Complications of Diabetes

People with diabetes have an increased risk of developing a number of serious health problems. Consistently high blood glucose levels can lead to serious diseases affecting the heart and blood vessels, eyes, kidneys, nerves and teeth. In addition, people with diabetes also have a higher risk of developing infections. In almost all high-income countries, diabetes is a leading cause of cardiovascular disease, blindness, kidney failure, and lower limb amputation.

Complications of Diabetes

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Most people with diabetes will develop some form of eye disease (retinopathy) causing reduced vision or blindness. Consistently high levels of blood glucose, together with high blood pressure and high cholesterol, are the main causes of retinopathy.1 With these eye complications, at first you may not notice changes to your vision. But over time, diabetic retinopathy may get worse and can cause vision loss. It can be managed through regular eye checks and keeping glucose and lipid levels at or close to normal. That's why it's important to have a comprehensive eye exam every year. These eye complications can usually be treated if they are discovered in the early stages.2

Diabetic RetinopathyDiabetic Retinopathy

1http://www.idf.org/complications-diabetes
2http://www.lillydiabetes.com/Pages/diabetes-complications.aspx

Diabetes can also damage small blood vessels in the kidneys. This type of kidney damage is called diabetic nephropathy that may lead to the kidneys becoming less efficient or to fail altogether. Approximately 40% of people with diabetes will develop nephropathy.

Nephropathy is a general term for the deterioration of proper functioning in the kidneys. Diabetic nephropathy can affect people with both type 1 and type 2 diabetes. Diabetic nephropathy is divided into five stages of deterioration, with the final one being End Stage Renal Disease (ESRD). It commonly takes over 20 years for patients to reach stage 5.

The symptoms of diabetic nephropathy tend to become apparent once the condition has reached the later stages. Typically the following symptoms may start to be noticed around stage four of its progression:

  • Swelling of the ankles, feet, lower legs or hands caused by retention of water
  • Darker urine, caused by blood in the urine
  • Becoming short of breath, when climbing the stairs for instance
  • Tiredness as a result of a lack of oxygen in the blood
  • Nausea or vomiting 1

If your kidneys fail, you must depend upon a special filtering machine, called a dialysis machine, to remove impurities from your bloodstream. However, kidney damage can be detected at an early and treatable stage with simple office testing that identifies small amounts of protein in the urine. This test is called a microalbumin screen. A second test to check kidney function is a blood test called serum creatinine. You should have both of these tests done at least once a year. 2


1http://www.diabetes.co.uk/diabetes-complications/kidney-disease.html
2http://www.lillydiabetes.com/Pages/diabetes-complications.aspx

Neuropathy & Peripheral Vascular Disease

Nerve damage from diabetes is called diabetic neuropathy. When blood sugar is too high, nerve cells can swell and scar. In time, the nerves lose their ability to send signals through the body the way they should. About half of all people with diabetes have some form of nerve damage. It is more common in those who have had the disease for a number of years and can lead to many kinds of problems.

Among the most commonly affected areas are the extremities, in particular the feet. Nerve damage in these areas is called peripheral neuropathy, and can lead to pain, tingling, and loss of feeling. Loss of feeling is particularly important because it can allow injuries to go unnoticed, leading to serious infections and possible amputations. People with diabetes carry a risk of amputation that may be more than 25 times greater than that of people without diabetes. 1

Further symptoms may include:

  • Wasting of muscles in feet or hands
  • Indigestion, nausea and vomiting
  • Diarrhoea
  • Constipation
  • Urinary problems
  • Impotence
  • Vaginal dryness
  • Dizziness
  • Weakness of the limbs2

If you keep your blood glucose levels on target, you may help prevent or delay nerve damage.3 If you already have nerve damage, this will help prevent or delay further damage. In most cases, proper care of your feet can help reduce the risk of injury and the need for any surgery. This is why it's so important to protect your feet-especially when you exercise-and check them daily for any sign of a complication. Read more about Foot Care and learn some important tips.

There are treatments for painful neuropathy, so be sure to tell your doctor or diabetes educator if you have any of the above painful symptoms.4


1http://www.idf.org/complications-diabetes
2http://www.diabetes.co.uk/diabetes-complications/diabetes-neuropathy.html
3http://www.diabetes.org/living-with-diabetes/complications/neuropathy/?loc=lwd-slabnav
4http://www.lillydiabetes.com/Pages/diabetes-complications.aspx

Among the most commonly affected areas are the extremities, in particular the feet. Nerve damage in these areas is called peripheral neuropathy, and can lead to pain, tingling, and loss of feeling. Loss of feeling is particularly important because it can allow injuries to go unnoticed, leading to serious infections and possible amputations. People with diabetes carry a risk of amputation that may be more than 25 times greater than that of people without diabetes. 1

Further symptoms may include:

  • Wasting of muscles in feet or hands
  • Indigestion, nausea and vomiting
  • Diarrhoea
  • Constipation
  • Urinary problems
  • Impotence
  • Vaginal dryness
  • Dizziness
  • Weakness of the limbs2

If you keep your blood glucose levels on target, you may help prevent or delay nerve damage.3 If you already have nerve damage, this will help prevent or delay further damage. In most cases, proper care of your feet can help reduce the risk of injury and the need for any surgery. This is why it's so important to protect your feet—especially when you exercise—and check them daily for any sign of a complication. Read more about Foot Care and learn some important tips.

There are treatments for painful neuropathy, so be sure to tell your doctor or diabetes educator if you have any of the above painful symptoms.4


1http://www.idf.org/complications-diabetes
2http://www.diabetes.co.uk/diabetes-complications/diabetes-neuropathy.html
3http://www.diabetes.org/living-with-diabetes/complications/neuropathy/?loc=lwd-slabnav
4http://www.lillydiabetes.com/Pages/diabetes-complications.aspx

Heart disease and stroke are major causes of death in people with type 2 diabetes. Two out of three people with diabetes die from heart disease or stroke, also known as cardiovascular disease.1 Diabetes can change the makeup of blood vessels, and this can lead to cardiovascular disease. The lining of the blood vessels may become thicker, and this in turn can impair blood flow.2 High blood pressure, high cholesterol, high blood glucose and other risk factors contribute to increasing the risk of cardiovascular complications.

Controlling your blood sugar levels is also essential in both prevention and treatment, with research showing that reducing HbA1c by 1% decreases the risk of heart failure by 16% in people with type2 diabetes.

To prevent heart disease, a number of factors must be considered. It is imperative to control your weight, through regular exercise and a balanced diet, avoid or quit smoking (if you smoke). You should also have both your cholesterol and blood pressure checked at least once each year.

Consult a physician and base your prevention plan on their advice.


1http://www.lillydiabetes.com/Pages/diabetes-complications.aspx
2http://www.diabetes.co.uk/diabetes-complications/heart-disease.html

When your blood sugar (glucose) falls too low (below 70 mg/dL), you have low blood sugar (hypoglycemia). When this happens, many people experience unpleasant hypoglycemia symptoms that can be both physical and emotional. These symptoms can come on quite suddenly.

Low blood sugar is usually easy to treat. However, if it is not dealt with quickly, it can be life-threatening and may cause you to pass out or have seizures.

Hypoglycemia

The most common causes of low blood sugar are:

  • Skipping or not finishing meals or snacks
  • Getting more exercise than usual
  • Taking too much diabetes medication
  • Not eating enough
  • Drinking alcoholic beverages

When blood sugar gets too low, you may:

Hypoglycemia

Feel shaky

Hypoglycemia

Sweaty

Hypoglycemia

Tiredness

Hypoglycemia

Hungry

Hypoglycemia

Angry

Hypoglycemia

Headache or blurred vision

Or

  • Have no symptoms at all 1

A mild case of hypoglycemia can be treated through eating or drinking approximately 10-20g of sugar (i.e. carbohydrates). Diabetics carry glucose tablets for this express purpose.

  • Consume 15-20 grams of glucose or simple carbohydrates

    Hypoglycemia Treatement
  • Recheck your blood glucose after 15 minutes

    Hypoglycemia Treatement
  • If hypoglycemia continues, repeat.
  • Once blood glucose returns to normal, eat a small snack if your next planned meal or snack is more than an hour or two away2.

Having no symptoms of low blood sugar at all is a dangerous situation! If you have a blood sugar reading below 70 mg/dL and aren't experiencing any of the symptoms described above, you should immediately treat your low blood sugar level. Even if you are feeling fine, this situation still needs to be treated. Make sure to notify your doctor of this event


1http://www.lillydiabetes.com/Pages/what-is-low-blood-sugar-hypoglycemia.aspx
2http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html?loc=lwd-slabnav

A mild case of hypoglycemia can be treated through eating or drinking approximately 10-20g of sugar (i.e. carbohydrates). Diabetics carry glucose tablets for this express purpose.

  • Consume 15-20 grams of glucose or simple carbohydrates

    glucose or simple carbohydrates
  • Recheck your blood glucose after 15 minutes

    blood glucose
  • If hypoglycemia continues, repeat.
  • Once blood glucose returns to normal, eat a small snack if your next planned meal or snack is more than an hour or two away2.

Having no symptoms of low blood sugar at all is a dangerous situation! If you have a blood sugar reading below 70 mg/dL and aren't experiencing any of the symptoms described above, you should immediately treat your low blood sugar level. Even if you are feeling fine, this situation still needs to be treated. Make sure to notify your doctor of this event


2http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html?loc=lwd-slabnav

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