Importance Of Glucose Control In Diabetes:
epending on how high your A1c is, your doctor may try “lifestyle modifications” first. It includes all the preventive things I discussed in my post, “The Sweet Tea on Diabetes.”
A healthy diet, regular activity, and sufficient sleep with a probable follow up in 3 months to recheck your A1c to see how you’re doing.
But sometimes, your doctor will know that even if you do your part, your A1c is too high to start with to reach the goal with just lifestyle changes, or you may have tried the lifestyle modifications without enough of an effect on your A1c. So, they will likely recommend medical therapy.
There are so many options, too extensive to discuss here. But the most common first choice in treatment is a medicine called Metformin as long as you don’t have any contraindications. I’ll think about writing a post on different treatment choices for type 2 diabetes, but let us put that on hold.
But why all the fuss on how high your sugar is? Why do you need to control so much? Well, it’s because you want to prevent complications. Let’s go over them. Now, this does not mean everyone with lower blood sugars will experience these complications. It does mean that if your control of blood sugar levels for a long time, your chances of experiencing these complications are enhanced.
COMPLICATIONS – Glucose Control:
These can be divided into an effect on Small blood vessels (Microvascular) or Large blood vessels (Macrovascular).
Effects on large blood vessels include – Stroke, heart attack, and low blood flow in lower legs. In contrast, effects on small blood vessels include kidneys, eyes, and nerves.
Let’s go over each of these and why they occur, and then I’ll even throw in some complications of uncontrolled Gestational Diabetes.
Increase risk of Stroke (Large Blood Vessels)
On its own, reducing blood glucose due to diabetes is a considerable risk factor for stroke. There is a 4-fold increased risk of stroke in people with uncontrolled diabetes.
This risk is due to the effect of high sugar on blood vessels. Many people who have diabetes don’t know ways of controlling glucose levels, and it results in generating high blood pressure and high cholesterol. In this way, it further increases risk factors for a stroke.
Not only is the risk of stroke higher, but so are the number of days in the hospital, risk of more significant disability after the stroke, higher risk of another stroke, and a higher risk of stroke-related dementia (memory issues).
Coronary Artery Disease (Large Blood Vessels) Increased risk of a heart attack.
Your heart has its blood supply, called coronary arteries. Since diabetes affects blood vessels, damage to these blood vessels can lead to decreased blood flow to the heart muscles. Less blood flow means less oxygenation of the tissue. Your muscles need oxygen to keep living. When the blood vessels are significantly affected, this is when it leads to chest pain and even a heart attack if severe enough.
Peripheral Artery Disease (Large Blood Vessels)
As I mentioned above, your coronary arteries are affected. But, you also have arteries that feed your arms, hands, lower legs, and feet. These are referred to as peripheral arteries. At the periphery, get it?
Your hands and feet are the most distant from your heart. Your feet are even farther away than your hands. So it takes extra power to supply these areas with blood. If your heart is not getting enough blood because of damaged coronaries, it will have a hard time working well. It means that less blood will be pushed out to your peripheral arteries. If you also have damaged peripheral arteries, your feet will be getting even less blood. Good healing requires good blood flow. So this can lead to decreased wound healing, therefore, chronic ulcers and infections. It can even lead to amputations.
Besides, sometimes walking too much can cause pain or cramping in your lower legs. It is termed ‘claudication.’ It sometimes gets better once you sit and rest. It’s kind of like a ‘chest pain’ of your legs. It happens because when you perform an activity, your muscles need more blood, but it doesn’t get it because of your affected blood vessels.
It happens when the sugar in your blood coats your nerves. Short term, this is not too bad. But, in a long time, it causes nerve damage and nerve death.
Your entire body is filled with nerves. Nerves that help you feel things on your skin, nerves that help stimulate your stomach for digestion, and even nerves necessary for erections.
You might experience things like tingly sensations, like ants crawling on you in your feet or hands. You may have issues with erections or impotence. You might even notice you have slow stomach emptying called gastroparesis. It can lead to feelings of fullness after a meal, nausea, vomiting, or acid reflux.
The long-term high sugar in your bloodstream leads to damage to both the nerves and the arteries that supply your eyes, leading to progressive blurry vision and loss of visual acuity. Diabetes is known to be the most prominent reason for damaged vision in people 25-74 years old.
Your doctor will likely schedule a yearly ophthalmology check to make sure your eyes remain healthy.
Nephro means kidney, yes, that’s right. Long-term uncontrolled diabetes can lead to kidney damage. One of the leading causes of chronic kidney disease and end-stage renal disease is diabetes. Many of these patients require dialysis to help filter their blood because their kidneys can’t do it anymore.
You might experience changes in your urinary frequency and amount. You might also notice swollen ankles or lower legs, and even puffiness under your eyes.
Remember that some of these symptoms might occur with many other medical conditions. They are not specific to kidney disease.
Decreased wound healing
Diabetes affects your circulation and even prevents angiogenesis (creation of new capillaries and arteries). For good wound healing, you need good blood flow. It leads to delayed wound healing, which increases your susceptibility to chronic ulcerations and, therefore, infections. It contributes to possible future amputations.
Increased risk of infection
As mentioned above, you are having a greater chance of catching infections. Not only because chronic wounds are predisposed to disease, but also because sugar is like food for bacteria. These infections, mostly if not “felt” or caught early, can lead to more severe conditions. These include disorders of the bloodstream called septicemia. It can have catastrophic effects on your body, including causing it to go into shock. It happens when the bacteria gets into your bloodstream, causing vasodilation of all your arteries.
It results in additional difficulty for your heart to pump blood and keep your blood pressure high enough to get blood to your other organs and extremities. Further, it requires hospitalizations and intravenous antibiotics. It may even need medications that help boost your heart so it can pump better and keep your blood pressure within acceptable ranges. Don’t forget that high blood pressure long term is not right, but low blood pressure means that your other organs won’t get enough blood, which is also wrong.
- Symptoms of infection:
- Fevers, chills
And in the elderly: changes in mental status. Including confusion or not being able to wake up.
SUMMARY – Best way to control glucose blood sugar, Including “The Sweet Tea on Diabetes.”
You can control the sugar level effectively by employing acceptable practices is necessary. They can help you in developing natural sugar control, thereby making your body immune. Following your doctor’s advice is the best way to reduce blood sugar significantly and grab control over reducing glucose levels.
- Diabetes can be managed with lifestyle behaviors.
- If that’s not enough, medications are needed.
- Reasonable control of lower blood sugars is crucial for your long-term wellbeing.
- Your A1c is how your doctor will monitor your response to treatment.
- Your goal A1c is different based on age.
- Not having blood sugar control leads to increased risk of stroke, heart attack, renal disease, vision decline, nerve damage, including impotence, chronic wounds that won’t heal, leading to amputations.
As always! It is not medical advice. It is meant to inform you of possible complications of diabetes, especially if uncontrolled. You should see your doctor for more information. You can always ask me general questions via IG or email, but make sure that you regularly see your doctor for timely causes and prevention of diabetes.
I hope this post has helped many of you understand the long term consequences of lousy glucose control in diabetes and why doctors will always emphasize the need for adequate dietary lifestyles, exercise, and sleep, and why will offer the help of medications.
Eventually, the damage can be so severe. You might lose consciousness in your hands and feet entirely. It becomes an issue because if you cut your skin, you won’t know or notice, which can lead to un-noticed infections.
Since your nerves are damaged, the bones of your feet can get weak and even fracture. Since you have no sensation, you may continue to walk on it, making the fractures worse, which can change your feet’ shape. It is called Charcot Foot, and it can also lead to amputations.
Your doctor will recommend daily foot checks for cuts or wounds. They may also refer you to podiatry once a year for evaluation.