Managing Your Diabetes in the Short Term, to Live Better in the Long Term
In a world where instant gratification is increasingly possible, managing your diabetes, or any chronic disease, can be difficult. Considering the long-term impact of poor control might seem unnecessary when the short-term side effects aren’t so bad. But the truth is, for most chronic diseases, what you do now has a huge effect on how you live in the future.
Understanding what your daily, unpleasant treatments prevent is a critical part of motivating yourself to continue managing your diabetes. If you don’t know what not pricking your finger multiple times a day to check your blood sugar, not injecting yourself with insulin regularly, and/or not watching your intake of carbohydrates will lead to later in life, you have little reason to give up the delicious taste of bread. So, I’m here to shed some additional light on the topic.
Long term effects of not managing your diabetes
Many people think there’s plenty of leeway with blood sugar levels, particularly when they’re not feeling ‘bad.’ As long as your blood sugar isn’t so high as to cause a diabetic coma or other diabetes complications, there’s nothing to worry about, right? Wrong. Our bodies adapt in the short term by trying to process excess blood glucose, and – in the short term — they generally do a decent job. But over time, even if you can’t feel it, excess blood glucose significantly wears down our bodies — most notably, it wears down our large blood vessels and the small blood vessels of our kidneys, eyes, and nerves.
When large blood vessels wear out, it’s easier for inflammatory and cholesterol-related plaques to form in them, causing what is known as macrovascular complications, that is, heart disease, peripheral arterial disease, and stroke. Heart disease is one of the most serious diabetes complications because – when combined with nerve damage (see below) – it may not even present with the classic symptoms of chest and left arm pain. While there is no data to confirm tighter blood sugar control in and of itself decreases the rates of heart disease and stroke in patients with diabetes, studies have shown that controlling hypertension, hyperlipidemia, and obesity in patients with diabetes can lower their risk of the kind of vascular wear-and-tear that creates an environment for these serious long-term effects of diabetes that’s been poorly managed.
Complications of the small blood vessels, or, microvascular complications, are less well known, but can be equally devastating for diabetes patients. Diabetic nephropathy (kidney disease) can cause complete kidney failure, while diabetic retinopathy (eye disease) can lead to blindness. Diabetic neuropathy (nerve disease) can cause debilitating pain in the lower extremities and can crescendo to a severe lack of sensation and chronic foot ulcers that become infected and require amputation. Multiple studies have shown that all of these long-term effects of diabetes that has been poorly managed are entirely preventable through day-to-day tightening of blood sugar control, which makes their onset all the more heartbreaking.
The best way to guard against these long-term complications of diabetes is to stay on top of managing diabetes now. Patients with diabetes should meet with their doctors every 3 to 4 months for routine check-ups that track blood sugar and screen for microvascular complications. Patients should also have regular eye exams to screen for diabetic retinopathy, regular urine testing to screen for diabetic nephropathy, and regular foot exams to screen for diabetic neuropathy.
The time and effort and restrictions you face in managing your diabetes may be frustrating, annoying, or seem unimportant now, particularly if you feel well. But you’ll thank yourself in the years ahead when you have a better quality of life and fewer (if any) diabetes complications.