Diabetes Complications

Diabetes Complications Disability:

Amongst all chronic diseases, complications of diabetes cause the longest duration of disability and dementia, the second most expensive annual cost for treatment and, directly and indirectly, the third most common cause of death in the USA.


Causes of death, rates of mortality and length of life all influence our concerns about diseases affecting our health. But the effect of disease on duration and severity of disability is even more compelling for us.

The complications of peripheral neuropathy, kidney failure, loss of vision and dementia cause pain, loss of function and disability that completely disrupt normal life. They are affected more by metabolic dysfunction including insulin resistance than by high levels of blood glucose alone.


Fortunately, metabolic dysfunction including insulin resistance can be corrected almost completely when intra-abdominal fat is reduced by losing weight and increasing physical activity.


At 55 years of age, patients with type 2 diabetes can extend years of Good Health and Total Life Years. Intentional weight loss will decrease Death Rate by about 1/3 and extend Life by about 3 years. Intentional weight loss also will extend years of Good Health by about 6 years.

Complications of Diabetes:


Complications of Diabetes:

In the maintenance of health and the lengthening of life, the most effective treatment is control of insulin resistance and metabolic dysfunction by eating less and accomplishing more physical activity.

Diabetic Ketoacidosis:

The most sudden and dangerous complication of diabetes is ketoacidosis. That's a combination of excess fatty acids circulating in the blood and dehydration. It occurs when amount of insulin available is insufficient to move glucose into vital organs such as the brain.

The most compelling objective for treating diabetes has become the control of blood glucose to prevent diabetic ketoacidosis.

Microvascular and Metabolic Disease:

The most frequent direct complications of diabetes are caused by microvascular disease. These include:
• retinopathy leading to blindness
• neuropathy leading to pain, numbness and weakness
• nephropathy leading to kidney failure and dialysis
• gastroparesis leading to nausea, vomiting and abdominal pain
• peripheral vascular disease leading to ulcers and infection
• dementia leading to loss of memory and cognition

These complications are commonly attributed to high levels of glucose circulating in the blood. In fact, aggressive treatment with insulin and insulin enhancing drugs has little effect on microvascular disease. The major cause of microvascular disease is metabolic dysfunction including insulin resistance.

Indirect Complications:

The most frequent indirect complications of diabetes are heart attack, stroke, cancer and Alzheimer's disease.

How does all this happen?

In addition to excess glucose and fatty acids in the blood, eating too much and too little physical activity cause cells to develop insulin resistance. This creates a combination of excess insulin and glucose causing inflammation and endothelial dysfunction from hormonal and chemical factors largely arising from intra-abdominal fat tissue.

The medical treatment of diabetes is primarily the control of blood glucose and prevention of diabetic ketoacidosis.

The rest is up to you. The prevention of diabetes and remission of diabetes depend on keeping your maximum waist circumference less than half your height and maintaining physical activity.

We can help you do this and enhance the quality and length of your life.

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JA Herd, MD: April 27, 2018