by diabetes. Secondly, the blood vessels in the penis may be narrowed or blocked. Some men are impotent because their diabetes has caused both nerve damage and blood vessel narrowing.

                Certain medications, such as those used to control high blood pressure, may cause impotence. A person should not stop taking the medicines, however, without discussing the problem with his doctor.

                Some men become impotent simply because they are afraid that they will. The real cause of their impotence is not the diabetes itself but their emotional reaction to the diabetes. In many men, stress can greatly add to the chances of impotence.

                Alcohol is another cause of impotence, even in a nondiabetic. Alcohol also contains a large amount of sugar, which often causes the blood sugar level to be higher than normal. George was only 41 when he suddenly found himself unable to perform sexually. He had been cheating on his diet by drinking a lot of alcohol—except for the two weeks before going for his regular diabetes checkups, so the doctor wouldn’t know. After spending a lot of money seeing medical specialists abroad, George finally found a cure—he simply gave up alcohol and began exercising regularly instead.

                Because smoking causes all of the arteries to become narrower, it also affects the blood vessels in the penis. Any blockage of blood flow can cause impotence.

                Impotence can often be treated successfully, even in the diabetic. A diabetic who is suffering with this problem should discuss it with his doctor, and together they can most likely work out a solution to the problem.

 

Infections

                A diabetic may have more infections than his nondiabetic friends and relatives. The reason is relatively simple: the germs which cause infections grow best when the blood glucose level is high. Normally, white blood cells are the soldiers on guard helping to fight off all infections. When the blood sugar level is high, however, the white blood cells slow down their work and allow the germs to grow and cause trouble.

                When a person has diabetes, he may get infections in various parts of the body. Here we will look at some of the likely trouble spots, then we will see more about foot infections and good foot care in the next chapter.

                The skin is a likely place for trouble to begin. Boils, styes (infections of the tear glands of the eyes), and infections around the fingernails or toenails may be problems for the diabetic.

                Diabetics often have dry skin, which is more likely to crack and allow germs to enter and cause infections. In a very wet and humid climate, dry skin may not be so much of a problem, but where the weather is cold or windy, the skin may become very dry. To prevent dry skin, the diabetic should use only mild soaps. Bath oils, lotions and creams—especially after a shower or bath—may also be a help. When the heels of the feet or other parts of the body become so dry that they threaten to crack, rubbing on a generous amount of petroleum jelly (Vaseline) may be very effective in softening and moisturizing the skin.

                When nerve damage causes numbness so that minor injuries are not noticed, infection may easily begin. Even small cuts and blisters may become infected. All minor injuries should be cleaned quickly and thoroughly with a mild soap and water, then disinfected with hydrogen peroxide. Antibiotic reams and ointments may be used, but the diabetic should avoid using antiseptics such as alcohol (spirits), iodine, potassium permanganate, Mercurochrome, or any other colored medicine which may hide a more serious problem.

                Fungus infections are also fairly common. They usually affect moist areas of the body such as the underarms, between the toes (athlete’s foot), or the groin (“jock itch”). Ringworm—a ring-shaped itchy place on the skin—is another fungus infection which the diabetic may get.

                To prevent the fungus infections, it is important to try to keep the skin dry under the arms, in the groin area, and between the toes.  Underclothing and socks should be kept clean and fresh. Mild fungus infections can often be treated by mixing half a tablespoon of vinegar in a liter of water and using this to soak the toes or apply with a clean washcloth to other parts of the body. Infections which are more serious or do no clear up quickly should be treated by the physician.

                A diabetic woman with high blood sugar is more likely to get infections of the vagina. Vaginal itching a white discharge, and burning sensation during urination are some of the common signals that she has such an infection.

                The urinary bladder is another possible trouble spot. A diabetic is more likely to get urinary infections, which may become serious if not properly treated. A person with a urinary infection will likely pass urine more often than usual. He will probably feel an urgent need to pass urine but not be able to urinate. He may have a burning sensation when he passes urine. He may also have pain in his back. The urine may look cloudy or have some blood in it. One of the best ways to prevent urinary infection is to drink at least six to eight glasses of water every day.

                Most people over 40 are likely to have some dental problems and gum disease. A diabetic may have gum infections—called periodontal disease—even earlier than the average person. Periodontal disease can make blood sugar control more difficult, it can increase tooth loss, and it can make it more difficult to eat the right kinds of foods. Proper brushing of teeth is very important in helping the diabetic to avoid problems. The diabetic should also visit the dentist regularly to be sure that his teeth and gums are in good condition.

                The best way to prevent all kinds of infections is to avoid high blood sugar levels—not providing food for the germs! In other words, keeping diabetes under good control helps to prevent infections.

 

Avoiding Complications

                Thousands of people have diabetes without even knowing it. Many of them will only discover their diabetes when they go to a doctor for other problems. And then they find out that the trouble with their eyes, feet, or heart is actually a complication of diabetes.

                If you have never been checked for diabetes, if you are overweight and if you are above the age of 35, you may be at risk. Don’t take a chance—go for a diabetes screening test or ask your doctor to check your blood sugar level.

                If you know that you have diabetes, the best way to avoid—or at least delay—complications is to keep your blood glucose as close to nondiabetic levels as possible. This requires staying in constant control of diabetes—testing frequently, exercising regularly, eating wisely.

                A diabetic who already has a complication may be able to prevent it from getting worse by staying in good control of his blood sugar level.

                No one can accurately predict who will develop any lf the complications of diabetes, but whether or not you’re a gambling person, one thing is a safe bet: Prevention is much better than cure! Living a healthy lifestyle—with good blood glucose control, proper diet,  regular exercise, and no smoking—will greatly reduce your chances of trouble.

 

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