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Quality Diabetes Management: Long-Term Benefits
Have you ever spilled a sweet drink? Makes quite a sticky mess. Excess sugar in the bloodstream causes a sticky mess as well. Sugar sticks to proteins and cells in the blood, keeping them from performing their normal functions. It can also damage the smooth inner lining of blood vessels, making them susceptible to a variety of problems, from leaking to hardening to thickening and eventual clogging.
The damage caused by elevated blood sugar levels can begin within a few years of diagnosis. For those with type 2 diabetes, damage may already exist at the time of diagnosis, since the disease may have been present for many years. Diabetes is the fifth leading cause of death in the United States. It is the leading cause of blindness and new cases of kidney failure. It impairs circulation in the extremities, which limits the body’s ability to fight infection. It damages nerve fibers that signal to us when a problem is present – further exposing us to injury and infection. As a result, diabetes contributes to 60,000 foot and leg amputations annually in the United States.
Diabetes is the most common cause of erectile dysfunction (impotency) in men, affecting 50 – 60% of all men with diabetes over age 50. it can also cause vaginal dryness and reduced sexual arousal. Diabetic nerve diseases cause a variety of digestive, thermoregulatory, urinary, and cardiovascular ailments. Heart disease and stroke are two to four times more common – and substantially more deadly – in people with diabetes. Poor diabetes management accelerates periodontal (gum) disease, resulting in oral infections and premature tooth loss for thousands of people. Because sugar tends to stick to the collagen surrounding tendons and ligaments, poorly controlled diabetes is linked to limited joint mobility syndromes such as frozen shoulder and trigger fingers.
Elevated blood sugar levels during pregnancy contribute to a variety of birth defects; the risk of miscarriage is four times greater for women with diabetes.
Overall, the annual health care cost for a person with diabetes exceeds $13,000 per year, compared to just over $2,500 for a person without diabetes. In 2002, treating diabetes and its complications in the United States cost more than $90 billion. Add nearly $40 billion in indirect costs resulting from disability and lost productivity, and the total annual cost of diabetes in the United States exceeds $130 billion.
Even though most diabetic complications appear several years after diagnosis, minor damage can begin within the first few years. Two major studies: The Diabetes Control and Complications Trial (DCCT – United States) and the United Kingdom Prospective Diabetes Study (UKPDS) confirmed that intense blood sugar control can dramatically reduce the risk for long- term diabetic complications.
In the DCCT, conducted from 1983 to 1993, more than 1,400 people with type 1 diabetes and mild (if any) existing complications were randomly assigned to either an intensive therapy group (three or more injections daily or use of an insulin dosage adjustment for diet/exercise), or a conventional therapy group (one or two fixed doses of insulin and one or two blood sugar tests daily). The participants were followed for an average of 6 years. The intensive therapy group had an average HbA1c of just over 7% (average blood sugar 150-160 mg/dl or 8.3–8.9 mmol), whereas the conventional therapy group was over 9% (average blood sugar 210-220 mg/dl or 11.7-12.2 mmol). Intensive therapy reduced the risk of retinopathy (eye disease) by 76%, nephropathy (kidney disease) by 54%, and neuropathy (nerve disease) by 60%. The UKPDS produced similar results for people with type 2 diabetes.
The DCCT and UKPDS research studies proved that intensive blood sugar control dramatically reduces the chances of developing long-term diabetic complications.
The math is quite simple. Every 1-point reduction in HbA1c corresponds with about a 30% reduction in your risk of developing complications. Amazing! If you lower your HbA1c from 10 to 9, you reduce your risk by 30%. Go from 9 to 8, another 30% reduction. Amazing! It’s like getting a clearance discount on an item that is already on sale!
Of course, nothing is guaranteed. I’ve seen plenty of people with A1c’s in the 6s and 7s who developed complications, and some in the 9s and 10s who never developed a problem. But the simple fact is this: Getting and keeping your A1c down puts the odds tremendously in your favor. With so many things beyond our control, it makes sense to do this one important thing to help ensure a healthy future.
Another long-term benefit of good blood sugar is optimal growth. For children and adolescents, optimizing blood sugar levels will result in enhanced muscle and bone development. Elevated blood sugars typically reflect a deficiency of insulin, which is needed to fuel growing body tissues. Case in point: A high school basketball phenom, projected to be approximately 6’4” by the time he graduated, topped off at only 5’11” by the end of his senior year. The reason: During his junior and senior years, he all but ignored his diabetes, and with his A1c climbing from 8% to over 14%. He grew only 1 inch during those 2 critical years and likely will never be more than 6 feet tall. Adequate insulin will help ensure that you reach your maximal height and muscle development.
Quality Diabetes Management: Short-Term Benefits
Immediate gratification – two words that motivate us like nothing else. If the thought of possibly preventing health problems several years from now fails to get you excited about controlling your blood sugars, perhaps these two words will.
Effective management of diabetes produces a number of important, immediate benefits:
Enhanced physical performance:
Improved blood glucose control will boost your strength, flexibility, stamina, speed, and overall energy level. Your reaction times will be quicker and you will recover from injuries more rapidly. Many of my patients have tracked their performance in a variety of sports (basketball, hockey, sprinting, swimming, lacrosse, tennis, etc.) and have consistently performed best when blood sugars are well controlled. One young man’s first MVP trophy coincided with the first time he managed to keep his blood sugar in the 100s (5.5-11mmol) throughout a tournament. High blood sugar (hyperglycemia) tends to produce dehydration, impair visual acuity, and slow reflexes. Muscle loss and cramping are also common side effects of hyperglycemia. Low blood sugars result in insufficient fuel for working muscles and may impair the brain’s ability to coordinate movements. You’re likely to see improved performance in everyday activities as well as athletics when your blood sugars are near normal.
Enhanced Intellectual Performance:
Proper blood sugar regulation will improve your ability to focus, memorize, and perform complex tasks. With hypoglycemia (low blood sugar), the brain is deprived of sufficient fuel to function properly. Repeated bouts of severe hypoglycemia can result in learning deficits. High blood sugars, on the other hand, tend to cause “sluggishness.” The increased mental energy resulting from quality blood sugar control should yield positive results at work as well as school.
Enhanced Social/Coping Skills:
It didn’t take my wife long to realize that my moods are affected by my blood sugar levels. For most people, low blood sugars cause a variety of unusual behaviors. High blood sugars impair our ability to deal with stress and interact effectively with other people. Irritability seems to increase with high blood sugars. Keeping your diabetes in check might just allow you to enhance your social standing and find simple solutions to many of your daily challenges.
Better Sleep:
Perhaps the only thing worse than a low blood sugar waking you up in the middle of the night is a full bladder causing you to toss and turn until, you dash to the bathroom for a good 2-minute sugar-induced pee. Keeping your nighttime blood sugars under good control will allow you to get some well-deserved rest.
Fewer Infections:
High blood sugars create a virtual breeding ground got viruses and bacteria. Improving your blood sugar control should result in fewer and less severe infections – including vaginal yeast infections, skin infections, urinary tract infections, upper respiratory infections, and common colds.
Healthier Skin:
Another side effect of chronically high blood sugar is dry skin and an increased tendency towards acne. Maintaining normal blood sugar levels helps to keep skin moist and provides less fuel for bacteria-causing blemishes.
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