Diabetes: An Overview

Diabetes Complications

What are some Complications of Diabetes?

Untreated diabetes leads to very serious complications. If you have diabetes, it is very important that you follow your doctor's directions for controlling the amount of glucose in your blood. High levels of glucose in the blood can damage multiple organs of the body.

Heart Disease and Stroke

Having diabetes places you at twice the risk of heart disease and stroke.^[8][9] Over time, high levels of blood glucose cause increased plaque or fatty deposits in blood vessel walls. This is often called atherosclerosis or hardening of the arteries. This increases the likelihood that blood clots will form causing either a heart attack or stroke.

Nerve Damage from Diabetes

Uncontrolled blood glucose can lead to nerve damage.^[8][9] About 60% to 70% of people with diabetes have some nerve damage. Risk of nerve damage or neuropathy increases with age; typically, it occurs after 25 or more years after you get diabetes. Nerve damage results in symptoms such as pain, tingling, or numbness in hands, arms, feet and legs. There can also be nerve damage in the digestive tract, heart and sex organs.

Loss of feeling in the feet and legs and poor blood circulation can lead to infection and ultimately amputation. Always protect your feet by wearing slippers or shoes, even at home. Be sure to check your feet on a daily basis for problems. Wash them daily and be sure to dry them carefully, especially between the toes. Use lotion if the skin is dry but do not use lotion between your toes. Discuss extra steps you can take to protect your feet with your doctor.

Sexual Problems

Diabetes can lead to sexual problems. For men this involves erectile dysfunction or an inability to have or sustain an erection. For women, there can be difficulties with lubrication and painful intercourse. For both sexes, there may be issues with urinary tract infections and bladder control. Controlling blood glucose, blood pressure and cholesterol levels can help you avoid these problems. Stay active and manage your weight. If you are having problems, discuss them with your doctor.

Problems with Digestion

Diabetes can also affect the digestive tract resulting in delayed emptying of the stomach. This is due to damage to the nerves that control the stomach. Symptoms include heartburn, abdominal pain, nausea, vomiting of undigested food, a feeling of fullness after eating very little food, weight loss, bloating, lack of appetite and abdominal spasms.

You can avoid digestive tract problems by managing glucose levels and changing your diet. Talk with your doctor about dietary changes. He or she may recommend eating six small meals a day instead of three larger meals. You may also consider eating liquid or pureed food rather than solid food. You should avoid foods high in fat.

Kidney Damage from Diabetes

Kidney failure causes the kidneys to stop removing waste materials from your blood. Diabetes is the most common cause of kidney failure.^[9] More than 100,000 people develop kidney failure each year in the United States and nearly 180,000 people are living with kidney failure at any given time.

When the kidneys no longer remove wastes from the blood, people must either have dialysis on a regular basis or have a transplant of a healthy kidney from a donor.^[9][10] Dialysis involves having the blood filtered outside the body. Federal funds are available for this expensive process.

It takes several years to develop kidney failure-up to 15 to 25 years.^[9] Initially, the kidneys of diabetics may work harder to cleanse the blood, but with time they stop working properly. As the kidneys begin to fail, a protein called albumin begins to leak into the urine. Gradually, the kidneys' ability to remove waste from the blood declines. Blood pressure often increases as waste builds up in the blood.

Eye Disease or Retinopathy from Diabetes

Diabetes is the single, largest cause of blindness in the United States.^[10] Eye disease due to diabetes involves three things: damage to blood vessels in the retina, cataracts and glaucoma or increased pressure inside the eye.^[11] In some people, damage to the blood vessels in the eyes causes the blood vessels to swell and leak. In others, abnormal, new blood vessels grow on the retina blocking vision. In the case of cataracts, the lenses of the eyes become clouded, which also interferes with vision. Glaucoma increases the fluid pressure inside the eye, which damages the optic nerve and impairs vision. Glaucoma is twice as likely in people with diabetes.

Early signs of vision problems include blurry vision and spots or floaters in your eyes.^[11] Leakage from blood vessels is most likely to occur while you are sleeping. Enlarged blood vessels may block vision. If damage is occurring, it is likely to occur in both eyes. If you have any of these problems, see your doctor as soon as possible. Treatment of eye disease may involve laser surgery or vitrectomy to remove the fluid in the eye clouded by blood.

Because the risk of eye damage is so great among diabetics, it is important to see your doctor at least once a year for eye exams.^[11] During the early stages of disease, it may not be clear that your vision is being affected. Only your doctor can tell for sure whether your vision is being damaged. The most important step you can take to avoid vision loss is to carefully control your blood glucose level. In addition, controlling blood pressure and cholesterol is important. Be sure to discuss these issues with your doctor.

This Elder Health Guide was published on October 13, 2009 and was updated on October 28, 2009.