Beyond Blood Sugar: Understanding Diabetes Complications and the Role of Comprehensive Care

Delve into the complexities of diabetes beyond glucose control. The causes of diabetes complications and challenges the notion of solely relying on blood sugar management.

5/6/20242 min read

Diabetes is a group of metabolic diseases characterized by chronic high blood sugar, which can cause damage to many body organs such as eyes, kidneys, nerves, and cardiovascular systems. The goal of diabetes prevention and treatment is to prevent diabetic complications, and the key to controlling diabetes is to control blood sugar within the normal range for a long time, that is, blood sugar control reaches the target.

Diabetic complications are more common in chronic form, mainly manifesting as macrovascular lesions, microvascular organ lesions, and nervous system disorders. Among them, macrovascular disease mainly involves two organs: the brain and the heart, such as stroke, coronary heart disease, myocardial infarction, etc.; microvessels have two parts: the eyes and kidneys. The eyes have fundus lesions, which can gradually cause vision, visual field impairment, and even blindness. ; Kidney disease eventually leads to decreased kidney function. The factors that cause complications in diabetic patients are relatively complex. Let’s take a look at two of the reasons.

1. Strictly controlling blood sugar can only significantly reduce but not completely avoid diabetic complications. Two large-scale studies in the international field of diabetes, the Diabetes Control and Complications Trial (DCCT) and the UK Prospective Diabetes Study (UKPDS), have confirmed that strict blood sugar control can reduce the microvascular complications of diabetes (complications of the kidney, retina and nervous system) by approximately It is reduced by 2/3, and macrovascular complications (cardiovascular and cerebrovascular complications) are also reduced to a certain extent. But "reduced" does not mean "none". However, as a patient, you must not relax the strict control of blood sugar just because you cannot prevent complications 100%. After all, the effect of strict blood sugar control on preventing complications is quite certain.

2. Simply control blood sugar and ignore the intervention of other cardiovascular disease risk factors. Hyperglycemia is an important risk factor for diabetes complications, but it is not the only one. In fact, the vascular complications of diabetes are the result of the combined action of multiple risk factors (hypertension, hyperglycemia, dyslipidemia, smoking, obesity, etc.). It has been observed that hypertension plays a very important role in the occurrence and development of diabetic fundus disease, kidney disease, and cardiovascular and cerebrovascular diseases. Therefore, to prevent chronic complications of diabetes, it is not enough to just control blood sugar. It is also necessary to control blood pressure, blood lipids, blood viscosity and weight, and make them strictly meet the standards.

In addition, some patients become normoglycemic after complications have already occurred. Therefore, if you want to better prevent and treat diabetic complications, you must detect them early and treat them early. During treatment, attention must be paid to stably lowering blood sugar and reducing blood sugar fluctuations. At the same time, attention should also be paid to comprehensive control of multiple risk factors.

In short, chronic complications of diabetes are the result of multiple factors including hyperglycemia. Simply controlling blood sugar is not enough. Only early intervention can be started to comprehensively and effectively control various risk factors (such as blood sugar, blood pressure, and blood lipids). , obesity, etc.), can significantly reduce the occurrence of chronic complications of diabetes.