Insulin resistance

Complications of diabetes

Because diabetes is so intimately connected to our blood, and because our blood runs through every organ and tissue in our bodies, diabetes influences many of our bodily systems.  Scheduling regular check-ups with your healthcare practitioner, keeping blood pressure, cholesterol and glucose in balance and, most of all, knowing your own body and what feels normal or abnormal for you will go a long way in protecting you from many of the complications associated with diabetes. If diabetes or glucose control is an issue for you, here are some related health concerns you may want and need to watch closely.

Your heart and blood vessels

One of the biggest concerns for diabetics is keeping their hearts and vessels healthy. Arteriosclerosis — hardening of the arteries — tends to happen earlier in diabetics than in the average population and increases their risk for heart attack and stroke. Arteriosclerosis in the lower extremities can result in decreased strength, loss of a peripheral pulse, and eventually gangrene, or death of the surrounding tissue.

In the diabetic population gangrene happens most often in the feet or toes, typically beginning with injury, infection, or extreme temperature changes. With narrow or restricted blood vessels, your body is unable to fight the infection, heal the wound, or send more blood to regulate the temperature change. If caught in time, treatment involving revascularization of the tissue may be possible. Otherwise, removal of the dead tissue may become necessary, with the worst case scenario meaning amputation.

It is important for you to maintain a blood pressure below 120/80, keep cholesterol levels within the normal ranges, and blood glucose under control. Simple steps to improve your peripheral circulation include quitting smoking and increasing your physical activity. Other influences like stress and genetic factors also play a role in the health of your blood vessels. Remember, you have more control than you may think — so do what you can about factors you can control to keep your blood flowing smoothly.

Your kidneys

Along with your intestines, your kidneys are responsible for getting rid of excess waste in your blood. When there is too much glucose in the blood, the kidneys can become overloaded and, with time, fail. Once kidney failure occurs, the kidneys require dialysis — a procedure that allows a machine to “clean” the blood in place of the kidneys.

There are many different forms of kidney damage, or diabetic nephropathy; however, you can prevent them by keeping your heart, cholesterol, and blood glucose in balance. Be sure to have your healthcare practitioner test for protein in your urine and creatinine in your blood at least once a year. Unusual results for either test are a warning sign that there is something wrong with a kidney which, if corrected early enough, can prevent serious damage.

There are a few signs to look for when assessing your kidney function. When a kidney or the bladder is not working properly, you might notice cloudy or bloody urine, back pain, pain or burning with urination, chills, or fever.

Your nerves

Persistent high blood glucose can lead to nerve damage in your body. This condition, known as diabetic neuropathy, can cause pain or loss of feeling in your extremities. Because neuropathy can develop slowly over time, you may dismiss it in its earliest stages. Try to tune in to possible changes in your body, such as pain or cramping in your arms, hands, legs and feet. Nerve damage can also lead to dizziness, problems going to the bathroom, digesting, or having sex. Being aware of the possible symptoms can alert you when things are off.

Risk of nerve damage can also be minimized by preventing blood glucose levels and blood pressure from spiking. Smoking cigarettes and drinking alcohol can aggravate neuropathy — a good reason to quit smoking and limit your alcohol intake. Schedule a neurological exam once a year so you and your healthcare provider can keep an watchful eye on any changes.

Your eyes

Your eyes may also go through various changes as a result of diabetes. Some of these changes include the hardening, narrowing or hemorrhaging of tiny veins and capillaries in your retina — the part of your eye that connects to your nervous system and brain. This condition, known as diabetic retinopathy, can eventually lead to blindness if not treated. In fact, diabetes is the leading cause of blindness in adults. Cataracts and glaucoma are two additional eye conditions related to diabetes that can cause blindness.

Like many of the complications associated with diabetes, it takes many years for this kind of damage to occur. You may notice general difficulty seeing, changes in the size of objects, sensitivity to light, or a shrinking of your field of vision. Pay close attention to changes in your eyes and be sure to have an eye exam once per year.

Your teeth and gums

Because diabetics are more likely to be susceptible to infection, they suffer from periodontal (gum) disease more often than those without diabetes. However, this relationship works both ways: gum infection may lead to an increase in blood glucose and can throw your balance off instantly. To prevent gum disease it is best to keep your blood glucose in balance and to floss and brush your teeth twice per day. It is also important to visit your dentist twice per year. If you do contract a gum infection, be sure to have it treated before your blood glucose balance suffers.

Ketoacidosis

Ketones are a kind of acid that naturally occur as a by-product of fat metabolism. They can build up in the blood when there is either too much or too little insulin, or if you are not getting enough food and your body is only burning fat. Ketoacidosis, more common in insulin-dependent diabetes mellitus (IDDM, or type 1 diabetes), is a serious condition that can lead to coma or even death.

You can use a simple urine test to determine whether or not you have an overload of ketones in your body. You can also watch for other signs, such as excessive thirst, frequent urination, high blood glucose, fatigue, dry or flushed skin, difficulty breathing, a sweet odor to your breath, difficulty paying attention, or nausea and vomiting. If any of these symptoms occur, you should contact your healthcare practitioner immediately.

Hypoglycemia

Hypoglycemia, or low blood sugar, is another potential complication associated with diabetes — particularly for insulin-dependent diabetics. Too little sugar in the blood can happen for several reasons, such as skipped or small meals, increased activity or exercise, increased alcohol intake, or an excessive dose of insulin. If experiencing hypoglycemia, you may notice hunger, nervousness or shakiness, dizziness, confusion, or trouble speaking. Eating something high in glucose or drinking a glass of orange juice can help. But if the situation is serious, you may need a glucagon injection to induce the liver to release stored glucose. The best way to prevent hypoglycemia if you have diabetes is by eating regular meals and snacks and matching your meals carefully to your insulin and activity levels.

Click here to return to our article on preventing type 2 diabetes and metabolic syndrome.

We’re always happy to welcome new patients to our medical clinic in Yarmouth, Maine, for those who can make the trip. Click here for information about making an appointment.

Related to this article:

References & further reading on the complications of diabetes

 

Original Publication Date: 04/23/2007
Last Modified: 01/14/2008
Principal Author: Amy Amoroso