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Managing diabetes

Managing diabetes

Complications

Over time, if your blood glucose levels (BGL's) are outside of the target range (hyperglycaemia), this can damage your body's organs.

 

Damage to the big blood vessels (macrovascular) can lead to heart attack and stroke. Damage to the small blood vessels (microvascular) can cause eye, kidney, feet and nerve problems.

 

It's important to understand the best ways to keep your BGLs within the target range to reduce your risk of developing these complications and to help you to stay well.

 

Managing your mind

Diabetes and your eyes

Teeth and gums

Your cardiovascular health

Your kidney health

Your sexual health

Diabetes and your feet

Reducing complications from diabetes

 

Managing your mind

When thinking of our health, too often we just think of our physical health, and forget our mental and psychological wellbeing. It's just as important. 

 

Managing your mind and mental health will help you to feel more confident to look after yourself and manage your diabetes.

 

Managing stress and emotions may also help us to feel more positive, perform better at work and have more fulfilling relationships with others. We also know that stress can lead to an increase in our BGL, so it is important to find strategies to help us cope.

 

Keeping your mind healthy
How you manage stress will depend on what works for you. Ways that may assist you might include:

  • Identify and address the problem
  • Talk to someone about your stress
  • Think positively
  • Keep active
  • Find time for hobbies and other leisure activities. Enjoy life!
  • Monitor your blood glucose levels and blood pressure

 

Who can help?
There are many sources of support available such as telephone helplines and local psychology services. Your GP may recommend a referral to a psychologist to work through managing stress, depression, anxiety and other mental health conditions.

 

Diabetes and your eyes

When you have diabetes you are at an increased risk of developing eye complications, which if left untreated can lead to poor vision and blindness. The great news is, almost all serious vision loss can be prevented with regular eye examinations.

 

Some eye complications associated with diabetes include:

  • Blurred Vision - High BGLs can change the shape of the lens in your eye, which can result in blurred vision. When glucose levels return to the target range, vision also usually returns to normal.
  • Cataracts  - This 'clouding' of the eye lens occurs earlier and more rapidly in people living with diabetes. If you have cataracts they can be removed with surgery.
  • Glaucoma - An eye disease in which the optic nerve is damaged. Glaucoma usually progresses slowly. Although it can affect anyone it is more common in people who have diabetes.
  • Retinopathy - Elevated BGLs over time may lead to damage of the tiny vessels that supply blood to the eye. If these vessels become blocked, weak or leaky this can cause loss of vision.

 

How can you keep your eyes healthy?

Regular eye examinations are the best way to monitor any changes in your eyes and vision. It is recommended you have a comprehensive eye examination at least once every two years - check your Annual Cycle of Care to see when your next check-up is due.

 

Who can help?
The members of your diabetes health care team who can help you to look after your eyes include:


GP: Your GP can provide you with referrals to eye specialists.


Optometrist: Your optometrist will examine the different parts of your eyes and assess whether there have been any changes to your vision or eye health. A report will be provided to your GP and you may be referred to an ophthalmologist for further treatment if necessary.


Ophthalmologist: An ophthalmologist (medical eye specialist) will be a part of your team if your eyes require specialised medical treatment such as surgery.

 

Teeth and gums 

Keeping your teeth and gums healthy helps protect you from gum disease. Gum disease (or periodontal disease) is a mouth infection which can get worse over time and can cause an increase in your BGL.

 

What are the signs of gum disease?

  • Red, tender gums that bleed easily
  • Bad breath
  • Pus around the teeth and gums
  • Teeth moving around or loose.

 

When you have diabetes you are at increased risk of developing gum disease compared to people who do not have diabetes. BGL's above the target range can increase your risk even further.

 

Keeping your teeth and gums healthy

The good news is, there is lots you can do to protect yourself from gum disease including:

  • Keeping BGLs in target range
  • Brushing your teeth twice a day, and flossing once a day
  • Visiting your dentist at least once every six months
  • Not smoking.

 

Who can help?
Your dentist and dental hygienist can assist in keeping your teeth and gums healthy. They can also assess and treat any issues with your teeth or gums.

 

A diabetes educator and your dietitian can also help you with maintaining BGLs within target which assists in reducing teeth and gum complications.

 

Your cardiovascular health

People with diabetes can often experience higher blood pressure and 'LDL' or bad cholesterol levels as well as increased blood glucose. When these factors are combined it can significantly increase your risk of heart attack, stroke and damage to the big blood vessels in your body (cardiovascular disease). 

 

Keeping your heart and blood vessels healthy
Reducing your risk of cardiovascular disease is similar to reducing your risk of other diabetes-related complications:

  • Be physically active
  • Maintain a healthy body weight
  • Don't smoke
  • Keep cholesterol and blood pressure within their target ranges.

 

Who can help?
Your GP can monitor your blood pressure, cholesterol and HbA1c. You may require one or more medications to help maintain your blood pressure, cholesterol and blood glucose within recommended targets.

 

Your GP may also refer you to a medical specialist such as a cardiologist who can support you further.

 

An exercise physiologist can also assist by helping you develop an individualised physical activity plan. You might also benefit from seeing a dietitian who can help you incorporate more low fat, low salt and high fibre foods in your diet.

 

Your kidney health
Our kidneys are important for filtering waste products from our blood. Over time, high BGLs and blood pressure can reduce our kidney's ability to filter increasing the risk of diabetic kidney disease, known as nephropathy. Early signs of kidney damage are protein leaking into the urine (microalbuminuria), and a slowing in the kidney's ability to filter the blood. (glomerular filtration rate or eGFR).

 

How can you keep your kidneys healthy?

Reducing the risk of damage to your kidneys is easy by following these simple steps:

  • Be physically active
  • Maintain a healthy body weight
  • Don't smoke
  • Maintain cholesterol and blood pressure within target range
  • Aim to keep your BGLs within target range.

 

Who can help?
It is important for your GP to monitor your kidney filtration rate and monitor the presence of protein in your urine at least once every 12 months. Check your Annual Cycle of Care to see when your next check up is due.

 

Your sexual health

Diabetes can contribute to sexual problems for both men and women. It is important to remember you are not alone, and there is support available to assist you.

Are you a male with diabetes?


Men with diabetes can experience problems with erectile funtion. This is generally due to reduced blood flow and never damage, which can both be affected by diabetes. There a number of treatments avaliable for erectile dysfunction. Speak to your GP or diabetes educator for more information on what's bset for you and partner. 

Are you a female with diabetes?


Diabetes can also impact on women's sexual health. There is less known about how diabetes effects women's sexual health. However, issues may include a decrease in sexual desire, increased vaginal dryness, pain during sexual intercourse and increased episodes of vaginal thrush. Thrush can be reduced by maintaining blood glucose levels within the recommended range. During menstruation (periods) or menopause a women's diabetes management may need to change. Speak with your GP or diabetes educator for more information. 

 

Diabetes and your feet

Caring for your feet is a very important part of your diabetes management. Complications of diabetes that can affect your feet include reduced sensation (peripheral neuropathy) or reduced blood flow (peripheral vascular disease).

 

How do you avoid problems with your feet?
Managing your diabetes, and in particular your BGLs, will go a long way to delaying or preventing complications with your feet.

 

Our top tips to remember when caring for your feet include:

  • Get to know your feet, wash and dry them carefully each day
  • Check for any bruises, blisters, or new marks
  • Seek medical advice if you notice any changes to your feet
  • Cut your toenails regularly. If you can't see or reach your feet have someone help you.

 

Who can help?
A podiatrist can help you look after your feet and is a key member of your diabetes healthcare team. They can complete foot checks and other assessments to determine your risk of developing any serious problems. A podiatrist can also provide you with advice on caring for your feet and appropriate foot wear. They can even show you how to check your feet at home.

 

It is recommended you have your feet checked at least twice a year by a health professional. If you aren't able to see a podiatrist your GP, Practice Nurse or specialist can check your feet for you. Refer to your Annual Cycle of Care to see when your next check-up is due.

 

Reducing complications from diabetes

  • Manage your diabetes well
  • Keep your blood glucose, blood pressure and cholesterol at target levels
  • Remember to see your GP for all your recommended screening tests
  • Take all prescribed treatments
  • Don't smoke. Call Quitline on 13 7848 for help
  • Be physically active for at least 30 minutes, five times a week
  • Follow a healthy eating plan
  • Limit your alcohol intake
  • Lose excess weight
  • Look after your feet and choose footwear that protects them.