Dr. Martin Abrahamson's Advice on How to Prevent Diabetes Complications

Visiting a dentist is important. Gum disease can worsen blood glucose control.
Martin J. Abrahamson, MD, is a senior vice president at Joslin Diabetes Center, the medical director of the Joslin Clinic and an associate professor of medicine at Harvard Medical School.

Q: Will diabetes affect my sex life?

A: It can. Men may develop erectile dysfunction, and may also have more frequent urinary tract infections. High blood pressure, high cholesterol, and obesity can increase the likelihood of erectile problems. Woman may experience difficulty having an orgasm, more frequent urinary tract and yeast infections, and vaginal dryness. Viagra and similar drugs for treating erectile dysfunction are safe for people with diabetes to take, and there are other options available if medications don't work. Good blood glucose control can prevent such problems from developing or getting worse. Half of men who have been diagnosed with type 2 diabetes suffer from erectile dysfunction, but that percentage falls to 30% among those whose blood glucose is well-controlled.

Q: What are other complications of diabetes?

A: Diabetes complications are divided into two types: those that affect the large blood vessels, known as macrovascular complications, and those that strike the smaller blood vessels, called microvascular complications. The most important macrovascular complication is cardiovascular disease (heart attacks and strokes), which is the leading killer of people with diabetes. Another macrovascular complication is peripheral vascular disease, where fatty deposits build up in arteries outside of the heart, such as in the legs.Microvascular complications include damage to the retina, the layer of cells lining the back of the eyeball that responds to light. This damage is known as diabetic retinopathy, and can eventually cause blindness. Peripheral neuropathy is damage to the nerves supplying sensation and motor strength to the arms and legs. Neuropathy, or nerve damage, can also affect the autonomic nervous system, which helps regulate heart rate, digestion, and other essential bodily functions. People with diabetes also are at risk of kidney damage—diabetes is the leading cause of end-stage renal disease in the western world.People with diabetes are also at greater risk than the general population of developing glaucoma and cataracts. Due to these complications, diabetes is the leading cause of blindness in the western world, as well as the most common cause of non-traumatic lower limb amputation.

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Last Updated: April 02, 2008

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