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Long-term complications of diabetes

Diabetic complications - long term

Diabetes makes your blood sugar higher than normal. After many years, too much sugar in the blood can cause problems in your body. It can harm your eyes, kidneys, nerves, skin, heart, and blood vessels.

  • You could have eye problems. You could have trouble seeing, particularly at night. Light could bother your eyes. You could become blind.
  • Your feet and skin can develop sores and infections. If it goes on too long, your toes, foot, or leg may need to be amputated. Infection can also cause pain, itching, or oozing in your feet, legs, and other areas.
  • Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to heart attack, stroke, and other problems. It can become harder for blood to flow to the legs and feet.
  • Nerves in the body can become damaged, causing pain, burning, tingling, and loss of feeling. Nerve damage can also make it harder for men to have an erection.
  • You could have problems digesting the food you eat. You could feel weakness or have trouble having a bowel movement.
  • High blood sugar and other problems can lead to kidney damage. Your kidneys might not work as well and may even stop working. As a result, you might need dialysis or a kidney transplant.
  • People with diabetes often have depression and the two diseases may be linked.
  • Some women with diabetes may have irregular periods and may have problems getting pregnant.
  • Diabetes increases the risk for dementia.
  • Diabetes increases the risk of bone diseases, including osteoporosis.
  • Low blood sugar (hypoglycemia) from treatment of diabetes can also increase the risk of heart disease.

Take Control of Your Diabetes

It is important to keep your blood sugar, blood pressure, and cholesterol in a healthy range. You should learn these basic steps for managing diabetes and staying as healthy as possible. Steps may include:

  • A healthy diet
  • Exercise
  • Medicines

You may need to check your blood sugar daily or more often. Your health care provider will also help you by ordering blood tests and other tests. All these may help you keep complications of diabetes away.

You will need to check your blood sugar level at home.

  • You will use a special device called a glucose meter to test your blood sugar. Your provider will let you know if you need to check it every day and how many times each day.
  • Your provider will also tell you what blood sugar numbers you are trying to achieve. This is called managing your blood sugar. These goals will be set for different times during the day.

To prevent heart disease and stroke, you may be asked to take medicine and change your diet and activity:

  • Your provider may ask you to take a medicine called an ACE inhibitor or a different medicine called an ARB, for high blood pressure or kidney problems.
  • Your provider may ask you to take a medicine called a statin to keep your cholesterol down.
  • Your provider may ask you to take aspirin to prevent heart attacks. Ask your provider if aspirin is right for you.
  • Regular exercise is good for people with diabetes. Talk to your provider first about what exercises are best for you and how much exercise you should do every day.
  • DO NOT smoke. Smoking makes diabetes complications worse. If you do smoke, work with your provider to find a way to quit.

To keep your feet healthy, you should:

  • Check and care for your feet every day.
  • Get a foot exam by your provider at least every 6 to 12 months and learn whether you have nerve damage.
  • Make sure you are wearing the right kinds of socks and shoes.

A nurse or dietitian will teach you about good food choices to lower your blood sugar and stay healthy. Make sure you know how to put together a balanced meal with protein and fiber.

See Your Doctor Often

If you have diabetes, you should see your providers every 3 months. At these visits your provider may:

  • Ask about your blood sugar level (always bring your blood glucose meter to every visit if you are checking your blood sugar at home)
  • Check your blood pressure
  • Check the feeling in your feet
  • Check the skin and bones of your feet and legs
  • Examine the back part of your eyes

The provider may also send you to the lab for blood and urine tests to:

  • Make sure your kidneys are working well (every year)
  • Make sure your cholesterol and triglyceride levels are healthy (every year)
  • Check your A1C level to see how well your blood sugar is controlled (every 3 to 6 months)

Visit the dentist every 6 months. You should see your eye doctor once a year. Your provider may ask you to see your eye doctor more often.

References

American Diabetes Association. 4. Lifestyle management: standards of medical care in diabetes-2018. Diabetes Care. 2018;41(Suppl 1):S38-S50. PMID: 29222375 www.ncbi.nlm.nih.gov/pubmed/29222375.

Brownlee M, Aiello LP, Cooper ME, Vinik AI, Plutzky J, Boulton AJM. Complications of diabetes mellitus. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 13th ed. Philadelphia, PA: Elsevier; 2016:chap 33.

  • Eye

    Eye - illustration

    The eye is the organ of sight, a nearly spherical hollow globe filled with fluids (humors). The outer layer or tunic (sclera, or white, and cornea) is fibrous and protective. The middle layer (choroid, ciliary body and the iris) is vascular. The innermost layer (the retina) is nervous or sensory. The fluids in the eye are divided by the lens into the vitreous humor (behind the lens) and the aqueous humor (in front of the lens). The lens itself is flexible and suspended by ligaments which allow it to change shape to focus light on the retina, which is composed of sensory neurons.

    Eye

    illustration

  • Diabetic foot care

    Diabetic foot care - illustration

    People with diabetes are prone to foot problems because the disease can cause damage to the blood vessels and nerves, which may result in decreased ability to sense a trauma to the foot. The immune system is also altered, so that the person with diabetes cannot efficiently fight infection.

    Diabetic foot care

    illustration

  • Diabetic retinopathy

    Diabetic retinopathy - illustration

    Diabetes causes an excessive amount of glucose to remain in the blood stream which may cause damage to the blood vessels. Within the eye the damaged vessels may leak blood and fluid into the surrounding tissues and cause vision problems.

    Diabetic retinopathy

    illustration

  • Diabetic nephropathy

    Diabetic nephropathy - illustration

    During diabetic nephropathy the kidney becomes damaged and more protein than normal collects in the urine. As the disease progresses, more of the kidney is destroyed. Over time, the kidneys ability to function starts to decline, which may eventually lead to chronic kidney failure.

    Diabetic nephropathy

    illustration

    • Eye

      Eye - illustration

      The eye is the organ of sight, a nearly spherical hollow globe filled with fluids (humors). The outer layer or tunic (sclera, or white, and cornea) is fibrous and protective. The middle layer (choroid, ciliary body and the iris) is vascular. The innermost layer (the retina) is nervous or sensory. The fluids in the eye are divided by the lens into the vitreous humor (behind the lens) and the aqueous humor (in front of the lens). The lens itself is flexible and suspended by ligaments which allow it to change shape to focus light on the retina, which is composed of sensory neurons.

      Eye

      illustration

    • Diabetic foot care

      Diabetic foot care - illustration

      People with diabetes are prone to foot problems because the disease can cause damage to the blood vessels and nerves, which may result in decreased ability to sense a trauma to the foot. The immune system is also altered, so that the person with diabetes cannot efficiently fight infection.

      Diabetic foot care

      illustration

    • Diabetic retinopathy

      Diabetic retinopathy - illustration

      Diabetes causes an excessive amount of glucose to remain in the blood stream which may cause damage to the blood vessels. Within the eye the damaged vessels may leak blood and fluid into the surrounding tissues and cause vision problems.

      Diabetic retinopathy

      illustration

    • Diabetic nephropathy

      Diabetic nephropathy - illustration

      During diabetic nephropathy the kidney becomes damaged and more protein than normal collects in the urine. As the disease progresses, more of the kidney is destroyed. Over time, the kidneys ability to function starts to decline, which may eventually lead to chronic kidney failure.

      Diabetic nephropathy

      illustration

    A Closer Look

     

    Self Care

     

     

    Review Date: 8/19/2018

    Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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