Treatment for severe diabetes complications

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Treatment for severe diabetes complications

Sometimes complications develop even when risk factors such as blood sugar level and blood pressure have been controlled. Following your treatment to control your blood sugar levels is still an important aspect of your treatment.

The most common serious complications from diabetes are coronary artery disease (CAD) and stroke, kidney failure, blindness, and foot disease. All diabetes complications can require specialized medical treatment depending on their severity. Some of these conditions, such as CAD, may be adequately managed by your primary care doctor. If the disease progresses, you may need to see a specialist.

CAD

Your doctor will monitor your heart closely—all people with diabetes are at risk for CAD. There are many diagnostic tests that can be used to determine the danger posed by this condition. These tools can all be used to diagnose the presence of either arterial blockages near your heart or damage to your heart because of poor blood flow.

If you are age 40 or older, talk to your health professional about taking a low-dose aspirin daily to help prevent heart attack, stroke, or other large blood vessel disease (macrovascular disease).¹

If you have had a heart attack, your doctor will treat your condition with medicines, angioplasty, or coronary bypass surgery. There is some evidence that coronary bypass surgery may be a better option than angioplasty for people with diabetes.²

Stroke

If you have a stroke, your doctor will prescribe treatments designed to help you recover with the least amount of disability. The sooner you recognize that you are having a stroke, the earlier you can seek treatment and decrease your chances of having severe effects.

Kidney failure

If you develop kidney failure, your treatment will include dialysis or a kidney transplant.

Vision loss

If you experience vision loss, you can use magnifiers, large-print materials, or assistive devices to enhance your remaining vision. If you become blind, your doctor will refer you to your local or state organization for the visually impaired.

Foot problems

If you have a foot infection, your doctor may prescribe an antibiotic, regular wound care by a podiatrist, negative-pressure wound therapy (sometimes called "vacuum-assisted closure"), non-weight-bearing activities, and sometimes a cast. The deeper the wound (ulcer), the more difficult it is to treat, meaning that you may need higher doses of antibiotics for a longer period of time. An infection of the skin is easier to treat than an infection that has spread to the bone (osteomyelitis).

A lack of good blood flow to your feet creates another major obstacle in your body's ability to heal. Regular exercise may improve circulation by stimulating development of blood vessels. You may need an angioplasty or vascular bypass surgery. In a vascular bypass, the surgeon takes a blood vessel from another area of your body and connects it above and below the blockage to reroute the blood to the affected area.

If bacteria from a foot infection invade your blood, they can cause a whole-body condition known as sepsis, which can be fatal. To prevent sepsis, your doctor may recommend surgery to remove infected tissue. If the infection has spread into your bones, your doctor may recommend amputation of the infected area. Amputation is only done if there is no hope of saving the infected area or the infection threatens to spread to the rest of your body.

References

Citations

1. American Diabetes Association (2008). Standards of medical care in diabetes. Clinical Practice Recommendations 2008. Diabetes Care, 31(Suppl 1): S12–S54.

2. Bypass Angioplasty Revascularization Investigators (BARI) (1996). Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease. New England Journal of Medicine, 335(4): 217–225.

Credits

Last updated:	August 09, 2007
Author:	Caroline Rea, RN, BS, MS
Reviewed By:	Caroline S. Rhoads, MD - Internal Medicine, Matthew I. Kim, MD - Endocrinology & Metabolism
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC