What complications can occur with diabetes?

Dr. Douglas S. Denham, DO
Family Practitioner

Diabetes is not just a problem with managing blood sugars. The complications of poorly controlled diabetes affect the entire body. Diabetes causes damage to the heart, kidneys, eyes, nerves and immune system. Diabetes is the leading cause of kidney failure, non-traumatic lower limb amputations and new cases of blindness in the USA. It is a major cause of heart disease and stroke with an increased risk of 2-4 times that of a non-diabetic person. It is the 7th leading cause of death in the United States. The effects of diabetes on the immune system lead to decreased protection from infections and poor wound healing. People with diabetes have increased blood pressure, periodontal (gum) disease and depression. People with diabetes have medical expenses 2 times higher than non-diabetics.

This is the reason that it is so imperative that people with diabetes get their blood sugars controlled and keep them in control over the long time. Studies such as the United Kingdom Prospective Diabetes Study (UKPDS) demonstrated that with improved diabetes control, there was a decrease in risk of developing and reduction in the effects of diabetes on patients.

Diabetes can have severe complications if it's not managed properly. Regular checkups are vital for those dealing with high blood sugar. Regular testing is important to avoid complications of diabetes, which include stroke, heart attack, kidney disease and blindness.

Cholesterol testing, blood pressure checks and regular foot care should be a regular part of a diabetic's health regimen. A good dilated eye exam is also important. Kidney issues in diabetics are diagnosed by checking blood pressure and urine to see how much protein may be spilling in the urine.

William Lee Dubois

Uncontrolled diabetes has a host of complications including blindness (20,000 cases per year); kidney failure (44,000 cases per year): and amputations (84,000 per year). Oh yeah. And death too (135,000 fatal heart attacks per year).

The very, very, very important point here is that having diabetes does not mean that any of these things will happen to you. All of our complications happen when diabetes gets out of control and stays out of control. High blood sugar is like a tornado tearing though your body, destroying all that it touches.

Complications are not fate, not destiny, not unavoidable. You can fight back. You can prevent complications. And you know what? You are already well on that road, and I know that because you are here at Sharecare learning more about your diabetes and how to keep it in control!

There are five common complications of diabetes:

  • Cardiovascular disease and stroke
  • Retinopathy (eye disease)
  • Nephropathy (kidney disease)
  • Neuropathy (nerve disease)
  • Infections, including dental disease

Cardiovascular disease and stroke
People with diabetes are two to four times as likely to have a heart attack or stroke as people without diabetes. It is the number one killer of people with diabetes. Therefore, it’s important to understand and mitigate the risk of cardiovascular disease and stroke.

Retinopathy (eye disease)
The most common eye disease in people with diabetes is retinopathy, a disease of the retina. The retina is the light-sensing region of the inner eye. It acts like a miniature “movie screen” in the back of your eye, on which the images you see are projected.

Nephropathy (kidney disease)
Nephropathy or kidney disease can occur in people with type 1 or type 2 diabetes. However, severe kidney damage is more common in people with type 1 diabetes than in those with type 2.

Neuropathy (nerve disease)
Diabetes usually doesn’t impair the brain and spinal cord, but it can damage the nerves in other parts of the body. The nerves may be unable to send messages, may send them at the wrong times, or may send them too ­slowly. This is called diabetic neuropathy.

Infections, including dental disease
People with diabetes have a higher risk for infection and skin problems than other people. Skin problems and infections include everything from a scrape on the toe that gets out of hand to gum disease.

Diabetes can dump a big sack of trouble on you, since it can lead to so many health issues. There are many problems associated with diabetes, including frequent urination, fatigue, impotence, nerve dysfunction, numbness, and even the development of vision problems that can cause blindness.

Diabetes is a big contributor to accelerated arterial aging—and that, in turn, can lead to a multitude of conditions and ailments-including heart attacks and stroke. This is one reason that keeping your blood pressure under control if you're a diabetic (and if you're not, as well) is so important.

Although a dangerous diagnosis, diabetes is one of those conditions that is a perfect example of what you can do to help yourself. Diabetes can steal one-third of your life, but if you do three things-control your blood pressure, walk 30 minutes a day, and control your blood sugar-the disease won't age you at all.

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Diabetes can affect almost any major organ system and cause serious damage if uncontrolled. It can affect your vision and is the leading cause of acquired blindness in the United States. It can also damage your kidneys and is a leading cause of kidney failure requiring dialysis in the United States. Diabetes can damage nerves and blood vessels, possibly leading to wound infections, chronic pain, and even amputations.

Dr. Michael T. Murray, ND
Naturopathic Medicine Specialist

Complications that occur with diabetes include the following:

  • Heart disease and stroke: Adults with diabetes have death rates from cardiovascular disease about two to four times higher than adults without diabetes.
  • High blood pressure: About 75 percent of adults with diabetes have high blood pressure.
  • Blindness: Diabetes is the leading cause of blindness among adults.
  • Kidney disease: Diabetes is the leading reason why people need to go on dialysis, accounting for 43 percent of new cases.
  • Nervous system disease: About 60 to 70 percent of people with diabetes have mild to severe forms of nervous system damage. Severe forms of diabetic nerve disease are a major contributing cause of lower-extremity amputations.
  • Amputations: More than 60 percent of lower-limb amputations in the United States occur among people with diabetes.
  • Periodontal disease: Almost one third of people with diabetes have severe periodontal (gum) disease.
  • Pain: Many diabetics fall victim to chronic pain due to conditions such as arthritis, neuropathy, circulatory insufficiency, or fibromyalgia.
  • Depression is a common accompaniment of diabetes. Clinical depression can often begin to occur even years before diabetes is fully evident. As well, depression is difficult to treat in poorly controlled diabetics.
  • Autoimmune disorders: Thyroid disease, inflammatory arthritis, and other diseases of the immune system commonly add to the suffering of diabetes.

In diabetes it is the long-term complications which cause damage to internal organs. These include the following:

  • kidney disease
  • blindness
  • nerve damage
  • a higher risk of atherosclerosis in blood vessels of the heart, kidney, legs, brain and other organs
  • a higher risk of death from coronary heart disease
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Pharmacy Specialist

Diabetes can cause complications that affect your nerves, eyes, feet, kidneys, heart, skin and emotions. Diabetes increases your risk of heart disease as well as stroke. It can damage your nerves, including the nerves in your eyes and feet. In the eyes, this damage is called diabetic retinopathy. People with diabetes should have regular checkups with specialists such as podiatrists and ophthalmologists to handle any such complications. The best way to prevent or slow the development of complications is to keep your blood glucose levels under control.

Diabetes can cause all sorts of nasty complications over time. We’ll start at the top with the eyes. Diabetes can affect the blood vessels in the back of your eyes and cause extra vessels to grow. Sometimes these vessels can get in the way and begin to cause vision loss and eventually blindness. However, this takes many years and is usually the result of very poorly controlled diabetes. As a precaution, all diabetics should see their eye doctor yearly to screen for this.

Secondly, diabetes can affect the arteries (blood vessels that carry oxygen and nutrients to the different parts of the body) and make them more likely to become clogged, causing heart attacks, strokes and poor circulation in the feet and legs. These artery problems tend to happen more rapidly if you have uncontrolled high blood pressure or high cholesterol, or if you smoke.

Third, it can affect kidney function over time. Left unchecked, it can eventually lead to kidney failure and the need for dialysis.

Fourth, it can affect nerves in the body, most commonly in the feet. This is due to a degeneration of the longest nerves in the body, which are in the feet. This causes tingling and numbness that starts in the toes, and over time, starts to creep up into the legs. Because of the numbness and poor circulation in diabetics, careful foot examination by both the person with diabetes and the doctor on a regular basis is important.

These are the most significant complications, although there are many others that are less common. I know this all sounds rather dismal and negative, but the good news is that with careful sugar control and help from your doctor, you can avoid most of these complications. Or, if you already have them, you can work with your doctor to keep them from worsening.

People with diabetes are predisposed to having elevated blood pressure levels and high levels of cholesterol and triglycerides, all of which are major contributors to higher rates of cardiovascular disease. Many people with diabetes have several of these conditions at the same time. This combination of problems is often called metabolic syndrome.

  • Diabetes can damage your retina, your kidneys and cause neuropathy, a leading cause of foot wounds and ulcers, which can lead to foot and leg amputations.
  • Diabetes can also accelerate heart disease, or the formation of fatty plaques inside the arteries, which can lead to blockage.
  • Elevated blood glucose, called glucose toxicity, is essentially a toxic substance in the body.
RealAge Admin
Administration Specialist

About 24 million Americans have diabetes today. If you have diabetes (diabetes mellitus), it means your blood glucose is too high. If you don't manage your blood sugar levels with diet, exercise, and medications, you can have serious complications. Diabetes may cause serious eye problems and even blindness over time. If your blood glucose is not controlled each day, diabetes can increase the risk of heart disease and stroke. Diabetes can also cause kidney disease and kidney failure. If blood flow to your feet is hampered, you can have severe nerve damage called neuropathy. This may result in the need for amputating a toe or even a foot. For pregnant women, gestational diabetes increases the chance of having serious complications during pregnancy. Gestational diabetes may even lead to birth defects.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.