Managing Type 2 diabetes

The complications of Type 2 diabetes can be devastating. They can affect the eyes, kidneys, nerves, heart and brain and the damage caused by high blood sugar is often irreversible.

The devastation of diabetes

“High blood sugar damages blood vessels and other proteins in the body,” says Dr Micky Sunnyraj, a physician and diabetes expert at Mediclinic Louis Leipoldt.

“The damage to blood vessels can lead to a number of complications, including diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy,” he says. “Diabetic retinopathy is a disease of the retina, the light-sensitive tissue at the back of the eye. It can lead to blurry vision, vision loss and even blindness. Diabetic nephropathy is a disease of the kidneys that can lead to kidney failure. Diabetic neuropathy is a disease of the nerves that can lead to numbness, tingling, and pain in the hands and feet.”

The damage to blood vessels can also lead to heart disease – the leading cause of death in people with diabetes – and stroke.

“It’s essential for people with Type 2 diabetes to get regular check-ups to screen for complications,” Dr Sunnyraj adds. “This includes an annual eye exam, a urine albumin-to-creatinine ratio test (which is a measure of diabetic nephropathy), a renal function test, an electrocardiogram (ECG), an echocardiogram and a podiatry assessment of the extremities.

“By catching complications early, they can often be prevented or managed. This can help people with Type 2 diabetes live long and healthy lives.”

Preventative measures

The treatment of patients with complications of Type 2 diabetes is complex and individualised, Dr Sunnyraj says. “The specific treatment plan will vary depending on factors like the patient's age, life expectancy and the severity of their complications.”

In general, the treatment plan may include:

• Drug therapies (anti-diabetic treatment) to help control blood sugar levels.
• Strict glucose control to prevent further complications.
• Monitoring of glycaemia (the presence of glucose in the blood) and other biomarkers to track the patient's progress.

A multidisciplinary approach involving a team of healthcare professionals, such as ophthalmologists, nephrologists, cardiologists, dieticians and podiatrists.

“The goal of treatment is to prevent further complications and improve the patient's quality of life,” Dr Sunnyraj says. “Once complications have developed, it is too late to prevent them.

Management techniques

A number of factors contribute to a metabolic disease like diabetes, including genetics, environment and lifestyle.

Early in the process of dysfunction, parameters such as blood sugar, blood pressure, cholesterol and waist circumference are examined, Dr Sunnyraj says.

“A basic screening tool that can be used to identify people who are at risk of diabetes is the metabolic syndrome criteria. Criteria include risk factors such as high blood sugar, high blood pressure, high cholesterol and obesity.

“Management can consist of lifestyle changes, drug therapies and a multidisciplinary approach. Lifestyle changes include exercise, weight loss, and a healthy diet. Drug therapies can also be used to help control the risk factors for metabolic syndrome.

“A multidisciplinary approach that includes healthcare professionals from a variety of disciplines can help to ensure that people with metabolic syndrome receive the best possible care.”