What Is the Prognosis of Diabetes?
Diabetes is a leading cause of death in all industrialized nations. Overall, the risk of premature death of people with diabetes is twice that of people without diabetes. Prognosis depends on the duration of diabetes, degree of blood sugar control, and development of complications.
Type 1 diabetes
About 15% of people with T1D die before age 40 years, which is about 20 times the rate of this age group in the general population.
- Diabetic ketoacidosis (DKA), kidney failure, and heart disease compose the most common causes of death related to T1D.
- The good news is prognosis improves with good sugar control. Maintaining tight blood (or CGM) sugar control prevents, slows the progression of, and can improve established complications of T1D.
Type 2 diabetes
The life expectancy of people who are diagnosed with T2D during their 40s decreases by five to 10 years because of the disease.
- Heart disease leads the causes of death related to T2D.
- Aim for excellent glycemic control, tight blood pressure control, keeping the “bad” cholesterol (LDL) level at the recommended level below 100 mg/dL (or even lower, particularly if other risk factors for cardiovascular disease are present), and keeping the “good” (HDL) cholesterol as high as possible. When indicated, aspirin can prevent, slow the progression of, and improve established complications related to diabetes.
Is It Possible to Prevent Diabetes?
No approach has yet been approved by the FDA to prevent T1D, though recent research showed promising results for teplizumab for some at highest risk of developing T1D.
T2D can be prevented in some cases.
- Control weight to normal or near-normal levels by eating a healthy low-fat, high-fiber diet with appropriate content of calories.
- Regular physical activity is essential to prevent T2D.
- Keep alcohol consumption low.
- Quit smoking and other tobacco products.
- To control high blood fat levels (e.g., high total cholesterol) or high blood pressure, take medications as directed.
- Lifestyle modifications and/or certain medications can sometimes prevent progression of prediabetes to T2D. Prediabetes can be diagnosed by checking fasting glucose or two hours after ingesting up to 75 grams of glucose (dose based on patient’s weight).
If you or someone you know has any type of diabetes, focus on preventing diabetes-related complications. Complications can cause serious disabilities, such as blindness, kidney failure requiring dialysis, amputation, or even death.
- Tight glucose control! The single best thing people with diabetes can do is to keep their blood sugar level within the suggested range every day. The only way to accomplish this goal is the combination of glucose monitoring, appropriate diet, high personal motivation sustained over time, and appropriate medical treatment. Consult a nutritionist or your health care professional regarding diet.
- Quit smoking and stop use of other tobacco products.
- Maintain healthy weight.
- Increase physical activity. Adults should aim for moderate to vigorous physical activity lasting at least 30 minutes every day.
- Drink adequate amounts of water, and avoid consuming excessive salt.
- Take care of your skin. Keep it supple and hydrated to avoid sores and cracks that can become infected.
- Brush and floss your teeth at least twice every day. Encounter your dentist and dental hygienist regularly to prevent tooth decay and gum disease.
- Wash and examine your feet daily. Including the soles, look for small cuts, sores, or blisters that may worsen. File toenails to avoid damaging the surrounding skin, rather than cutting them. A specialist in foot care (podiatrist) may be necessary to help care for your feet.
- Follow treatment recommendations of your health care team.
- Keep records of blood sugar levels or CGM results as often as recommended by your health care team, including times when levels were checked, when and how much insulin or medication was taken, when and what was eaten, and when and for how long the patient exercised.
- Contact your health care professional if you have issues with treatment or symptoms suggesting poor glucose control.
- Fast-acting glucose should always be available for emergency use in case of hypoglycemia.
- Glucagon should always be available for emergency use by the patient or patient’s support in case of seizure or unconsciousness suspected to be due to hypoglycemia.
- People with diabetes should always wear a medical identification tag that identifies their diagnosis and shows contact information for their healthcare provider. For children with diabetes, it is appropriate to show contact information for the parent(s).
- Attend diabetes education classes at the local hospital. The more educated you and your family are about your diabetes, the better your health is likely to be.
- If taking insulin, you should see your health care professional about every three months at a minimum. Every three to six months is generally adequate for those with uncomplicated diabetes and not taking insulin.
- Become educated to recognize the signs and symptoms of low blood sugar levels. Have a clear plan for treating low blood sugar levels, and know when to call 911. Mild symptoms include confusion and sweating. These symptoms can progress to lethargy, agitation (sometimes with violent, jerking motions), or seizures.