Diabetes can cause other related medical issues that can affect many organs in the body if it is not managed well.
The following is provided for information and a guide only. You should be aware of your own well being and seek regular attention from your own heath professional.
We have discussed diabetes-related complications on this page; they include the microvascular complications such as retinopathy (eye damage), nephropathy (kidney damage), and neuropathy (nerve damage), as well as the macrovascular complications such as heart disease, stroke and peripheral vascular disease.
But did you know that people with diabetes are at higher risk of hypertension (high blood pressure) and cholesterol issues?
To reduce the risk of developing diabetes related complications, and in particular to reduce macrovascular complications you should aim to:
- Manage your blood glucose levels as high BGLs can damage your blood vessels and arteries, which increases the risk of plaque formation, which can lead to blockages.
- Manage any hypertension (high blood pressure)
- Manage your cholesterol levels
People with diabetes are also at higher risk of hearing loss.
Hypertension
Hypertension is the medical term for high blood pressure.
Blood pressure is the measurement of the pressure of your blood in your arteries. The blood in your arteries push against the walls each time your heart pushes blood out; this creates a pressure that changes throughout the day, based on how much fluid is in your body. It can also vary depending on what you are doing at the time your blood pressure is measured and any medications you take.
If your doctor tells you that you have hypertension, it means that your blood pressure is constantly elevated.
Your doctor may recommend that you check your blood pressure yourself, on a regular basis. If you have been recommended to check your blood pressure, you should read this article that Carolien wrote for diabetes Australia, as it explains exactly how to do this, and how to choose the best blood glucose monitor, so you get the best, most trustworthy results.
This article also explains what the general targets are for blood pressure and any special considerations.
There are lots of different medications that can be prescribed if your blood pressure is chronically elevated. Talk to your doctor or pharmacist for more information on anti-hypertensive medications.
Find out more about the link between blood pressure and your heart we recommend you read this article from the Heart Foundation.
High cholesterol
High cholesterol can lead to the formation of plaque in your blood vessels, which in turn can lead to complete blockages. There are different types of cholesterol in your blood:
- HDL, or High-Density Lipoprotein, helps to protect against heart disease and is therefore often referred to as the ‘Good’ cholesterol. Higher is generally better, you should aim for an HDL greater than 1.0 mmol/L. You can increase your HDL by doing more physical activity.
- LDL, or Low-Density Lipoprotein, can increase the risk of cardiovascular problems and is therefore often referred to as the ‘Bad’ cholesterol. It is best to aim for LDL below 2.0 mmol/L, you can lower your LDL by taking medications called ‘statins’ (more on this shortly).
- Triglycerides are a type of fat in your blood that come from your body changing any unused calories into a separate type of fat that can easily be stored. High triglyceride levels can be a sign of a diet high in carbohydrates and fats, but it can also be a sign of hyperglycaemia (high blood glucose levels). Having triglycerides above 2.0 mmol/l can increase your risk of atherosclerosis (a hardening of the arteries which increase the risk of stroke and heart disease) and pancreatitis (an inflammation of the pancreas). To lower your triglycerides, you should do regular physical activity, reduce your alcohol intake and quit smoking.
Eating heart-healthy foods can also help improve cholesterol levels. You can do this by reducing saturated fats (mainly animal fats, but also often found in processed foods such as cakes, biscuits, fried foods), by eating foods rich in Omega-3 fatty acids (found in fish and other seafood, nuts, and seeds) and by increasing your intake of soluble fibre (by eating beans, Brussel sprouts and oat bran).
If you are having trouble remembering the difference between HDL and LDL cholesterol this may help: HDL is the good cholesterol, which keeps us Happy, whereas LDL is the bad cholesterol which can make you feel Lousy.
Cholesterol lowering medications
The main group of cholesterol lowering medications is known as ‘Statins’ and include medications such as Crestor, Lipitor, Pravachol and Zocor. Your doctor will recommend you take a statin if you are at high risk of macrovascular disease. These medications work by blocking a substance that your body needs to make cholesterol. They also help your body to reabsorb some of the cholesterol that has built up in your arteries.
Another group of cholesterol lowering medications is the ‘Fibrates’. These include medications such as gemfibrozil or Lopid and fenofibrate or Lipidil. They lower triglycerides by decreasing the production of triglycerides in the liver, and by increasing the rate at which they are removed from the blood stream.
Sometimes doctors will prescribe the above medications, even if your cholesterol levels are to target. If so, it is to reduce your risk of problems down the track or to assist in managing other conditions. For example, fibrates have been proven to slow the progression of retinopathy (eye damage). It is important to always follow the advice from your doctor. Do not stop taking medications just because “you feel better”.
You can read more here about blood cholesterol.
Diabetes and hearing
All people can get hearing problems, as the most common cause for reduced hearing and deafness is noise. In particular long exposure to noisy, loud environments (such as listening to loud music using headphones, or working in construction, mining, or farming), can increase your risk of hearing loss.
But for people with diabetes there is an increased risk of hearing loss, which is linked to ongoing, high blood glucose levels. It is estimated that people with diabetes are twice as likely to experience hearing loss as those who do not have the condition. Similarly, people with pre-diabetes have 30% higher rates of hearing loss, than people who do ot have any issues with their blood glucose levels.
Hearing loss can be temporary or permanent, it can be caused also by other factors, such as issues in any part of the ear canal or hearing pathway.
There are different types of hearing issues, such as conductive hearing loss (when sound cannot pass through your middle ear due to a build-up of wax, an infection, a torn ear drum, or fluid build-up), auditory processing conditions (when your brain has problems processing sounds) or sensorineural hearing loss (when there is a problem with the auditory nerve or with the hearing organ in your inner ear called the cochlea). Some people get mixed hearing loss, when there are both sensorineural and conductive issues, others get ‘single-ear’ hearing loss, which can make it difficult to hear when there is background noise, such as in cafes and restaurant.
Some hearing loss can be genetic, such as in the relative rare condition of Maternally Inherited Deafness and Diabetes (MIDD). MIDD is a condition that is linked to mutations in mitochondrial or nuclear DNA. It is a type of diabetes that, as the name suggests, is passed on through the mother’s side of the family, and involves people who also have hearing loss or deafness. MIDD involves other organs in the body as well, there is a strong link to dementia and strokes, and people with MIDD can have eye issues relating to loss of pigment in the retina. Treatment of MIDD is different from most other types of diabetes; Metformin needs to be avoided due to the risk of lactic acidosis and there is a faster progression onto insulin. On the upside, MIDD is a rare condition, it only affects up to 1% of all people with diabetes.
If you think your hearing is reduced, speak to your GP or see an audiologist, a hearing specialist, who can arrange a hearing check. They can also tell you what type of hearing loss you have, to what degree, and what can be done about it. There is also an online test you can do; however, this should serve as a guide only.
You can find out more information about technology for hearing loss at Hearing Australia ’s website.
You may also like to check out the Australian Government’s website on hearing.