Treatment for severe diabetes complications

Sometimes complications develop even when risk factors such as blood sugar level and blood pressure have been controlled. Following your treatment to control your blood sugar levels is still an important part of your treatment.

The most common serious complications from diabetes are coronary artery disease (CAD) and stroke, kidney failure, blindness, and foot disease. All diabetes complications can require specialized medical treatment depending on their severity. Some of these conditions, such as CAD, may be adequately managed by your primary care doctor. If the disease progresses, you may need to see a specialist.

CAD

Your doctor will monitor your heart closely—all people with diabetes are at risk for CAD. There are many diagnostic tests that can be used to determine the danger posed by this condition. These tools can all be used to diagnose the presence of either arterial blockages near your heart or damage to your heart because of poor blood flow.

Talk to your doctor about whether you should take low-dose aspirin. Daily low-dose aspirin (81 milligrams) may help prevent heart problems if you are at risk for heart attack or stroke.1 If you have CAD, your doctor will treat you with medicines and possibly angioplasty or coronary bypass surgery. Your treatment depends on how serious your CAD is and how well your symptoms respond to medicines.

Stroke

If you have a stroke, your doctor will prescribe treatments designed to help you recover with the least amount of disability. The sooner you recognize that you are having a stroke, the earlier you can seek treatment and decrease your chances of having severe effects.

Kidney failure

If you develop kidney failure, your treatment may eventually include dialysis or a kidney transplant.

Vision loss

If you experience vision loss, you can use magnifiers, large-print materials, or assistive devices to enhance your remaining vision. If you become blind, your doctor will refer you to your local or state organization for the visually impaired.

Foot problems

If you have a foot infection, your doctor may prescribe an antibiotic, routine wound care by a podiatrist, negative-pressure wound therapy (sometimes called "vacuum-assisted closure"), non-weight-bearing activities, and sometimes a cast. The deeper the wound (ulcer), the more difficult it is to treat, meaning that you may need higher doses of antibiotics for a longer period of time. An infection of the skin is easier to treat than an infection that has spread to the bone (osteomyelitis).

A lack of good blood flow to your feet creates another major obstacle in your body's ability to heal. Regular exercise may improve circulation by stimulating development of blood vessels. You may need an angioplasty or vascular bypass surgery. In a vascular bypass, the surgeon takes a blood vessel from another area of your body and connects it above and below the blockage to reroute the blood to the affected area.

If bacteria from a foot infection invade your blood, they can cause a whole-body condition known as sepsis, which can be fatal. To prevent sepsis, your doctor may recommend surgery to remove infected tissue. If the infection has spread into your bones, your doctor may recommend amputation of the infected area. Amputation is only done if there is no hope of saving the infected area or the infection threatens to spread to the rest of your body.

Citations

  1. American Diabetes Association (2009). Standards of medical care in diabetes. Clinical Practice Recommendations 2009. Diabetes Care, 32(Suppl 1): S13–S61.

Last Updated: August 8, 2009

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