What are the complications of diabetes?
This section is meant to familiarize you with some of the most common diabetes-related problems. Keeping blood glucose levels as near normal as possible, along with getting regular check-ups and blood tests may help delay or prevent complications of diabetes.
Many people with diabetes develop some form of eye disease (retinopathy), caused by damage to the network of blood vessels that supply the retina. This can damage vision or cause blindness. Retinopathy can be quite advanced before it affects vision, so it is important that people with diabetes have regular eye screenings. If caught early, treatment can prevent blindness.
There is an increased risk of inflammation of the tissue surrounding the teeth (periodontitis) in people with poor glucose control. Periodontitis is a major cause of tooth loss and is associated with an increased risk of cardiovascular disease. Management of periodontitis is very important in people with diabetes because good oral hygiene can prevent tooth loss and improve glucose control.
Cardiovascular disease is the most common cause of death and disability among people with diabetes. The types that accompany diabetes include: angina (chest pain or discomfort); myocardial infarction (heart attack); stroke; peripheral artery disease (reduced blood flow to limbs); and congestive heart failure (heart weakness that leads to a build-up of fluid in the lungs and surrounding body tissues). High blood pressure, high cholesterol, and high blood glucose (all common in diabetes) are some of the factors that increase the risk of cardiovascular disease.
Kidney disease (nephropathy) is more common in people with diabetes. Diabetes is one of the leading causes of chronic (long-lasting) kidney disease. The disease is caused by damage to small blood vessels, which can cause the kidneys to be less effective, or to fail altogether. Maintaining near-normal levels of blood glucose and blood pressure greatly decreases the risk of nephropathy.
Women with any type of diabetes are at risk of a number of complications during pregnancy, as high glucose levels can affect the development of the fetus. They therefore need careful monitoring before and during pregnancy to decrease risks. High blood glucose during pregnancy can lead to changes in the fetus that cause it to become larger than usual size and gain weight. This in turn can lead to problems during delivery, including injuries to the child and mother and low blood glucose (hypoglycaemia) in the child after birth. Children who are exposed to high blood glucose in the womb are at higher risk of developing type 2 diabetes later in life.
Nerve damage (neuropathy) results from prolonged high blood glucose levels that can cause damage to any nerve in the body. The most common type is peripheral neuropathy, which mainly affects the sensory nerves in the feet. This can lead to pain, tingling, and loss of sensation. This is important because it can allow injuries to go unnoticed, leading to ulcers, serious infections and in some cases, amputations. Nerve damage can also lead to erectile dysfunction (sexual problems in men), as well as problems with digestion, urination and a number of other functions.
In addition to nerve damage, people with diabetes can experience problems with poor circulation in their feet, as a result of damage to blood vessels. These problems increase the risk of ulcers, infection and amputation. People with diabetes face a risk of amputation that may be more than 25 times greater than that in people without diabetes.
With good management however, a large proportion of amputations can be avoided. In view of these risks, it is important that people with diabetes examine their feet regularly to identify problems early.
How can you prevent diabetes complications?
The major complications of diabetes can be prevented by:
- Good control of blood glucose levels
- Good control of blood pressure and cholesterol levels
- Getting regular laboratory tests, eye and foot exams
- Learning everything you can on how to best manage your diabetes including
- Making healthy food choices and staying physically active
- Taking medication as prescribed by your doctor
- Testing your blood sugar regularly
1. IDF Diabetes Atlas (7th Ed.) (2015). Brussels, Belgium: International Diabetes Federation.