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Diabetes is associated with many complications including
eye disease, kidney disease, neuropathic foot disease and
coronary heart disease. This is because high
glucose damages the
arteries of these organs. The damage is worse if blood pressure and cholesterol levels are also high.
Proven associations exist also for a relationship between
blood glucose levels and
erectile dysfunction, gastrointestinal symptoms and
rheumatological complaints.
The development of these complications is not inevitable and can be reduced significantly by managing the control of Glucose, Blood pressure, and Cholesterol.
The 3 C’s.
Always check with your Doctor before changing your medications or diet as you Doctor will have your medical history and is best equipped to deal with your medical concerns.
The 3 C's...
Control your blood sugar
Control your blood pressure
Control your cholesterol levels
Glucose
Glucose can be measured easily at home using a
glucometer in certain situations such as before and after meals.
However, it is the laboratory based test,
glycated haemoglobin (HbA1c), which is usually performed at the clinic, and which provides us with most evidenced based information about diabetes control and complications.
The
HbA1c level is a long-term assessment of blood glucose control because the test gives us a measure of the average glucose levels over a period of time.
Some caution is needed when assessing the
HbA1c result in someone with other medical conditions which affect haemoglobin levels and also in people whose high glucose spikes are balanced by multiple episodes of low blood glucose. On the whole, however, this test has proven very useful for researchers to answer the questions about what level of diabetes control causes complications and what level is more likely to prevent them. The results after many decades of study in patients with both
Type 1 and
Type 2 diabetes are quite consistent. A low and good
HbA1c result is associated with a very significant reduction in all diabetes related complications.
Blood pressure
It is advisable to establish the level of your
blood pressure control first with your doctor.
Blood pressure can be measured by a
blood pressure monitoring machine purchased at any Pharmacy.
An acceptable
blood pressure to aim for would be a level of about
130/80 or below. The lower the
blood pressure the better. Lower
blood pressures have been demonstrated to decrease the risk of diabetes complications. If yours is high your doctor will assess with you any contributing factors such as being
overweight or having a high content of
salt in your diet.
If the
blood pressure stays high, it is usual to recommend taking medicines to lower
blood pressure. These are known as
anti-hypertensives and the aim of treatment is to lower the
blood pressure to within a target range, for example lower than
130/80 if possible.
Cholesterol
Cholesterol levels are measured in blood samples and are usually checked at the diabetes clinic. The laboratory is able to analyse the different sub-fractions of the sample and provide a table of the result.
Cholesterol is basically fat and high levels in the blood can block your arteries causing
heart attacks and
strokes.
The table will include the total
cholesterol level, the
LDL cholesterol level (so called
'bad' cholesterol), the
HDL cholesterol level (so called
'good' cholesterol) and another blood fat called
triglycerides. These individual fractions give us more information about the risk of
cardiovascular complications compared to measuring just one of the fractions.
International research publications in this area are very consistent. High levels of total
cholesterol, 'bad' LDL cholesterol and
triglycerides are associated with narrowing of the arteries.
HDL 'good' cholesterol helps keeps the arteries clear of fat deposits and for this reason we like to see high levels in the blood.
The medicines, which are most often prescribed to lower
cholesterol levels, are called
statins. The drugs are highly effective at not only lowering the
bad cholesterol levels but they also very significantly lower the incidence of
coronary heart disease in people with diabetes
There are also several things which lower blood fats. Weight loss and exercise is very effective. Changing to a diet, which is low in saturated fat, also works.