Keeping your HbA1c in the target range reduces the chance of getting long-term complications.
Complications
High blood glucose results over time can damage the body’s blood vessels. Small blood vessel damage occurs in the eyes, kidneys and nerves, while large blood vessel damage may cause heart attacks, strokes and other serious complications.. The best way to deal with complications is to avoid them altogether.
The risk of both DKA and long-term problems rises with HbA1c.
There are many ways that the risk of developing diabetes related complications can be reduced:
- Never smoke
- Eat a healthy, balanced diet
- Be more physically active
- Try to keep to a healthy weight
- Take medication as prescribed
- Keep blood glucose levels on target – aim for HbA1c less than 48mmol/mol
- Blood pressure and cholesterol checks every year for those over 12 years old
Eye Problems (retinopathy)
High blood glucose results may affect the eyes in a number of ways. It takes about 4 or 5 years before any damage to the eyes can be detected, and such changes are rare under the age of 12 years. If you are over 12 years old, your eyes should be checked every year. Diabetes eye disease is the most common cause of adult sight problems in the United Kingdom.
Kidney Problems (nephropathy)
Kidneys filter waste from the blood, and keep substances such as protein within the body. High glucose levels damage this filter system, and protein may leak into the urine. High blood pressure may also occur. The test for protein in the urine is very sensitive and quite often needs to be rechecked to see if it is persistently abnormal. As with eye problems, the most common cause of kidney failure in adults in the United Kingdom is poorly controlled diabetes. However, it is very unusual to find diabetes-related kidney problems in children and young people.
Large blood vessel disease (vascular disease)
Large blood vessels supply the body with oxygen (from the lungs) and nutrients (from our food). If a diet is high in fat, and little exercise is taken, arteries are blocked leading to heart attacks, strokes, and poor blood supply to the feet and other parts of the body. This process occurs more widely and more rapidly with poorly-controlled diabetes.
Nerve Problems & Feet (neuropathy)
Nerve damage in the arms and legs occurs over many years of repeatedly high blood glucose. When the nerves fail to work properly, they cannot send messages about pain and touch to the brain. Damage is more likely to occur to the feet, but is very rare in children and adolescents. We do not usually test for this, but adult clinics will test for nerve and foot problems very carefully.
Gut Problems
We are not normally aware of the gut working, but damage to the nerve supply may cause the stomach to empty slowly after a meal, as well as causing other gut problems such as diarrhoea or constipation.
Other associated conditions
Compared to the rest of the population, some medical conditions occur more often in people who have diabetes. The organs most commonly affected include:
The recommendation is that blood tests to check thyroid function are taken every year, and coeliac antibody levels are tested every few years. Adrenal function tests are carried out if there are symptoms suggestive of Addisons’ disease.
- Thyroid gland - hypothyroidism (underactive thyroid gland)
- Small intestine - coeliac disease (gut hyper-sensitivity to gluten )
- Adrenal gland - hypoadrenalism/“Addison’s Disease” (underactive adrenal gland)
The recommendation is that blood tests to check thyroid function are taken every year, and coeliac antibody levels are tested every few years. Adrenal function tests are carried out if there are symptoms suggestive of Addisons’ disease.
