Organ protection from Clutches of Diabetes

What are the organs that can be damaged by Diabetes?

High blood sugar for a few days may not create lots of problem but if high sugar remains for some time chronic complications set in. We are concerned about the eyes, kidneys and the nerves.

Circulation can be a problem with diabetes and that’s why the problem with the heart (angina, heart attack), Brain (stroke) and leg (diabetic foot) are common in Diabetes.

How do I know whether I have Diabetic eye disease?

At the beginning you may not have symptoms, so the only way is to check the eye (specially the back of eye called retina). If you have Diabetes and are seeing an eye specialist you must tell him or her that you have Diabetes.

The specialist will do the required check. If you have already Diabetic eye disease, the specialist will also tell the solution. Remember Diabetes is the commonest cause of blindness all over the world and early detection and treatment can prevent that.

Why people with Diabetes develop foot problem?

Foot problem can be there for three reasons in people with Diabetes. The first and the most common is Diabetes affecting the nerves so that you don’t feel the pain when you get hurt or pricked. The unnoticed and uncared wound gets deeper and bigger.

The next is Diabetes affecting the circulation so that blood supply becomes less and the wound does not heal. Lack of circulation can also cause gangrene. The other one, as you will know, Diabetes reduces the resistance to infection, so the wound gets infected and does not heal. Amputation of toes/limb is 25 times commoner in people with Diabetes in comparison to general population.

What are the warning signs of Diabetic foot?

There are certain features when patient with Diabetes should consult doctor without wasting time. They are redness, unusual pain, ulcer or cut, swelling and change of colour. Delay in getting treatment may lead to septic or gangrene.

How to check for Diabetic Kidney?

At the beginning you may not have symptoms, so the only way is to check for it. The simple things are to check urine for protein and blood for creatinine.

Protein starts leaking in urine when the kidneys are affected with Diabetes and we have treatment available now for this. Ultrasound scan of the kidney is not helpful for diagnosis of Diabetic kidney disease.

What is the relation between Diabetes and BP or Cholesterol?

Adult (or type 2) Diabetes is very often associated with high blood pressure, blood cholesterol and obesity. This is called Metabolic Syndrome. For complete management we should look from all these angles.

What is the target BP in Diabetes?

Target BP is less than 130/80 mm, we should be taking good effort to keep BP normal as it is clear from the current medical research that BP control in people with Diabetes is equally if not more important than controlling Diabetes.

Is heart attack or stroke common in Diabetes?

Heart attack is at least five times more common in people with Diabetes than without and stroke four times. This is because circulation is affected in Diabetes and unfortunately this happens all over the body.

We are concerned for three organs mainly; the compromise of circulation in the heart gives rise to angina or heart attack. Similar problem in brain would give rise to stroke and in the feet would result into gangrene.

What are the minimum tests to be done given the fact that there is no end of tests these days?

Routine test of urine to check for infection and protein is very important. Blood should be checked for kidney function (creatinine and cholesterol). A detailed eye check up should be done by an eye specialist. An electrocardiogram on top of detailed clinical examination is all that is usually necessary for assessment of circulation in routine clinical practice.

How frequently tests should be done?

If the reports are normal, we recommend them doing once in a year. If they are not normal, your doctor will decide you what to do and whom to see.

Teamwork is the key for success

There have to be a teamwork for success. The team includes family physician, diabetes physician, diabetes nurses, dieticians, foot care specialists, medical specialists like eye specialists, surgeons, cardiologists, etc.

Obviously the cornerstone is the patient and family. We need help from government and non-governmental agencies interested in healthcare, pharmaceutical companies and importantly media who have a tremendous role in taking the message to the mass.