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Reality Bites - My Meal Plan

Long term complications can happen to people with either type 1 or type 2 diabetes. The key to preventing or minimizing the complications is to keep good blood glucose control. The recommendation of keeping your blood sugars between 4 – 7 mmol/L (90 – 130 mg/dL) is based on that reason. We know that once your blood sugars stay outside of that range for prolonged periods of time, you put yourself at risk for developing the following complications:

Cardiovascular disease (disease of heart and circulation)

  • High blood sugars slowly damage your blood circulation over the years. This can lead to heart attack, stroke, hypertension (high blood pressure) and peripheral vascular disease (restricted blood flow to arm and leg muscles).

Eye complications (Retinopathy)

  • Problems start to occur when the fragile blood vessels at the back of the eye (retina) break and bleed. This blocks the passage of light through the eye causing poor vision. Cataracts are also more common in people with diabetes.

Kidney problems (nephropathy)

  • Prolonged high blood glucose levels and high blood pressure damage the filtering units of the kidneys (nephrons). This causes protein to escape into the urine and waste products to build up in the blood.

Nerve complications (Neuropathy)

  • High levels of blood glucose affect our nerves. Peripheral neuropathy means the nerves to the outer most parts of the body, such as your hands and feet, are affected. Symptoms usually include numbness, tingling sensation or burning pain. Autonomic neuropathy refers to the nerves controlling parts of the body that you don’t move voluntarily are affected. Some symptoms may include dizziness, inability to empty your bladder completely, and erectile dysfunction.

Screening for Complications

A very important part of managing diabetes is making sure that you are tested for potential complications. It is much easier to manage the complications if they are caught early. The table below indicates how often you should be tested for the possible complications. Note: all of these tests should also be done at diagnosis.

Complication Test to be done When should you be tested
Cardiovascular disease Blood pressure

Cholesterol and blood fats
Every 3 months

Every 1- 3 years (More often if you have a history of high cholesterol)
Nephropathy (kidney disease) Urine for microalbuminuria (check for protein in urine) Every year if you don’t have albuminuria

Every 6 months if you have albuminuria
Neuropathy (nerve damage) Sensitivity test with a 10-g monofilament Every year
Foot problems Foot examination Every year or more often if you have feet problems (If you can, have your feet checked every time you see your doctor or diabetes nurse)
Retinopathy (eye problems) Dilated eye exam Every 1 – 2 years
Poor blood sugar control A1C blood test Every 3 months