Over time, if your blood glucose levels (BGL's) are outside of the target range (hyperglycaemia), this can damage your body’s organs. Damage to the big blood vessels (macrovascular) can lead to heart attack and stroke. Damage to the small blood vessels (microvascular) can cause eye, kidney, feet and nerve problems.
It’s important to understand the best ways to keep your BGLs within the target range to reduce your risk of developing these complications and to help you to stay well.
When thinking of our health, too often we just think of our physical health, and forget our mental and psychological wellbeing. It’s just as important!
Managing your mind and mental health will help you to feel more confident to look after yourself and manage your diabetes.
Managing stress and emotions may also help us to feel more positive, perform better at work and have more fulfilling relationships with others. We also know that stress can lead to an increase in our BGL, so it is important to find strategies to help us cope.
Keeping your mind healthy
How you manage stress will depend on what works for you. Ways that may assist you might include:
Who can help?
There are many sources of support available such as telephone helplines and local psychology services. Your GP may recommend a referral to a psychologist to work through managing stress, depression, anxiety and other mental health conditions.
When you have diabetes you are at an increased risk of developing eye complications, which if left untreated can lead to poor vision and blindness. The great news is, almost all serious vision loss can be prevented with regular eye examinations!
Some eye complications associated with diabetes include:
How can you keep your eyes healthy?
Regular eye examinations are the best way to monitor any changes in your eyes and vision. It is recommended you have a comprehensive eye examination at least once every two years – check your Annual Cycle of Care to see when your next check-up is due.
Who can help?
The members of your diabetes health care team who can help you to look after your eyes include:
GP: Your GP can provide you with referrals to eye specialists.
Optometrist: Your optometrist will examine the different parts of your eyes and assess whether there have been any changes to your vision or eye health. A report will be provided to your GP and you may be referred to an ophthalmologist for further treatment if necessary.
Ophthalmologist: An ophthalmologist (medical eye specialist) will be a part of your team if your eyes require specialised medical treatment such as surgery.
Your teeth and gums
Keeping your teeth and gums healthy helps protect you from gum disease. Gum disease (or periodontal disease) is a mouth infection which can get worse over time and can cause an increase in your BGL.
What are the signs of gum disease?
When you have diabetes you are at increased risk of developing gum disease compared to people who do not have diabetes. BGL’s above the target range can increase your risk even further.
Keeping your teeth and gums healthy
The good news is, there is lots you can do to protect yourself from gum disease including:
Who can help?
Your dentist and dental hygienist can assist in keeping your teeth and gums healthy. They can also assess and treat any issues with your teeth or gums.
A diabetes educator and your dietitian can also help you with maintaining BGLs within target which assists in reducing teeth and gum complications.
Your cardiovascular health
People with diabetes can often experience higher blood pressure and ‘LDL’ or bad cholesterol levels as well as increased blood glucose. When these factors are combined it can significantly increase your risk of heart attack, stroke and damage to the big blood vessels in your body (cardiovascular disease).
Keeping your heart and blood vessels healthy
Reducing your risk of cardiovascular disease is similar to reducing your risk of other diabetes-related complications:
Who can help?
Your GP can monitor your blood pressure, cholesterol and HbA1c. You may require one or more medications to help maintain your blood pressure, cholesterol and blood glucose within recommended targets.
Your GP may also refer you to a medical specialist such as a cardiologist who can support you further.
An exercise physiologist can also assist by helping you develop an individualised physical activity plan. You might also benefit from seeing a dietitian who can help you incorporate more low fat, low salt and high fibre foods in your diet.
Your kidney health
Our kidneys are important for filtering waste products from our blood. Over time, high BGLs and blood pressure can reduce our kidney’s ability to filter increasing the risk of diabetic kidney disease, known as nephropathy. Early signs of kidney damage are protein leaking into the urine (microalbuminuria), and a slowing in the kidney’s ability to filter the blood. (glomerular filtration rate or eGFR).
How can you keep your kidneys healthy?
Reducing the risk of damage to your kidneys is easy by following these simple steps:
Who can help?
It is important for your GP to monitor your kidney filtration rate and monitor the presence of protein in your urine at least once every 12 months. Check your Annual Cycle of Care to see when your next check up is due.
Your sexual health
Diabetes can contribute to sexual problems for both men and women. It is important to remember you are not alone, and there is support available to assist you.
Are you a male with diabetes?
Men with diabetes can experience problems with erectile funtion. This is generally due to reduced blood flow and never damage, which can both be affected by diabetes. There a number of treatments avaliable for erectile dysfunction. Speak to your GP or diabetes educator for more information on what's bset for you and partner.
Are you a female with diabetes?
Diabetes can also impact on women's sexual health. There is less known about how diabetes effects women's sexual health. However, issues may include a decrease in sexual desire, increased vaginal dryness, pain during sexual intercourse and increased episodes of vaginal thrush. Thrush can be reduced by maintaining blood glucose levels within the recommended range. During menstruation (periods) or menopause a women's diabets management may need to change. Speak with your GP or diabetes educator for more information.
Caring for your feet is a very important part of your diabetes management. Complications of diabetes that can affect your feet include reduced sensation (peripheral neuropathy) or reduced blood flow (peripheral vascular disease).
How do you avoid problems with your feet?
Managing your diabetes, and in particular your BGLs, will go a long way to delaying or preventing complications with your feet.
Our top tips to remember when caring for your feet include:
Who can help?
A podiatrist can help you look after your feet and is a key member of your diabetes healthcare team. They can complete foot checks and other assessments to determine your risk of developing any serious problems. A podiatrist can also provide you with advice on caring for your feet and appropriate foot wear. They can even show you how to check your feet at home.
It is recommended you have your feet checked at least twice a year by a health professional. If you aren’t able to see a podiatrist your GP, Practice Nurse or specialist can check your feet for you. Refer to your Annual Cycle of Care to see when your next check-up is due.
Aboriginal and Torres Strait Islander health workers can support individuals and families in manging diabetes and connect you with other health professionals.
The amount of carbohydrate refers to both the serving size and the carbohydrate content of the food.
The amount of glucose in the bloodstream. Can be measured with capillary (taken from a finger prick) or venous (pathology test) blood.
An abbreviation of blood glucose level, BGLs refers to the amount of glucose in the bloodstream.
Carbohydrates are one of the body's main energy sources. Carbohydrates are broken down in our digestive system into glucose. This glucose is then released into the bloodstream where it can travel around the body and be used for energy.
Includes high density liproprotein cholesterol (HDL) and low density lipoprotein cholesterol (LDL). It is ideal to have high HDL and low LDL as HDL helps prevent heart disease by moving fat to the liver to be processed, whereas LDL encourages fat to deposit in our arteries.
A diabetes educator will provide you with information to manage your diabetes. They can also help you develop action plans for the unexpected (e.g. low or high BGLs).
A dentist assists with oral health and provides treatment.
Your dietitian can provide you with individualised information about healthy eating.
The estimated glomerular filtration rate (eGFR) is a blood test that is used to assess how well your kidneys are working.
An endocrinologist is a medical specialist who sees people with diabetes, especially those with type 1 diabetes, or those who are pregnant and have diabetes.
Your GP has a central role in overall assessment and management. Visit your GP regularly and discuss any problems as soon as they arise. Other members of your team, including specialists, will link in with your GP.
The glycaemic index (GI) is a way of describing how a carbohydrate containing food affects blood glucose levels.
Refers to a raised level of glucose in the blood.
Refers to a low level of glucose in the blood.
A measure of, on average, how much glucose has been in your blood stream over the previous 2-3 months. It is reported either as a percentage (%) or in mmol/mol.
High density liproprotein cholesterol (otherwise known as 'good' cholesterol) is the type of cholesterol carrier which takes fats from our bloodstream, to our liver for processing. It is ideal to have high levels of HDL cholesterol as this can help prevent heart disease.
Ketones are compounds produced by the body when fat is broken down for energy. Small amounts of ketones in the bloodstream are harmless. However, in large amounts they can be extremely dangerous.
Low density lipoprotein cholesterol (otherwise known as 'bad' cholesterol) is the type of cholesterol carrier which deposits fat in our arteries. High levels of this cholesterol can lead to blockages in the arteries and heart disease.
This urine test measures how much albumin (protein) is released through the kidneys which can indicate kidney damage.
Damage to the big blood vessels that can lead to peripheral vascular disease, heart attack and stroke.
Damage to the small blood vessels that can cause eye, kidney, feet and nerve problems.
Monounsaturated and polyunsaturated fats are found in fish, avocados and nuts, as well as olive, sunflower, peanut and canola oil. These fats help to increase HDL cholesterol and decrease LDL cholesterol, which can decrease the risk of heart disease.
An ophthalmologist is an eye specialist who can monitor any changes in your eyes and provide treatment.
Your optometrist assesses eye health and prescribes your glasses.
Refers to nerve damage of the feet or hands.
Damage to the blood vessels in the legs and feet resulting in limited blood supply, pain and sensation changes.
A pharmacist prepares and dispenses drugs and medicine. They can also give you advice about your medicines.
A physiotherapist or exercise physiologist can give advice about exercise choices.
A podiatrist will advise you on how to keep your feet healthy and treat foot problems.
A psychiatrist is a medical specialist who can help people who have emotional and psychological problems.
A psychologist counsels people with emotional and psychological problems and can help you make lifestyle changes such as giving up smoking.
A social worker can provide counselling to individuals and families regarding personal and family problems.
Saturated fats are found in foods like processed and fatty meats, full fat milk products, butter, coconut and palm oils. It is recommended you limit saturated fat in your diet as it can increase LDL cholesterol levels, which may increase your risk of heart disease.
Trans fats are found in some processed biscuits and commercially-made bakery products. They act the same way as saturated fats in the body so it's recommended we minimise our intake of these fats.
The type of carbohydrate refers to the glycaemic index (GI) of the food. The glycaemic index (GI) is a way of describing how a carbohydrate food affects blood glucose levels.
A type of fat found in the blood that the body uses for fuel or stores away.