Preventing Complications

People routinely ask me if there will be a cure for diabetes some time soon. Well, I wish I could say there is something just around the corner, but I'm afraid if there is, we're going to have to walk a pretty long block until we get to that corner. But, let me stress that even if research stood still, even if we never had better therapy than we have right now, we (note that I am including you when I say we) have the means today to reduce your risk of diabetes complications by up to 75 percent!

On this page I look at the most important measures you can to take to prevent complications. You will find a further discussion about protecting yourself from heart attack and stroke here.  I discuss screening for complications here and treating/monitoring complications here.

These are the most important measures you can take to help prevent getting diabetes complications:

Eat healthfully. Eat the right types of foods in the right amounts. Avoid unhealthy foods like saturated and trans fats. Meet with a registered dietitian to learn all about healthy eating strategies.

Control your weight. Aim for a BMI less than 25.0. (And if you don't get there, remember that if you are overweight, any weight loss can be helpful.) You can calculate your BMI here.

Don't smoke. Everything about diabetes managment is negotiable...except smoking. If you have diabetes and you smoke your arteries are guaranteed to clog and put you at enormous risk of stroke, heart attack, amputations, erectile dysfunction, eye damage, and the sad list goes on and on. If you have diabetes and you smoke, I can't encourage you strongly enough to do everything in your power to lick the addiction. (Speaking of which there are some effective therapies out there to help you if you need them including nicotine patches, Zyban, and Champix.)

Don't drink excess alcohol. Up to 1 drink a day for a woman, 2 a day for a man isokay; more than that is unwise. (And no you can't save up your 2 a day and qualf 14 Ex while you watch HNIC on a Saturday night!)

Exercise.  Aim for a minimum of 150 minutes per week (that averages out to about 20 or so minutes per day). Do the exercise you enjoy (or at least can tolerate); there's no point doing exercise you hate because you're not likely to stick with it.  Excercise doesn't just mean cardio activites (such as walking and biking); resistance training (lifting weights) is also helpful.

Control your blood glucose levels. Aim for before-meal blood glucose levels of 4 to 7; two hour after meal blood glucose levels of 5 to 10 (sometimes, 5 to 8 depending on your situation); an A1C of 7 or less.

Keep your blood cholesterol in target. Most important is to keep your LDL cholesterol no higher than 2.0. For most people this can be readily achieved with a combination of following a low fat diet and taking statin medication.

Keep your blood pressure in target. The goal is for your blood pressure to be less than 130/80. This often requires use of blood pressure-lowering medication (or even several different ones used together).

Take an ACE inhibitor or ARB medication if you are high risk of a heart attack or stroke. ACE inhibitors are excellent medications to treat high blood pressure, however if you are at high risk of a heart attack or stroke, this risk will be substantially reduced by taking an ACE inhibitor or ARB even if your blood pressure is normal to start with. You can learn more about this here.
 
Take a daily ASA (such as aspirin)? The court is still out on whether taking ASA reduces the risk of heart attack and stroke if you have diabetes. If you've already had a heart attack or stroke, taking ASA is likely a good idea; however if you've not had such a complication then the evidence for the benefits of ASA are more uncertain.