In Most Patients

7/28/2019 In Most Patients

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In most patients, diabetes can be controlled by diet, exercise, and insulin injections. If the

condition is not treated, however, some serious complications may result. For example,

uncontrolled diabetes is the leading cause of blindness, kidney disease, and amputations of

arms and legs. It also doubles a person's risk for heart disease and increases the risk of stroke.

Eye problems also occur more commonly among diabetics than in the general population.

Some other long-term effects of diabetes mellitus include the following:

Loss of sensitivity in certain nerves, especially in the legs and feet Foot ulcers Delayed healing of wounds Heart and kidney disease

Read more:Prognosis - Diabetes Mellitus - body, effects, disease

http://www.faqs.org/health/Sick-V2/Diabetes-Mellitus-Prognosis.html#ixzz1Z96bYRqb

http://www.faqs.org/health/Sick-V2/Diabetes-Mellitus-Prognosis.html

Prognosis

Your treatment plan is likely to require adjustment over time. Insulin resistance increases

with age. And the insulin-producing cells in the pancreas may wear out as the pancreas tries

to keep up with the body's extra insulin needs.

After the first few years, the majority of people with type 2 diabetes require more than one

medicine to keep their blood sugar controlled. About one out of three people with type 2

diabetes requires insulin.

The prognosis in people with type 2 diabetes varies. It depends on how well an individual

modifies their risk of complications. Heart attack, stroke and kidney disease can result in

premature death. Disability due to blindness, amputation, heart disease, stroke and nerve

damage may occur. Some people with type 2 diabetes become dependent on dialysis

treatments because of kidney failure.

There is a tremendous amount you can do to decrease your risk of complications:

Eat a healthy diet Get regular exercise Pay careful attention to your blood sugar levels Reduce your other risks of heart disease

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Cooperative study

The effect of diabetes mellitus on prognosis and serial left ventricular function after acute

myocardial infarction: Contribution of both coronary disease and diastolic left ventricular

dysfunction to the adverse prognosis

Peter H Stone MD FACC, a, b,c

, James E Muller MD FACCa,b, c

, Tyler Hartwell

PhDa,b, c

, B.J York MSa,b,c

, John D Rutherford MD FACCa,b,c

, Corette B Parker

MSPHa,b, c

, Zoltan G Turi MD FACCa,b, c

, H.William Strauss MD FACCa,b, c

, James

T Willerson MD FACCa,b,c

, Thomas Robertson MD FACCa,b,c

, Eugene Braunwald MD

FACCa,b,c

, Allan S Jaffe MD FACCa,b, c

and MILIS Study Group

aCardiovascular Division. Departments of Medicine, Brigham and Women's Hospital, Harvard

Medical School, USA

b

Cardiovascular Division, Barnes Hospital, Washington University Medical School, St. Louis,

Missouri, USA

cCooperating Institutions of the Multicenter Investigation of the Limitation of Infarct Size (MILIS),

USA

Received 28 September 1988; revised 1 February 1989; Accepted 15 February 1989.

Available online 4 February 2004.

Abstract

Patients with diabetes mellitus experience a more adverse outcome after acute myocardial

infarction compared with nondiabetic patients, although the mechanisms responsible for these

findings are not clear. From the Multicenter Investigation of the Limitation of Infarct Size

(MILIS) study, the course of acute infarction in 85 diabetic patients was compared with that

in 415 nondiabetic patients, all of whom had serial assessments of left ventricular function.

The diabetic patients experienced a more complicated in-hospital and postdischarge course

than did the nondiabetic patients, including a higher incidence of postinfarction angina,

infarct extension, heart failure and death, despite the development of a smaller infarct size

and similar levels of left ventricular ejection fraction.

Although diabetic patients had a worse profile of cardiovascular risk factors at the time of theindex infarction, the increased incidence of adverse outcomes among them persisted despite

adjustment for these baseline imbalances. Diabetic women had a poor baseline risk profile

compared with the other groups categorized by gender and diabetic status, and experienced

an almost twofold increase in cardiac mortality despite development of the smallest infarct

size during the index event. The duration of diabetes and the use of insulin at the time of the

index infarction were associated with a better in-hospital mortality rate, but the duration of

diabetes did not exert a major influence on the outcome of the diabetic patients.

The factors responsible for the increased incidence of adverse outcomes among diabetic

patients may be related to an acceleration of the atherosclerotic process, diastolic left

ventricular dysfunction associated with diabetic cardiomyopathy or other unidentified

unfavorable processes.
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