Diabetes care: 10 ways to avoid complications

By Mayo Clinic Staff

Diabetes is a serious disease. Following your diabetes treatment plan takes commitment all day, every day. But your efforts are worth it. Careful diabetes care can lower your risk of serious and life-threatening complications.

Here are 10 ways to take an active role in your diabetes care and enjoy a healthier future.

Members of your diabetes care team can help you learn the basics of diabetes care and offer support along the way. Your care team can include your primary healthcare professional, diabetes care and education specialist, and dietitian. But it’s up to you to manage your condition every day.

Learn all you can about diabetes. Make healthy eating and physical activity part of your daily routine. Work toward getting and keeping a healthy weight.

Monitor your blood sugar. Follow your healthcare professional’s instructions for managing your blood sugar level. Take your medicines as directed. Ask your diabetes care team for help when you need it.

Don’t smoke, or quit smoking if you do smoke. Smoking raises the risk of type 2 diabetes and the risk of some diabetes complications, including:

• Lower blood flow in the legs and feet. This can lead to infections, ulcers that won’t heal, and possible removal of one or more limbs, called amputation.
• Worse blood sugar management.
• Heart disease.
• Stroke.
• Eye disease, which can lead to blindness.
• Nerve damage.
• Kidney disease.
• Premature death.

Talk to your healthcare professional about ways to help you stop smoking or using other types of tobacco.

Like diabetes, high blood pressure can damage your blood vessels. High blood pressure, also called hypertension, affects the body’s blood vessels and causes the heart to work harder to pump blood. In general, hypertension is a blood pressure reading of 130/80 mm Hg or higher.

High cholesterol is a concern too. Cholesterol is a waxy substance in the blood that the body needs to build healthy cells. But high levels of cholesterol can build up in the walls of blood vessels, causing them to become narrower. This makes it hard for enough blood to flow through, raising the risk of heart disease. Damage from high cholesterol is often worse and more rapid when you have diabetes.

When diabetes, high blood pressure and high cholesterol happen together, they can lead to a heart attack, stroke or other life-threatening conditions.

Eating a healthy diet that has reduced fat and low salt, avoiding too much alcohol, and exercising regularly can go a long way toward managing high blood pressure and cholesterol. Your healthcare professional also may recommend taking medicine for high blood pressure and cholesterol if needed.

Have 2 to 4 diabetes checkups each year, plus your yearly physical.

During these visits, your healthcare professional asks about your nutrition and activity level and looks for any other medical conditions and diabetes-related complications. Complications can include signs of kidney damage, nerve damage and heart disease. Your physical exam includes checking your feet and looking for any issues that may need treatment.

Also have an eye exam each year. Your eye care specialist checks for signs of retinal damage, cataracts and glaucoma, which can be related to diabetes.

Diabetes raises your risk of getting certain illnesses. Routine vaccines can help prevent them. Ask your healthcare professional about:

• Flu vaccine. A yearly flu vaccine can help you stay healthy during flu and prevent serious complications from the flu.
• Pneumonia vaccine. Sometimes the pneumonia vaccine requires only one shot. If you have diabetes complications or you’re age 65 or older, you may need a booster shot.
• Hepatitis B vaccine. The hepatitis B vaccine is recommended for adults with diabetes who haven’t gotten the vaccine before and are younger than 60. If you’re age 60 or older and have never gotten the hepatitis B vaccine, talk to your healthcare professional to see if it’s right for you.
• COVID-19 vaccine.People with diabetes may get sicker with COVID-19 than people who don’t have diabetes. Talk with your healthcare professional about getting vaccinated for COVID-19.
• Other vaccines. Stay up to date with your tetanus shot, which is usually given every 10 years. Your healthcare professional may recommend other vaccines as well. Examples include the RSV vaccine if you’re older than 60 years and the shingles vaccine if you’re older than 50.

Diabetes may raise your risk of gum infections. Brush your teeth at least twice a day with fluoride toothpaste. Floss your teeth once a day. Get dental exams at least twice a year. Call your dentist if your gums bleed or look red or swollen.

High blood sugar can lessen blood flow and damage the nerves in your feet. Without treatment, cuts and blisters can lead to serious infections. Diabetes can lead to pain, tingling or loss of sensation in your feet, a condition called diabetic neuropathy.

To prevent foot problems:

• Wash your feet daily in lukewarm water. Don’t soak your feet, as this can lead to dry skin.
• Dry your feet gently, especially between the toes.
• Moisturize your feet and ankles with lotion or petroleum jelly. Do not put oils or creams between your toes. The extra moisture can lead to infection.
• Check your feet daily for calluses, blisters, sores, redness or swelling.
• Talk with your healthcare professional if you have a sore or other foot condition that doesn’t start to heal within a few days. If you have an open sore, called a foot ulcer, see your healthcare professional right away.
• Don’t go barefoot, even at home, indoors or outdoors.

If you have diabetes and other risk factors for heart disease, such as smoking or high blood pressure, your healthcare professional may recommend taking a low dose of aspirin every day. This may help lower your risk of heart attack and stroke.

If you don’t have other risk factors for heart disease, the risk of bleeding from aspirin use may outweigh any of its benefits. Ask your healthcare professional if daily aspirin therapy is right for you. Also ask what dose of aspirin you should take.

Alcohol can cause high or low blood sugar, depending on how much you drink and whether you eat at the same time. If you choose to drink, do so only in moderation. Moderation means no more than one drink a day for women and two drinks a day for men.

If you choose to drink, always do so with a meal or snack. Remember to include the calories from any alcohol you drink in your daily calorie count. Also, be aware that alcohol can lead to low blood sugar later, especially for people who use insulin.

If you’re stressed, it’s easy to ignore your usual diabetes care routine. To manage your stress, set limits. Prioritize your tasks. Get plenty of sleep. Learn relaxation techniques.

And above all, stay positive. Diabetes care is within your control. If you’re willing to do your part, diabetes won’t stand in the way of an active, healthy life.