Detecting and treating diabetic eye disease with laser therapy can reduce the development of severe vision loss by an estimated 50% to 60%.4 With regards to hypertension as the second leading attributable cause of end-stage renal disease in the USA, detecting and treating early diabetic kidney disease by lowering blood pressure has been shown to reduce the decline in kidney function by 30% to 70%.4,18,19 Treatment with angiotensin converting enzyme (ACE) inhibitors (e.g., Ramipril) and angiotensin II receptor blockers (ARBs – e.g., Atacand® (candesartan cilexetil) are more effective in reducing the decline in kidney function than other blood pressure lowering drugs, but only in the absence of severe kidney failure.20 Consultation with a physician is strongly advised on the casual use of acetaminophen (Tylenol™) and to a lesser degree with aspirin as studies have shown an association with the cumulative lifetime dose and the exacerbation of chronic renal failure.21
Comprehensive foot care programs can reduce amputation rates by 44% to 85% through a systematic assessment, treatment and tracking protocol.4,22 Simple measures such as routine foot inspection (at least yearly), fitting of appropriate shoes and orthotics, and management of simple foot problems, combined with patient education about the importance of self-care, lends toward decreasing the incidence of wounds in the diabetic population.23
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