There is little doubt that diabetes is a serious disease. There is also little doubt that people with diabetes can live long, healthy, happy lives if they keep their diabetes under control. But do you know that how well you manage your disease on a day-to-day basis can have a dramatic impact on your degree of risk for the complications of diabetes?
The complications of diabetes are both numerous and serious. The most common include:
Diabetes is one of the major, modifiable risk factors for heart disease and stroke. If you have other risk factors, like high blood pressure and high cholesterol, you have an even higher chance of developing problems with your blood vessels. A clogged or narrow vessel in your heart can lead to a heart attack, while the same problem in your brain can lead to a stroke. This means that people with diabetes must not only keep their blood sugar levels under control, but also effectively control their blood pressure and cholesterol levels as well.
Type 2 diabetes damages the small blood vessels in the eyes. This can put you at increased risk for 3 types of vision problems: glaucoma, cataracts, and retinopathy (a general term for disorders of the retina caused by diabetes). Retinopathy is a leading cause of blindness. Fortunately, most diabetes-related vision problems can be slowed or stopped if caught early and can be prevented with good blood sugar and blood pressure control.
High levels of blood sugar cause the kidneys to overwork. This excess strain can cause the kidneys to function poorly. Eventually, needed protein is lost in the urine and waste products build up in the blood. If diagnosed early, there are several treatments that may prevent your kidney disease from getting worse. If caught later, this can result in permanent kidney damage and kidney failure. People whose kidneys are no longer working need to have dialysis, a procedure which filters the blood by machine. A kidney transplant may also be needed.
Diabetic neuropathies are a family of nerve disorders caused by diabetes. Neuropathy is the most common complication of diabetes and can be both painful and disabling. Over time, diabetes can damage the nerves throughout the body. This may lead to numbness and sometimes pain and weakness in the hands, arms, feet, and legs. It may also affect other organ systems, such as the digestive tract and the cardiovascular system.
A common type of neuropathy is called peripheral neuropathy. When the nerves of your foot are damaged, for example, you may not notice ulcers on your foot. These ulcers may take a long time to heal, which can lead to gangrene and amputation.
Glucose control seems to play a role in neuropathy. This means that the longer a person has diabetes, the greater their risk of developing nerve damage, particularly if they have difficulty controlling their glucose, cholesterol, and blood pressure levels. Fortunately, maintaining good blood sugar control seems to help prevent or delay neuropathy.
Diabetes can also affect the skin. Indeed, skin problems are sometimes the first indication that a person has diabetes. Common, diabetes-related skin disorders include itchy skin, bacterial infections, fungal infections, and diabetic dermopathy (patches of brown, scaly skin). Fortunately, many of these conditions can be either prevented or easily treated if caught early.
If you have diabetes, you are at higher risk for gum disease than people who do not have the disease. To make matters worse, gum disease also raises your risk of heart disease and stroke. This is because diabetes may weaken your mouth's ability to fight germs. And while it’s true that anyone can get gum disease, having diabetes can make it worse and make it more difficult to control. Proper oral care and regular dental visits can help keep gum disease under control.
Frozen shoulder can affect people with diabetes. A frozen shoulder, technically known as adhesive capsulitis, often begins as tenderness or soreness in the shoulder joint, usually following a bout with another musculoskeletal condition such as tendonitis or bursitis. As the shoulder becomes stiffer and more painful, people tend to use it less and less. Unfortunately, this adds to the stiffness and pain, creating a vicious cycle in which the shoulder’s range of motion decreases while the pain and stiffness increases.
Researchers aren’t sure exactly why diabetes is a risk factor for frozen shoulder. One theory is that uncontrolled levels of glucose in the blood may contribute to abnormal deposits of collagen in the cartilage and tendons of the shoulder. Collegen is a major part of the ligaments that hold the bones together in a joint. This buildup can cause the affected shoulder to stiffen.
Other joints may be affected.
In addition to the above complications, there are many other conditions that have been associated with diabetes. While thinking about your long-term health may feel overwhelming, there are steps that you can take today to reduce your chance of future health problems:
American Diabetes Association
National Institute of Diabetes and Digestive and Kidney Diseases
Canadian Diabetes Association
Complications. American Diabetes Association website. Available at: http://www.diabetes.org/living-with-diabetes/complications. Accessed September 28, 2017.
Diabetes mellitus type 2 in adults. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115259/Diabetic-peripheral-neuropathy. Updated July 27, 2017. Accessed September 28, 2017.
Diabetic neuropathies: the nerve damage of diabetes. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies. Updated November 2013. Accessed September 28, 2017.
Diabetes peripheral neuropathy. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113993/Diabetes-mellitus-type-2-in-adults. Updated November 2, 2015. Accessed September 28, 2017.
Dietary considerations for patients with type 2 diabetes. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T270045/Dietary-considerations-for-patients-with-type-2-diabetes. Updated February 7, 2017. Accessed September 28, 2017.
Living with type 2 diabetes. American Diabetes Association website. Available at: http://www.diabetes.org/living-with-diabetes/?loc=404. Accessed September 28, 2017.
Standards of medical care in diabetes—2012. Diabetes Care. 2012;35 Suppl 1:S11-S63.
Last reviewed September 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP Last Updated: 11/18/2013