Living With Type 2 Diabetes + Complications: “I am a person first”
The scary truth is that having diabetes can significantly increase your risk for additional health problems. From heart disease to kidney failure, complications can develop over time if blood glucose levels remain elevated long-term. Beyond Type 2 sat down with a diabetes educator, Veronica Brady, to discuss the red flags to watch for and how to manage living a happy, healthy life if you do develop complications. Listen to or read the interview below to learn more.
This interview has been edited for length and clarity.
BT2: Today we are being joined by Veronica Brady, who will talk to us about discussing complications around type 2 diabetes. Veronica, can you tell us a little about yourself?
Veronica: Thank you for the opportunity. I am a certified diabetes care and education specialist. I have worked in the area of diabetes for greater than 20 years. It is my pleasure to be here with you today.
Type 2 diabetes complications can be a really scary topic to talk about. What are some red flags that people with diabetes can look out for before developing complications with diabetes?
We do know that complications usually occur as a result of having elevated blood sugars for a prolonged period of time. Some of the early complications that people might have are vision issues like blurred vision, spots/floaters in your eyes or things are just not quite right visually—that could be a red flag that there are some problems.
As for feet, numbness or tingling or decreased sensation are warning signs.
Sores that don’t heal. If you get a sore on the bottom of your foot that hasn’t healed, that also could present a red flag as far as complications are concerned.
Some of the other complications that can occur are kidney problems. People may get urinary tract infections, some burning or pain, but true complications for kidneys unfortunately don’t usually come with a lot of red flags.
Heart problems are also a complication associated with type 2 diabetes. Chest pain is a red flag, but certainly your left-sided chest pain with jaw pain and things like that could be a red flag that something is going on.
Those are the primary four complications and red flags.
Do we know if there’s a certain timeline for developing these types of complications? For example, people may hear “long-term” and think a couple of months isn’t a big deal, or the opposite where, “If my blood sugar levels are consistently high for two weeks, will I develop neuropathy from that?”
When we talk long-term, we are talking problems. Elevations in your blood sugars, six months to two years. Most people develop complications as a result of problems with their diabetes within two to five years, so if your blood sugars are running high for two weeks, should you address them?
Are you at risk for complications such as retinopathy or blindness and amputations? Not at all.
Is it possible for people with diabetes to minimize complications? Or if they do start developing some of these complications, how do they heal from them?
The biggest thing about minimizing complications, and I’m sure that people with diabetes have heard this a thousand times, is blood sugar management. Getting those blood sugars within range is key. That is the biggest way to minimize complications.
11.1 mmol/l200 (mg/dL) is our catch point because we know that when blood sugars are higher that risk increases. Consistently keeping those blood sugars below 200 (mg/dL) can help to eliminate or alleviate vision issues.
We use our three pillars all the time—diet, exercise and taking medications as prescribed—are the other ways to help to minimize complications, but it all really hinges on what’s going on with those blood sugars.
For a person with diabetes who has been told they’re starting to develop complications, that can sound really scary because we don’t know what that means for day-to-day life. What lifestyle impacts occur when someone is told that they’re developing complications?
I think one of the first things when you’re told that you start to develop complications, and I’ll start with the eyes first, is to see the eye doctor. When the eye doctor does that examination and says, “you’ve got the beginnings of some retinopathy,” that is not automatically, “Oh, you’re going to lose your vision.”
Getting those blood sugars within an acceptable range will help to alleviate or minimize some of these complications.
For lower extremities, the numbness and tingling and beginnings of some problems, lifestyle modification in that realm would be certainly good foot care. When you’re exercising, wear the appropriate footwear, and be mindful of where you’re placing your feet.
If you haven’t already, start to monitor your blood sugars consistently, perform exercise and be attentive to your personal care.
For someone who has been told that they are starting to develop complications, or already have complications, is it possible to heal or recover? What is their outlook?
It is possible to heal from some complications and it depends on the extent of the complication, the severity of it.
Say you develop retinopathy that requires treatment with injections. You can certainly recover from that because the injections or the treatments are designed to stop that bleeding at the back of the eyes, which oftentimes allows that vision to return and correct itself.
Complications may not go away totally, so you adapt to that and may have to make some adjustments, but certainly, you can minimize the progression.
People hear the word “complications” and they may think their life is over, anticipating it worsening in severity. It can be difficult to address these fears with providers. What is your advice for navigating these tough conversations, and what should people with diabetes takeaway from these conversations with their providers?
The first thing I would say is I would hope that everybody who is seeing a provider has a level of comfort with their provider.
But when you put that fear and that hesitancy aside and you go in to have that conversation, the first thing you should expect is to feel heard by your provider and supported. Then the next thing that provider should do is provide information to help you process what these potential complications mean for you.
People may be hesitant because they don’t want bad news. Coming out of that appointment, I would hope that they would be less fearful, knowing that there’s a plan going forward. A feeling of “Okay, I can manage this. I can do this. It is something that can be dealt with.”
For someone who may leave that appointment still feeling anxious or fearful, what are some tips you have to help them move past those feelings and towards taking care of preventing the progression of complications?
I think one of the first things that I would say is the diabetes community, in my opinion, is fairly close-knit. They might either personally know some other people who have had these complications, or they may be able to find some support and some resources that involve people who have had these complications.
There are a number of resources online that talk about complications, potential complications and what you should do. There are various places to find support with helping to deal with some of the feelings that are associated with complications and some of the unknowns.
I think a good support system is family, friends, folks who have had these complications, or with the health provider group. I have to put in for my professional group—the certified diabetes care and education specialists—is a great group of folks that can help you to manage these feelings. You can always go to the ADCES website and find one.
As you continue to think about next steps, support is key and knowing that you’re not in this and facing this, whatever the complication is, alone.
What are some practical solutions for daily living with diabetes to help people prevent the progression of complications?
You said a keyword—it is “living with diabetes.”
I often tell people, “I’m not the diabetes police. I’m not the food police.” I think people need to live, and one of the things about living is that you incorporate the diagnosis or the disease into your everyday life. It’s the things you do from the time you wake up to the time you go to bed that makes for successful living.
Living with diabetes, you need to know how to care for yourself. You know that you need exercise, that you need to eat healthy and knowing that if you’re on medications, you need to take your medications.
It’s doing all of the things that you know need to do for yourself, but enjoying life along the way. Not missing out on wonderful opportunities because you have diabetes.
Take five minutes out of your day just to breathe and remember, “I’m a person living with diabetes, but I’m a person first.”
Take care of your person.
Editor’s note: Educational content related to diabetes complications is made possible with support from Lilly Diabetes, an active partner of Beyond Type 2 at the time of publication. Editorial control rests solely on Beyond Type 2.