Diabetes Health Center

Treatment for your complication from type 1 diabetes depends on the stage of the disease.

For eye disease (diabetic retinopathy)

Keep all appointments with your eye specialist, and call if you notice any changes in your vision. Vision changes may mean your diabetic retinopathy is getting worse. Early detection and treatment of any changes can help prevent vision loss.

• If you have diabetic retinopathy in an early stage (nonproliferative stage), you need no treatment unless it is affecting the macula, the part of the retina that provides central vision. If the macula is damaged by swelling (macular edema), you may have laser treatment to seal leaking blood vessels, surgical removal (vitrectomy) of the fluid within the eye (vitreous gel), or steroid injections into the fluid of the eye.
• If the eye disease is advanced (proliferative stage), you may have either laser treatment or vitrectomy.

If you have severe vision loss, vision aids can help. Your local or state organization for the visually impaired can help you find these aids.

For more information, see the topic Diabetic Retinopathy.

For kidney disease (diabetic nephropathy)

Keep all appointments with your doctor, because the blood and urine tests done during these visits will monitor any kidney damage. Also, follow your doctor's instructions on taking your medicines (if you take any), because this can help slow damage.

If you have small amounts of protein in your urine (microalbuminuria), which is an early sign of kidney damage, you may be given an angiotensin-converting enzyme (ACE) inhibitor. Angiotensin II receptor blockers (ARBs) also treat kidney disease. These medicines are usually the first choice for people with type 1 diabetes who have microalbuminuria. Treatment for high blood pressure and high cholesterol may also help your kidneys work better.³ If you develop kidney failure, you may need dialysis, a kidney transplant, or possibly a pancreas-kidney transplant.⁸

You can also:

• Limit your intake of protein. This may help you preserve kidney function. Talk to your doctor or dietitian about how much protein is best for you.
• Limit salt in your diet because it makes your body retain fluid and can increase your blood pressure.

For more information, see the topics Diabetic Nephropathy and Chronic Kidney Disease.

For heart and large blood vessel disease (macrovascular disease)

You can treat heart and large blood vessel disease by:

• Controlling high blood pressure. You may try some lifestyle or behavioral therapy for 3 months before starting medicine if your systolic blood pressure is between 130 mm Hg and 139 mm Hg or your diastolic blood pressure is between 80 mm Hg and 89 mm Hg.⁵ Angiotensin-converting enzyme (ACE) inhibitors or other medicines can keep your blood pressure consistently below 130/80 mm Hg. Angiotensin II receptor blockers (ARBs) also help treat high blood pressure and kidney disease in people with diabetes. ARBs are used alone or along with an ACE inhibitor. For more information, see the topic High Blood Pressure (Hypertension).
• Controlling high cholesterol. Your LDL cholesterol goal is less than 100 mg/dL. Your LDL goal may be lower-less than 70 mg/dL-if you have heart disease. If you are a man, your HDL cholesterol goal is more than 40 mg/dL. If you are a woman, your HDL goal is more than 50 mg/dL. You want your triglyceride level to be lower than 150 mg/dL. For more information, see the topic High Cholesterol. To reach your goals, changes in diet and regular exercise can help. If these changes are not enough, you may need to take medicines too.
• Talk to your doctor about whether you should take low-dose aspirin. Daily low-dose aspirin (81 milligrams) may help prevent heart problems if you are at risk for heart attack or stroke. For more information, see the topics Coronary Artery Disease, Heart Attack and Unstable Angina, Peripheral Arterial Disease of the Legs, and Stroke.
• Not smoking. Smoking increases your risk for heart attack and stroke and makes many health problems worse. Quitting can lower your risk.⁹
• Exercising. Try to do at least 2� hours a week of moderate activity. One way to do this is to be active 30 minutes a day, at least 5 days a week. Take steps to exercise safely.

For nerve disease (diabetic neuropathy)