4 FAQs About Diabetes

Insulin, kidney disease concerns common

4 FAQs About Diabetes

Here are 4 of the most common questions I hear from my diabetes patients:

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1. Why should I care about blood sugar if I’m going to end up on dialysis anyway?

You can prevent or delay the progression of kidney disease and dialysis by controlling your blood sugar and blood pressure. Studies show that even if you’re late starting to control your diabetes, it doesn’t necessarily mean you’re too late to prevent progression of kidney problems and dialysis.

And even if you’re very late, you can still delay the onset of dialysis. Significantly fewer patients need dialysis each year, and this is declining by 3 to 4 percent annually.

2. Once I start taking insulin, does that mean I’ll be on it forever?

It depends on the person and the situation. Starting insulin can be just a temporary measure to fix a short-term problem, or it can be long-term.

The good news is that two-thirds of patients who are newly diagnosed with diabetes and have been started on insulin can revert to other medications as long as they follow a program of diet and exercise.

However, there are people who have had diabetes for many years, have followed a good diet and are using three or more medications to control blood sugar — yet still have high blood sugar. They will probably always need insulin.

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Gastric bypass surgery is now an option for overweight people with type 2 diabetes. This procedure may reduce the need for insulin. Diet and exercise both before and after gastric bypass surgery improve your odds of staying off medications, or at least to keep the number down. Both greatly improve the expected benefits of surgery.

3. Why do I need to follow a diet if I’m on insulin or taking diabetes medication?

The benefits of diabetes medication and insulin adjustments could be short-lived, and often won’t be achieved, without diet and exercise.

A good diet and exercise may reduce the amount of medications you need and alleviate insulin’s side effects, which include low blood sugars and weight gain. Less medication means fewer side effects, not to mention less cost.

4. Blood sugar control is the most important factor for people with diabetes, right?

Blood sugar control is very important, but you need to also consider blood pressure and cholesterol control.

Breaking it down a little more:

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  • Controlling blood sugar helps prevent kidney disease and eye complications, particularly diabetic retinopathy – a serious disease that can lead to blindness.
  • Blood pressure control, ideally staying under 130/80 in adults, may slow kidney disease and prevent heart attack and stroke.
  • Keeping cholesterol low, along with good blood pressure control, protects blood vessels – lowering risk of heart attack, stroke and circulation problems in the legs and feet.

Beyond making sure you control your diabetes, don’t neglect your overall health too, with annual physicals and screenings. Your good health improves your quality of life. And that’s the main purpose of any treatment.

Cleveland Clinic is teaming up with the American Diabetes Association to support Diabetes Alert Day, the Tour De Cure and the Step Out Walk Against Diabetes.

More information

Diabetes Treatment Guides
Diabetes Risk Test

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Marwan Hamaty, MD

Marwan Hamaty, MD, MBA, is a staff physician in the Endocrinology & Metabolism Institute. His specialties are diabetes and pre-diabetes.
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