Type 1 Diabetes: Complications

The best way to prevent or slow diabetes-related complications is by achieving good control over blood glucose levels with insulin and healthy lifestyle changes. An estimated three out of five Americans with diabetes (57.9 percent) have one or more complications associated with diabetes, according to the 2006 report released by the American Association of Clinical Endocrinologists (AACE). However, the Diabetes Control and Complications Trial (DCCT), a landmark ten-year study of the impact of good blood sugar control on complications associated with type 1 diabetes, found that for every 1 percentage point a patient reduces their A1C (i.e., three-month blood glucose average), they lower their risk of microvascular complications 37%. The study also found that keeping blood sugar levels as close to normal as possible slowed the progression of diabetes-related eye, kidney, and nerve diseases.

Over time, high blood glucose levels can cause damage to virtually every organ system of the body, including:

• Central Nervous System
• Vision
• Cardiovascular
• Kidney
• Skin
• Sexual
• Teeth and Gums
• Musculoskeletal
  

To stay on top of your diabetes management, you should know your ABCs – your A1c level, your blood pressure, and your cholesterol profile.

A1C: An A1C is a test that measures a person's average blood glucose level over the past 2 to 3 months. The American Diabetes Association A1c goal is 7% or less. The American Association of Clinical Endocrinologists AACE goal is 6.5% or less.

Blood Pressure: For people with diabetes, normal blood pressure is defined as <130/80 mmHg. The National Heart, Lung, and Blood Institute (NHLBI) has established the following clinical levels of hypertension:

• Stage one hypertension. Consistent (i.e., two or more consecutive) readings of 140-159/90-99 mmHg.
• Stage two hypertension. Consistent readings of 160/100 mmHg or higher.
• Prehypertension. Consistent readings of 120-139/80-89 mmHg. (Editor's note: prehypertension is a clinical category for people without diabetes; blood pressure goals for people with diabetes remain < 130/80 mmHg).

Cholesterol: The National Diabetes Education Program (NDEP) recommends that diabetes patients maintain cholesterol levels of:

• LDL (bad cholesterol) < 100 mg/dl (and <70 mg/dl for those considered “very high risk”*)1
• HDL (good cholesterol) > 40 mg/dl in men and >50 mg/dl in women
• Triglycerides < 150

SOURCE:

1 - National Diabetes Information Clearinghouse. Diabetes Overview. (Accessed 2/19/08).

2 - Centers for Disease Control. Chronic Disease Prevention. (Accessed 2/19/08).

Reviewed by Francine Kaufman, MD. 4/08