Health Check
糖尿病併發症評估 Q&A
1) What are diabetes complications?
Diabetes complications mainly result from damage to blood vessels and nervous system due to improper diabetes control, including high and unstable blood sugar levels.
2) How will our body be affected by poor diabetes control?
Diabetes complications include, but are not limited to:
‣ Cardiovascular diseases:
Coronary artery disease, stroke, peripheral vascular disease
‣ Microvascular and nervous system diseases:
Kidney failure, cataracts, retinopathy, glaucoma, foot ulcers, peripheral neuropathy, male sexual dysfunction
3) Is diabetes complications assessment not necessary if I am just recently diagnosed of diabetes?
Many people are mistaken that only long-term diabetes patients develop complications. Instead, high blood sugar may have been present for some time before diagnosis, and thus optimal treatment period may be missed if diabetes complications are not being assessed at this stage.
Two international studies indicate that reducing glycated hemoglobin (HbA1c) levels to around 7% can reduce the likelihood of diabetes microvascular complications (e.g. retinopathy, neuropathy, and diabetic nephropathy) by about 25%. Lowering HbA1c by 1% can decrease the likelihood of cardiovascular disease by 16%, reducing the chance of cataracts by 19%, and lowering the risk of amputation or death due to peripheral vascular disease by 43%.
4) Why do we need regular screening of diabetes complications?
Due to close relationship between diabetes complications and blood sugar control, regular assessments can allow healthcare professionals to detect and address possible complications before symptoms appear, therefore effectively preventing or delaying complications.
5) How often should diabetes complications assessment be conducted?
At least once every one to two years, but it will be more ideal to consult your own family doctor for a more personalized plan.
6) How does diabetes complications assessment differ from a regular check-up?
In addition to monitoring blood sugar control and high-risk factors for cardiovascular disease e.g. cholesterol, diabetes complications assessment focuses on evaluating microvascular and neuropathic changes, including microalbuminuria, retinal vessels, cataracts, peripheral neuropathy and skin damages at foot.
7) How to perform foot examination, and why is it important to perform it on a regular basis?
Foot examination includes:
‣ checking for nail/sole/toe deformities, athlete's foot, ulcers, cracks, calluses, etc
‣ conducting vibration sensation tests to detect peripheral neuropathy early
‣ assessing abnormal foot vascular conditions by checking foot arterial pulses
Regular foot exams can reduce the risk of diabetic foot ulcers and amputations, as patient can be referred accordingly for further management and more professional foot care by vascular specialist or podiatrist.
8) What is diabetic retinopathy?
Diabetic retinopathy can be broadly categorized into non-proliferative diabetic retinopathy and proliferative diabetic retinopathy:
‣ Non-proliferative retinopathy is an early stage of retinopathy which involves small vessel anomalies, inadequate retinal blood flow, and retinal edema. Visual symptoms may not be present at this stage, but vision can be impacted if it involves the macula.
‣ Proliferative retinopathy involves abnormal vessel and fibrous tissue growth due to inadequate retinal blood supply, which can lead to bleeding in the vitreous or retina and even retinal detachment, potentially causing severe vision impairment or blindness.
9) Is diabetic eye disease untreatable once it appears?
Early treatment with intraocular injections is effective for diabetic retinal edema. With timely retinal laser treatment for diabetic retinopathy, there is a significant chance of preventing worsening complications like intraocular bleeding or retinal detachment.
Since early-stage diabetic retinopathy may be asymptomatic, regular eye exams are crucial for monitoring retinal vascular damage and proliferation, allowing for early referral of high-risk cases to ophthalmologists for laser treatment to reduce the risk of blindness.
