Aug. 17, 2018
When faced with a diabetes diagnosis, some people have a hard time wrapping their heads around the complications that may come with the disease and why the complications happen. That is understandable, since there is so much information to absorb and the explanations can seem scary.
Learning how to prevent complications can be easier when you understand the science behind WHY they happen.
When medical professionals talk about diabetes, they usually mention the complications of damage to the eyes, kidneys, heart and nerves. These all have one thing in common- blood vessel damage. Blood vessels play a key role helping to transport glucose (sugar) and insulin throughout the body. Diabetes contributes to high blood sugar (hyperglycemia) and high blood sugar, over time, causes damage to blood vessels.1
When there’s a high level of sugar in your blood, and your body or medications are not lowering it, the excess sugar starts attaching to proteins in blood cells, forming advanced glycation end products (AGEs).2 When your healthcare provider orders a glycated hemoglobin (A1C) test, they are measuring one type of AGE.2
AGEs are present in all of our bodies, even in babies.2 But AGEs form at a faster pace, and accumulate, in people with diabetes because of the available excess sugar in the blood.2 These AGEs cause damage to the interior wall of blood vessels, causing inflammation, formation of blood clots, stiffness, and decreases their ability to regenerate.3 These disruptions affect blood circulation in small vessels causing tissue and organ damage, leading to vision loss and kidney failure. Over time this process can also lead to clogging of larger vessels, which may lead to heart attack and stroke.4
Smoking increases the concentration of AGEs in blood, leading to more severe blood vessel damage and risk of vascular-related diseases in people living with diabetes.3
The good news is that you can prevent further damage by keeping your blood sugar in a healthy range. Studies show that following a diet high in fresh, unprocessed foods, cooked briefly with ample water (like steaming) can decrease AGE intake by more than 50%.2 Consistent lifestyle changes, such as eating a healthy diet and adding moderate exercise to your routine, are helpful to keeping diabetes in check and avoiding complications.5,6 Keeping A1C levels below 7% decreases the risk of cardiovascular diseases and other complications.7,8
You’ll work closely with your healthcare provider to set what your target blood sugar levels should be, and when you should be checking. It's important to test your blood sugar levels frequently- especially when starting medications for the first time. You can track your blood sugar levels using our blood sugar log template. Share your results with your healthcare provider who can help determine how well your treatment program is working for you.
With the help of your physician and other health professionals, it is possible to maintain good health and avoid complications in the future.
Articles are written by MannKind Corporation staff and contributors from the diabetes community.
 Kolluru GK, Bir SC, Kevil CG. Endothelial Dysfunction and Diabetes: Effects on Angiogenesis, Vascular Remodeling, and Wound Healing. International Journal of Vascular Medicine. 2012;2012:918267. doi:10.1155/2012/918267.
 Peppa M, Uribarri J, Vlassara H. Glucose, Advanced Glycation End Products, and Diabetes Complications: What Is New and What Works. Clinical Diabetes. 2003;21(4):186-187. doi:10.2337/diaclin.21.4.186.
 Tabit CE, Chung WB, Hamburg NM, Vita JA. Endothelial dysfunction in diabetes mellitus: Molecular mechanisms and clinical implications. Reviews in endocrine & metabolic disorders. 2010;11(1):61-74. doi:10.1007/s11154-010-9134-4.
 Wei X, Schneider JG, Shenouda SM, et al. De NovoLipogenesis Maintains Vascular Homeostasis through Endothelial Nitric-oxide Synthase (eNOS) Palmitoylation. Journal of Biological Chemistry. 2010;286(4):2933-2945. doi:10.1074/jbc.m110.193037.
 Fox CS, Golden SH, Anderson C, et al. Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association. Diabetes Care. 2015;38(9):1777-1803. doi:10.2337/dci15-0012.
 Colberg SR, Sigal RJ, Fernhall B, et al. Exercise and Type 2 Diabetes: The American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care. 2010;33(12):e147-e167. doi:10.2337/dc10-9990.
 American Diabetes Association. Standards of Medical Care in Diabetes 2018. Diabetes Care 2018 Jan; vol41 (Supplement 1): S1 -S2. doi: 10.2337/dc18-S004.
 Kilpatrick ES, Rigby AS, Atkin SL. A1C Variability and the Risk of Microvascular Complications in Type 1 Diabetes: Data from the Diabetes Control and Complications Trial. Diabetes Care. 2008;31(11):2198-2202. doi:10.2337/dc08-0864.
Afrezza can cause serious side effects, including: Sudden lung problems (bronchospasms). Do not use Afrezza if you have long-term (chronic) lung problems such as asthma or chronic obstructive pulmonary disease (COPD). Before starting Afrezza, your healthcare provider will give you a breathing test to check how your lungs are working.
Afrezza can cause serious side effects, including: Sudden lung problems (bronchospasms). Do not use Afrezza if you have long-term (chronic) lung problems such as asthma or chronic obstructive pulmonary disease (COPD).
Afrezza can cause serious side effects, including:
Sudden lung problems (bronchospasms). Do not use Afrezza if you have long-term (chronic) lung problems such as asthma or chronic obstructive pulmonary disease (COPD). Before starting Afrezza, your healthcare provider will give you a breathing test to check how your lungs are working.
Do not use Afrezza if you:
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Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins or herbal supplements.
Before you start using Afrezza, talk to your healthcare provider about low blood sugar and how to manage it.
While using Afrezza do not:
Afrezza may cause serious side effects that can lead to death, including:
See “What is the most important information I should know about Afrezza?” at the top of this page.
Treatment with TZDs and Afrezza may need to be changed or stopped by your healthcare provider if you have new or worse heart failure.
Get emergency medical help if you have:
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The most common side effects of Afrezza include:
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Active ingredient: human insulin
Inactive ingredients: fumaryl diketopiperazine, polysorbate 80
General information about the safe and effective use of Afrezza.
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