Comment prévenir les complications associées au diabète ?
Un diabète bien contrôlé permet de réduire les risques ou retarder l’apparition des complications. Éléments clés de la gestion du diabète :
Education: Diabetes education is an important first step. All people with diabetes should be informed of their condition.
Physical activity: Regular physical activity helps your body lower blood glucose (sugar) levels, promotes weight loss, reduces stress and improves overall physical condition.
Nutrition: What, when and how much you eat all play an important role in regulating blood sugar.
Weight management: Maintaining a healthy weight is particularly important in managing type 2 diabetes.
Medication: Type 1 diabetes is still treated with insulin. Type 2 diabetes is managed through physical activity and meal planning and may require the use of medications and / or insulin to help your body more effectively control blood sugar.
Stress management: Learning how to reduce stress levels in everyday life can help people with diabetes manage their condition better.
Blood pressure: High blood pressure can cause eye disease, heart disease, strokes and kidney disease. People with diabetes should try to keep their blood pressure below 130/80. To do this, you may need to change your eating and physical activity habits and / or take medication.
Complications associated with diabetes
High blood sugar over a long period of time can damage blood vessels. Damaged blood vessels prevent your blood from moving where it needs to go. If your nerves and organs do not get enough blood, they stop working properly.
Possible complications of diabetes include:
- Maladie cardiaque et accident vasculaire cérébral;
- Maladie rénale (néphropathie);
- Lésions oculaires (rétinopathie);
- Dysfonction érectile;
- Problèmes de pied dus à des lésions nerveuses (neuropathie);
Heart disease and stroke
People with diabetes can develop heart disease 15 years earlier than others.
The most common form of heart disease in diabetes is coronary artery disease. It develops when the arteries that supply blood to the heart become narrowed or blocked by fatty deposits. If the arteries that supply the brain become blocked, it can lead to a stroke.
High blood sugar is a risk factor for heart attacks or strokes, but people with diabetes often have a number of other risk factors to contend with as well. These include being overweight (especially if the excess fat is around your waist), inactivity, high blood pressure and high cholesterol. People who smoke or have a family history of heart disease or stroke are at even higher risk.
Kidney failure (nephropathy)
Kidney failure is common in people with diabetes. Diabetes is the leading cause of kidney failure in Canada. Up to 50% of people with diabetes will show signs of kidney damage in their lifetime.
The kidneys are two bean-shaped organs located just below the ribs, near the back. Their job is to act as filters for the blood so that the waste is eliminated through the urine. They also regulate the amount of fluid and salt in the body, playing an important role in blood pressure control.
Over time, high blood sugar can damage the small blood vessels in your kidneys, which means they cannot filter your blood properly. As a result, tiny particles of protein (microalbumin) spill into the urine. This is called microalbuminuria. As kidney disease progresses, more protein goes into the urine. This condition is called proteinuria. As kidney disease progresses, the waste products accumulate in your blood because your body cannot eliminate them. If your kidney problems are left untreated, your kidneys will eventually fail (known as end-stage kidney disease) and kidney dialysis or transplant will be necessary.
Eye damage (retinopathy)
La rétinopathie diabétique peut entraîner des modifications de la vision ou la cécité. Avoir trop de sucre dans le sang peut endommager les vaisseaux sanguins de la partie de l’œil appelée rétine. La rétine est le tissu qui tapisse le dos de l’œil. Des taux de sucre élevés font gonfler les vaisseaux sanguins et pénètrent dans la rétine, entraînant une vision floue ou des angles morts. S’il n’est pas traité, de nouveaux vaisseaux sanguins peuvent se développer et causer d’autres dommages à votre vision. Les examens de la vue réguliers sont importants. Toutes les personnes atteintes de diabète (de type 1 et de type 2) sont à risque de rétinopathie diabétique. La rétinopathie diabétique se développe avec le temps et passe souvent inaperçue jusqu’à ce que la perte de vision se produise.
Erectile dysfunction affects approximately 35 to 45% of men with diabetes.
Foot problems due to nerve damage (neuropathy)
One of the long-term complications of diabetes is nerve damage or diabetic peripheral neuropathy. If left untreated, damage from neuropathy can potentially lead to infection and amputation of a limb.
High blood sugar over an extended period of time can damage nerves that go to your arms, hands, legs, and feet - these are called peripheral nerves. This damage prevents important nutrients from reaching these areas, so the nerves can no longer function properly or disappear.
Diabetic peripheral neuropathy increases the risk of foot ulcers and amputation. People with diabetes who have nerve damage to the feet and toes often do not notice minor cuts, sores, or blisters in these areas. If left untreated, these small sores can easily become infected, cause gangrene and possibly require amputation of the affected area.