Diabetes is a slow and often "silent disease. Most people who have it feel fine initially. By the time they develop symptoms, years of elevated blood sugar (glucose) have already caused widespread damage and complications, including cardiovascular disease, nerve damage and kidney disease.

Unfortunately, complications from diabetes can shorten life expectancy by about a decade.

Good news: Most people can reduce or eliminate these complications by maintaining optimal glucose control.

Here, the dangerous complications of diabetes and bow to control them.

Peripheral Neuropathy

Excess blood sugar can damage capillaries tiny blood vessels in the fingers, legs and/or feet. A lack of circulation to nerves can cause neuropathy, which can be painful and produce sensations of numbness, tingling and burning.

Important finding: One of my colleagues had his patients with neuropathy eat a low.at, vegan diet (no animal foods or dairy products) and take a daily 30-minute walk. In 17 out of 21 patients, leg pain stopped completely-the remaining four had partial relief.

Many patients with neuropathy eventually lose all sensation in the extremities. This is dangerous because small injuries, such as cuts or an ingrown nail, for example, won't be noticed and can progress to serious infections and tissue damage-and, in some cases, require amputation. What to do…

  • Exercise daily. It helps with weight loss and glucose control, which help reduce capillary damage and may reduce pain from neuropathy.
  • Check your feet every day. Look for abrasions, cuts and blisters. See a doctor if an injury isn't healing.

Also, ask your doctor to examine your feet two to four times a year. Most doctors don't do this routinely.

Helpful: Take off your shoes and socks while you're waiting in the examination room. This makes it impossible for the doctor to ignore your feet.

Eye Damage

Diabetes is the leading cause of blindness in American adults. High blood sugar can lead to glaucoma, resulting in optic nerve damage, which causes loss of vision. It also can damage the retinas (retinopathy) or the lenses of the eyes cataracts). What to do…

  • Avoid dairy. Many people lack the enzyme needed to metabolize galactose, a sugar that is released when the lactose in dairy is digested This can lead to lens damage and cataracts.
  • Eat more produce. The antioxidants in fresh fruits and vegetables, such as vitamin C lutein and zeaxanthin, appear to have a stabiliz ing effect on the retina and can reduce the risk for cataracts and other eye diseases

I do not recommend supplements for eye health because natural foods provide large amounts of these nutrients. It's likely that the combination of nutrients in foods, rather than single source nutri ents, offer the most protection.

Periodontal Disease

Doctors have known for a long time that pa tients with diabetes have a high risk for periodontal disease, a chronic bacterial infection of the gums that can lead to tooth loss.

Recent finding: A review of research by the Cochrane Database of Systematic Reviews found that people with diabetes who were treated for periodontal disease achieved better blood sugar control, indicating that periodontal disease is both caused by and causes higher blood sugar. Periodontal treatment includes regular scaling, the removal of bacteria and inflammatory material from beneath the gums. What to do…

  • See your dentist four times a year. The usual twice-a-year schedule might not be enough for people with diabetes.
  • Eat less sugar. This is important for every one, but more so for those with diabetes and periodontal disease. A high-sugar diet makes it easier for bacteria to proliferate.
  • Floss and brush your teeth after every meal—not just once or twice a day.

Heart Disease

Most people in the US have some degree of atherosclerosis plaque buildup in the arteries that increases the risk for heart attack. The risk for heart disease is much higher in people with diabetes, particularly when atherosclerosis is accompanied by hypertension and kidney disease.

Recent finding: People with diabetes who eat a typical American diet tend to accumulate intracellular lipids, tiny bits of fat inside muscle cells. This fat inhibits the ability of cells to respond to insulin, which leads to elevated blood sugar. What to do.

  • Avoid animal products and added fats. Research by Dean Ornish, MD, showed that people who get no more than about 10% of total calories from fat (preferably unsaturated can re verse blockages in the arteries (Traditional dia betes diets allow up to 39% of calories from fat.)
  • Reduce cholesterol. It's one of the best ways to reduce cardiovascular risks.

Helpful: Foods that are high in soluble fiber, such as oatmeal, fruits, whole grains and beans. People who eat beans regularly have average cholesterol readings that are about 7% lower than those who don't eat beans.

  • Reduce blood pressure. The same strategies that reduce cholesterol and arterial block ages also reduce blood pressure.

Kidney Disease

The filtering units of the kidneys, or nephrons, consist of millions of small blood vessels that frequently are damaged by diabetes. Extensive damage can lead to kidney failure and the need for a transplant. What to do...

  • Give up animal protein. The sulfur-containing amino acids in meats and eggs are harder for the nephrons to process than the proteins from plant foods. People with diabetes who switch to a vegetarian diet have a lower risk of developing kidney disease.
  • Maintain healthy blood pressure. Uncontrolled hypertension is a leading cause of kidney failure. The same low-fat, plant-based diet that reduces glucose and cholesterol also is effective for lowering blood pressure.

Alzheimer’s Disease

A Japanese study reported in Neurology found that patients with type 2 diabetes or resistance to insulin were more likely to develop brain plaques, clusters of abnormal proteins that occur in those with Alzheimer's disease.

It's not yet clear whether diabetes increases the risk of getting Alzheimer's or there's an underlying process that causes both conditions. What to do…

  • Avoid meat. Many studies have shown that people who eat diets that are high in meat, fat and cholesterol are more likely to develop Alzheimer's disease than those who eat a healthier diet. It's possible that the heme iron in meats is more likely than the non-heme iron in plant foods to be associated with brain plaques.

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