A few weeks ago we were delighted to be able to interview Dr Max Pemberton about the key questions many of us has about diabetes.
We covered one of these topics in a post a few days ago because we felt that the definition of type 1 , type 2, type 3 and type 1.5 (as well as gestational diabetes and pre-diabetes) was important enough to cover in its own post. You can check it out here.
Today we want to look at the treatments and complication of diabetes. So we lined up Max for a few more questions.
Patient Talk:- What are the treatments available for diabetes?
Max Pemberton:- So in recent years there’s been loads of developments in the way that we manage diabetes. As well as making key lifestyle changes, people with both Type 1 and Type 2 diabetes often need additional treatments such as medication like insulin to control their diabetes as well as things like their blood pressure and their blood fats so that’s their cholesterol.
Complications of Diabetes
Patient Talk:- Would you be able to elaborate on some of the complications of diabetes?
Max Pemberton:- So this is really important and this is why we take blood glucose levels so seriously is because if particularly, people have high blood glucose levels over long periods of time, it can cause really serious physical health complications and they include things like damage to blood vessels so that people are at increased risk of strokes and heart attacks. It can also cause damage to the very fine delicate blood vessels so that can cause problems with people’s kidneys. It can also cause problems with people’s eyesight so a condition called diabetic retinopathy whereby the delicate blood vessels at the back of the eye have problems and it can result in blindness. In fact it’s the leading cause of blindness in the UK. It can also develop things to do with circulation in the legs, for example where people can develop ulcers and in really extreme circumstances the circulation is so bad that people actually have to have their legs amputated.
Diabetic retinopathy and Diabetic foot ulcers
Patient Talk:- Explain what diabetic retinopathy and diabetic ulcers are?
Max Pemberton:- Diabetic retinopathy as I say it’s the leading cause of blindness in the UK so it’s so important that people get checked for this. On the NHS, everybody with a diagnosis of diabetes is entitled to free eye checks and I cannot emphasise enough the importance of going regularly to the optician to get your eyesight checked and make sure that this isn’t happening. If it is happening there’s tweaks and changes that can happen to your medication. Better blood glucose control can help it and various other procedures that doctors can do but it really is absolutely key that people are getting this monitored and also the same with the diabetic ulcers – so foot ulcers where the skin breaks down and forms an open sore and because of the difficulties of circulation they can take a really long time to heal. Sometimes they can be started by very small, tiny cuts or relatively insignificant wounds and one of the problems with diabetes is that some of the change that happens to circulation can also affect the very fine delicate nerves that are in the bottom of the feet so that often people can have damage to their feet – they stand on a drawing pin for example – and because the nerves in their feet aren’t working quite as well as they should do, they don’t actually feel it, they don’t realise that they’ve caused any damage and then that over time can develop into an ulcer. So again that’s why it’s really important that people with a diagnosis of diabetes go regularly to the chiropodist or podiatrist and they are entitled to free foot care on the NHS.
Prevention of Diabetes
Patient Talk:- In terms of lifestyle, what can be done to prevent diabetes? Are there any suggestions or advice?
Max Pemberton:- So there’s a whole range of lifestyle changes that can be made. So losing weight is really important, doing regular exercise, and also if you know family members who have a diagnosis of diabetes already it is important that you go regularly to the doctor to see whether or not you need to get checked to see if you’ve got diabetes. It’s not always obvious when somebody first develops it. The kind of typical presentation, things like feeling thirsty or tired or weight loss, they only happen to about half of patients, the other half have diabetes and they’re not aware of it and it’s picked up on routine screening. If people want more information there’s a website that’s being setup specifically to help people understand this delicate balance that has to take place when you have diabetes between the high blood glucose and the low blood glucose levels and that website is www.diabeteshighsandlows.co.uk