If you’ve been diagnosed with diabetes, keeping track of your blood sugar can feel like a full-time job. You might be more tired than usual too.

Given all that’s going on, it’s easy to lose track of the fact that diabetes can be a catalyst for other major conditions, including heart disease, kidney failure, bone-weakening osteoporosis, arthritis, diabetic neuropathy (nerve damage), and vision problems.

Being aware of the connection, though, is important because you can be an advocate for your own health and take charge of the situation.

To reduce your risk of complications, these steps can help you derail the diabetes domino effect.


Go on a fact-finding mission. Your HbA1C level is the best gauge of diabetes control because it’s an average of your blood sugar over the past two to three months.

Generally, you’re shooting for a number below 7 percent. Anything above 7 signals your blood sugar isn’t as well controlled as it could be.

“If your HbA1c is high, be your own detective and solve the mystery,” says Margaret Eckert-Norton, PhD, RN, a certified diabetes educator.

In addition to daily fasting blood-sugar testing, “I ask my patients to do more random checking of their blood sugar instead of sticking with a set routine,” she says.

Eckert-Norton suggests monitoring your blood sugar frequently during the day, such as an hour or two after breakfast and lunch and before bed, for a week or so. Then, show your data to your doctor to see if your medication needs adjusting.

Blood sugar that’s not well managed can quickly damage the tiny capillary blood vessels in your eyes, kidneys, and in extremities, such as your feet, which can lead to diabetic retinopathy, joint damage, and limb amputation. These blood vessels are thinner than a hair.

“There’s strong evidence that managing Type 2 diabetes reduces the risk of these complications considerably,” says endocrinologist Kevin Pantalone, DO.

Chronic high blood sugar can also affect your risk of heart attack and stroke. Cardiovascular disease is the No. 1 killer of patients with Type 2 diabetes.

That’s why you’ll also want to aggressively control your blood pressure and cholesterol by following your diabetes eating plan and taking high blood pressure and/or cholesterol-lowering medication, such as a statin drug, if necessary.


Don’t wait to lose weight. “When most patients are diagnosed with Type 2 diabetes, they’ve already lost 50 percent of their body’s ability to make insulin,” Pantalone says.

Still, shedding pounds (if you need to) as close to diagnosis as possible, when you still have 50 percent capacity, can make blood sugar easier to control over the long run and can help prevent diabetes complications, including heart disease, stroke, and osteoarthritis.

There’s a strong link between diabetes and osteoarthritis. Researchers suspect that high blood sugar may damage cartilage in joints.

But losing weight is a fix for both conditions. Shedding as little as 15 pounds can cut knee pain in half and reduce blood sugar, enabling some people to taper off insulin and other medications.

Overall, “overweight is the master condition that drives the development of other major conditions,” Pantalone says. But losing weight tends to make everything better.


Quit it! Smoking increases the risk of death from heart attack in people with diabetes by 52 percent, according to a study in BMJ Open.

Kicking the habit is not only good for your heart and blood sugar control, it’s also important for bone health. People with Type 1 and Type 2 diabetes have an increased risk of fractures. Researchers suspect it may be due to the interplay between insulin and osteocalcin, a hormone found in bone.


Switch medication. Some medications to manage blood sugar can cause weight gain, but several newer ones are available that don’t have this side effect. If you start to put on pounds after you’ve been diagnosed, ask your doctor about changing your medication.

Be sure to fill your prescriptions quickly and use injectable insulin exactly as it is prescribed. Don’t try to stretch insulin by skipping injections or taking smaller doses.

If the cost of insulin is a problem, ask your doctor about different, less expensive types of insulin available.


See where you are. In addition to keeping your regular doctor’s appointments to monitor your blood sugar, see an ophthalmologist regularly.

Diabetes can cause blood vessels in the eye to leak, which causes blurry vision and leads to vision loss. But in the early stages, you might not notice it. A yearly dilated eye exam can detect and treat the problem before it progresses.


Exercise your options. “Physical activity acts like insulin. If you’re more physically active, the amount of injectable insulin you may need might go down,” says diabetes researcher William Herman, MD, MPH.

Try to exercise 30 minutes per day at least five days per week with moderately intense activities, such as brisk walking, jogging, swimming, or cycling.

“Exercising five times per week really helped me,” says Ron Saul, 69, a former NFL offensive lineman for the Washington Redskins who was diagnosed with Type 2 diabetes at age 50. “I do the elliptical machine 45 minutes each day and lift weights, and feel great.”

Besides helping to manage blood sugar, being active can provide a feeling of well-being that can make you want to keep up the good work.


Sandra Gordon is an award-winning writer who delivers expert advice and the latest developments in health, nutrition, parenting, and consumer issues.

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