Prevention and Management of complications
Whether you have type 1 or type 2 diabetes, if blood sugar is not controlled properly you may develop one or more complications. Therefore, keep your blood sugar in the range that is best for you and regularly monitor your status.
Heart and blood vessels disease
People with diabetes have to be extra cautious of heart and blood vessel disease. Diabetes carries an increased risk for heart attack, stroke, and complications related to poor circulation. Do your best to follow a heart-healthy lifestyle:
- Keep your blood glucose levels as near to normal as possible.
- Quit smoking as it causes narrowing of blood vessels and also increases the levels of fats (low density lipoproteins i.e. the bad cholesterol) in your blood.
- Keep blood pressure under control.
- Keep blood fat levels in the good range especially cholesterol. Eat less saturated fat.
- See your doctor regularly for monitoring blood pressure, bloodfat levels, and overall blood glucose control. The doctor may also check pulse rate in your feet and legs to see if you have good circulation.
- Eat a heart-healthy diet : low in fat and salt.
- Regular aerobic exercise (such as walking or swimming), can improve your blood fat levels and your overall cardiovascular fitness.
- Avoid alcohol
- If the doctor suspects the involvement of heart he may recommend you certain tests like ECG (Electrocardiogram), coronary arteriography (which is a set of X-ray pictures of the heart and coronary arteries taken after a dye is sent through the same tube used for catheterization) to check your heart status.
- Arsenic album, Aurum Metallicum, Lecithin, Phosphorous.
Diabetic eye diseases
Get your eyes checked once a year. Finding and treating the disease early, before it causes vision loss or blindness, is the best way to control diabetic eye disease. Diabetic eye disease can be prevented by dedicatedly ensuing the following guidelines :
- First and most important, keep your blood glucose levels undertight control.
- Keep blood pressure under control as it can make eye problems worse.
- Try to quit smoking.
- Meet an eye specialist if:
- your vision becomes blurry.
- you have problem in reading.
- you see double.
- one or both of your eyes hurt.
- you feel pressure in your eye.
- you see dark spots or flashing light.
- If your eyes are already damaged, an eye doctor may be able to save your sight with laser treatment or surgery.
- Phosphorous, Argentum nitricum, Natrum muriaticum
Diabetic kidney disease can be prevented by keeping your blood glucose levels within the normal limits. This will also help in preventing loss of protein in urine. Other guidelines include :
- Get your urine tested once a year for signs of kidney damage.
- Keep your blood pressure under control.
- Ask your doctor whether you should reduce the amount ofprotein in your diet.
- Have your urine checked yearly for microalbumin (small amount of protein in urine) and protein. If there is protein in your urine, have your blood checked for elevated amounts of waste products such as creatinine.
- Meet your doctor immediately if you have :
- cloudy or bloody urine
- frequent urination
- pain or burning on urination
- back pain
- chills and fever.
But once kidneys fails, patient must undergo dialysis or kidney transplant.
- For albuminuria : Argentum nitricum, Apis, Arsenic album, Aurum metallicum, Helleborus, Helonias, Kali bichromicum, Nitric acid, Phosphoric acid, Phosphorous, Plumbum metallicum, Secale cor, Terebinth, Uranium nitricum
Nerve Damage (Diabetic neuropathy)
Treatment aims to relieve discomfort and prevent further tissue damage. To prevent nerve damage follow these basic guidelines :
- Control your blood sugar levels.
- Attain an ideal weight.
- Follow a regular exercise program. Check with your doctorbefore starting exercises that can be unsafe for your feet, such as running or aerobics.
- Quit smoking as it increases risk of vascular problems, thereby causing neuropathy and heart disease.
- Avoid alcohol.
- Take special care of your feet. Because of the loss of sensation caused by neuropathy, sores or injuries to the feet may not be noticed and may become worse, therefore foot care becomes very essential.
- For peripheral neuropathy : Phosphorous, Argentum Metallicum, Aurum metallicum, Nux vomica, Silicea, Causticum
- For autonomic neuropathy
- Urinary symptoms : Nux vomica, Phosphorous, Opium
- Impotency : Argentum nitricum, Graphites, Lycopodium, Phosphorous, Picric acid, Plumbum metallicum, Selenium
- Indigestion : Chelidonium, Hepar sulph, Kali bichromicum, Kali iodatum, Lycopodium, Mercurius solubilis, Nitric acid, Nux vomica
People with high glucose levels tend to have a very sensitive skin and less ability to fight off harmful bacteria. Both these conditions increase the risk of infection. If the infection or any injury is not treated on time necrosis (death of tissue) and gangrene (infection of dead tissue) may result. Here are some important steps you can take to avoid skin problems :
- Keep your blood glucose levels under tight control
- Keep your skin clean and dry as moisture encourages fungus to grow. Use talcum powder in areas where skin touches skin, such as armpits, groin, between the toes.
- Avoid very hot baths and showers.
- Prevent dry skin. Use any of the commonly available moisturizers to prevent excessive dryness, especially in cold or windy weather.
- Treat wounds right away. Consult a doctor immediately if you get a major cut, burn, or infection.
- Take good care of your feet.
- Consult a skin specialist immediately if there is any major problem such as non-healing of wounds.
- For boils and carbuncle : Arnica, Phosphorous, Arsenic, Silicea, Hepar sulph
- For gangrene : Arsenic album, Aurum metallicum, Carbo veg, Lachesis, Mercurius sol, Phosphoric acid, Secale cor, Sulphur, Sulphuric acid
Poor blood sugar control makes gum problems more likely hence keep your blood glucose level under control. Other guidelines include :
- Visit your dentist at least twice a year.
- Look for early signs of gum disease.
- Consult your dentist immediately if you :
- have bad breath
- bleeding from gums
- swelling of gums
- pus between gums and teeth
- gums pulled away from teeth.
- Brush at least twice a day and floss at least once a day. Ask your dentist to show you the correct way to brush and floss.
- Arsenic album, Carbo veg, Hepar sulph, Natrum muriaticum, Nitric acid, Sulphur.
There are many things you can do to keep your feet healthy :
- Keep your blood sugar in control.
- Make sure your doctor checks your feet at least once a year.
- Check your feet daily for presence of any blisters, cuts, scratches, sores, redness, increased warmth, ingrown toenails, corns and calluses.
- Wash your feet in warm (not hot) water every day. Use a mild soap. Do not soak your feet. Dry your feet carefully with a soft towel, especially between the toes.
- Never cut the corners of your nails.
- File the nails straight across never file them shorter than the underlying soft tissues of the toe
- Wear shoes that fit your feet well and allow your toes to move. Check inside your shoes before wearing them.
- Cover your feet with a lotion or petroleum jelly after washing them, before putting on your shoes and socks. Do not put the lotion or jelly between your toe.
- Wear soft socks with a padding to protect your feet at pressure points.
- Never walk barefoot as you may injure your feet. Always keep the slippers by your bed.
- Avoid sitting with your legs crossed as it can reduce the flow of blood to the feet.
- Consult your doctor at the first sign of any foot problem
- If you are not able to take care of your own feet, ask your doctor to recommend a podiatrist (specialist in the care and treatment of feet) who can help.
- For corns and callosities : Antimonium crudum, Arnica, Lycopodium, Phosphorous, Phosphoric acid, Sulphur
Diabetic ketoacidosis and coma
The main aim is to control blood glucose level. Other guidelines include:
- Diabetic patient must learn to recognize the early warning signs and symptoms of ketoacidosis.
- Call your doctor as soon as you observe early symptoms of ketoacidosis.
- Get your urine tested at regular intervals to detect presence ofketones.
- Once ketoacidosis becomes severe hospitalization is required to control the condition :
- First of all the cause has to be identified and treated.
- Insulin replacement therapy is given to control blood glucose level.
- Dehydration is treated by fluid and electrolytes replacement therapy.
- If ketoacidosis is not treated timely it may progress to diabetic coma. Treatment will again include :
- Fluid and electrolyte replacement.
- Insulin replacement.
- For ketoacidosis : Acetic acid, Camphor
- For diabetic stupor or coma : Carbo veg, Opium, Hyoscyamus, Nux vomica, Phosphorous.
Episodes of hypoglycemia can be prevented by :
- Monitoring blood sugar levels frequently.
- Learning to recognize the symptoms of low blood sugar and the situations that may cause it.
- Always carrying candy, juice, or sugar packets.
- Educating the friends and relatives about the symptoms of hypoglycemia and how to treat it in case of emergency.
- For treatment:
- In mild to moderate cases of hypoglycemia patient should be administered three to five pieces of hard candy, two to three packets of sugar, or half a cup (four ounces) of fruit juice.
- If there is not much response within 15 minutes, additional oral sugar should be provided or the patient should receive emergency medical treatment including the intravenous administration of glucose.