10 Complications of Diabetes

Having diabetes is challenging enough. So it's good to know diabetes complications don't have to be inevitable. There are things you can do to help prevent them. But if diabetes isn't controlled, it leads to more health problems over time. Some people develop heart disease. Others experience vision loss. Still, others end up with kidney disease. "Preventing complications is pretty straightforward," says Steve Edelman, MD, founder of Taking Control of Your Diabetes (TCOYD). "Keep your blood sugar levels as close to normal as possible to prevent and delay the progression of eye, kidney, and nerve disease." Here are 10 diabetes complications you can learn to prevent or delay.

People with diabetes are at least twice as likely to have a heart attack or stroke. They're also more likely to have a heart attack or stroke at an earlier age. To reduce your risk, lower your blood pressure and cholesterol with regular exercise and a healthy low-fat, low-salt diet that includes more fruits, vegetables and whole grains. Quit smoking. And do your best to lose 5 percent to 10 percent of your body weight. If you still need help, talk to your doctor about medication for high blood pressure and/or high cholesterol.

Blurry vision. Floating spots. Distorted images. If excess glucose (high blood sugar) damages the blood vessels that feed your retina, you may develop an eye problem called diabetic retinopathy. Diabetic retinopathy often starts with no symptoms, but over time, can destroy your eyesight and cause vision loss. In fact, diabetes is the leading cause of blindness in adults between the ages of 20 and 74. To prevent retinopathy, watch your blood sugar levels closely and see an eye doctor once a year for a complete eye exam.

Think of your kidneys as your body's filtration system. When blood vessels in the kidneys are damaged by excess glucose, your kidneys can't filter toxins. You end up with high levels of protein in your urine and waste products in your blood. Over time, your kidney function gets worse. And this can lead to kidney failure, dialysis or a kidney transplant. "Diabetes with hypertension is now the number one cause of end-stage kidney disease," says Betul Hatipoglu, MD, an endocrinologist at the Cleveland Clinic. Ask your doctor about routine tests to detect proteins in your urine. To keep your kidney disease from getting worse, your doctor may also prescribe medication to lower your blood pressure.

Up to 70 percent of people with diabetes have some degree of damage to their nervous system, known as neuropathy. The damage can result in loss of feeling or pain in the hands or feet, slow digestion of food in the stomach, carpal tunnel syndrome or other nerve problems. Mild cases may go completely unnoticed. Severe cases—most likely involving the feet and lower limbs—may lead to infections that require amputation. To keep neuropathy at bay, get a diabetes foot exam that tests your sensation every year.

Gastroparesis, a form of neuropathy, interferes with the emptying of the stomach and leads to poor digestion. In people with diabetes, it's often caused by extended periods of high blood glucose. "Food can get stuck in stomach because the nerves aren't working right, so the food isn't passing into the intestines," says Melinda Maryniuk, RD, CDE, director of clinical education programs for the Joslin Center in Boston. The result may be digestive problems, such as heartburn, stomach pain, constipation and weight loss. If you have diabetes and problems with digestion, talk to your doctor about getting tested for gastroparesis.

Both men and women may struggle with sexual dysfunction as a result of diabetes. Men who have diabetes are two to three times more likely to have erectile dysfunction than men who do not. Women may experience vaginal dryness, pain during intercourse or loss of libido (low sex drive). If you're having problems with your sex life due to diabetes, talk to your doctor about treatment options.

Managing diabetes can be stressful and exhausting. Between the constant vigilance over what you eat, the cost of care and frequent glucose testing, you might find yourself feeling depressed. Depression can get in the way of good diabetes care. If you feel sad or hopeless due to diabetes, talk to your doctor or a mental health professional. You may need medications, therapy or a combination of both.

Everyone experiences a little hearing loss with age. But in people with diabetes, hearing loss is often worse, especially if the disease isn't well-controlled. In fact, according to the American Diabetes Association, the rate of hearing loss is 30 percent higher in people with diabetes than it is in people without diabetes. That's because hearing relies on small blood vessels and nerves in the inner ear. High glucose levels can damage those vessels and nerves, which weakens hearing. Ask your doctor for a hearing test if you're having trouble.

High blood glucose levels can cause poor blood flow to your brain, making it more likely that you'll have dementia or Alzheimer's someday. A recent study showed that people with diabetes had more deterioration in the parts of their brain where problem-solving, decision-making and memory take place. Due to brain damage caused by diabetes, they also had more depression, walked slower and had more problems with balance. The best prevention—you guessed it!—is to keep your blood glucose levels as close to normal as possible.

Having diabetes puts you at risk for periodontal disease (gum disease). Over time, gum disease breaks down the bone and tissue that hold your teeth in place—leading to infection and tooth loss. If you have diabetes, your risk of gum disease is higher due to your body's lower resistance to infection. The high-sugar environment (brought on by high blood glucose) also gives bacteria in your mouth a chance to thrive. Diabetes can cause dry mouth, mouth infections and cavities, too. If you have diabetes, see your dentist at least twice a year, maybe more. And be sure to practice good oral hygiene, including regular brushing, flossing and rinsing every day.