Complications of Type 2 diabetes

• Obesity: Overweight individuals with Type 2 diabetes should strive for a 5% to 10% reduction in weight and should avoid weight gain.
• Fatty liver disease: Some patients with Type 2 diabetes may have unexplained elevated levels of hepatic transaminase concentrations, which in turn can lead to fatty liver disease. In these cases, improving metabolic abnormalities can be beneficial which includes weight loss, sugar control, and treatment with specific drugs for high sugars or cholesterol.
• Obstructive sleep apnea: OSA accounts for over 80% cases of co-morbid complications in patients with Type 2 diabetes. Treating sleep apnea can significantly help in improving the quality of life and controlling blood pressure.
• Diabetic neuropathy: Around 60 – 70 percent of people with diabetes are likely to develop some form of neuropathy or nerve problems. These can happen any time and the risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years.
• Diabetic retinopathy: Diabetic retinopathy is a serious sight-threatening complication of diabetes that occurs when the tiny blood vessels in the retina leak blood and other fluids. This causes the retinal tissue to swell, resulting in cloudy or blurred vision. The condition usually affects both eyes. The longer a person has diabetes, the more likely they will develop diabetic retinopathy. If left untreated, diabetic retinopathy can cause blindness. Glaucoma is also common in persons with diabetes and can be eye threatening.
• Diabetic nephropathy: People with diabetes can also suffer from kidney issues which in worse cases can also lead to kidney failure. There are no symptoms in the early stages hence making it important to have regular urine tests to find kidney damage early. Sometimes early kidney damage can also be reversed.

Setting up positive goals, proper diet management and education is beneficial for diabetic patients in the long run. Following lifestyle modifications can go a long way in ensuring effective management of diabetes:

• Eating right: Understanding the three key principles of eating- What to eat, how much to eat, and when to eat, can be really beneficial.
• Aerobic activity: For people with Type 2 diabetes, aerobic activity is a must as it helps in improving blood flow. It not only makes your heart and bones strong but also relieves stress, thus helping your insulin work well.
• Weight loss: Losing a lot of weight is not required. To begin with, just losing 5-10% of excess body weight can make a difference.
• Medicines: It is better to make a chart or set reminders so that you don’t forget to take your medicines routinely.
• Checking blood glucose: Checking your blood glucose on regular basis is important.
• Minimise stress: Some people get angry while some suffer from depression. Senses of loss, fear or stress are some of the usual reactions. These feeling are completely normal and one should find ways of getting out of these. (The writer is a Consultant Endocrinologist, Columbia Asia Referral Hospital)