Complications

Having diabetes increases a person’s risk of having serious health problems or complications. Health problems can be avoided or delayed by getting proper treatment: taking medication as the doctor prescribes, eating a healthy diet, exercising, and losing weight. Some of the health issues that a person with diabetes may have include problems with the skin, eyes, nerves, feet, kidneys, blood pressure; as well as stroke, eye problems, or a condition called ketoacidosis which is caused by too many ketones in the blood.1

Cardiovascular

A person with diabetes is at higher risk of getting cardiovascular disease. The word “cardiovascular” is the medical term for heart and blood circulation disease. Nearly 1 in 3 Americans has high blood pressure and 2 of 3 people with diabetes have high blood pressure or take medication to lower their blood pressure.8 High blood pressure can lead to heart attacks, strokes, eye problems, kidney problems among other problems. A person who has diabetes has a 1.5 times higher chance of having a stroke than a person who does not have diabetes. Having diabetes increases the risk of a stroke. And the risk is even greater if the person is over age 55, has a family background that is African-American, has a family history of strokes, has heart disease, has high blood pressure, is overweight, has blood cholesterol problems, is not very physically active and smokes.8

Nerve issues

High blood sugar can damage nerves. People with diabetes can develop nerve damage caused by high blood sugar over a long period of time. The medical term for this nerve damage is neuropathy. People with neuropathy can have tingling, pain, numbness, and weakness in the feet and hands. When this nerve damage occurs in the feet and hands it is called peripheral neuropathy.

Another kind of neuropathy due to diabetes is called autonomic neuropathy because it affects the autonomic nerves, or the nerves that control the body’s organs.4 Some of the organs that can be affected are the bladder, intestines and genitals. The bladder may become paralyzed and the person cannot empty the bladder, which can lead to bladder infections. A person whose intestines are affected may have constipation, or diarrhea, or may have stomach problems such as vomiting, indigestion, or feeling full after eating a small amount. Autonomic nerve damage can also cause erectile dysfunction (ED) in the penis or create problems with sexual arousal or vaginal dryness in women.5

Kidney issues

People with diabetes can develop kidney disease, or nephropathy. The kidneys of the body act as filters to remove waste products from the blood. When the blood sugar is high, it can cause damage to the filtering ability of the kidneys. Over time, stress to the kidneys can cause permanent damage and the kidneys may lose their filtering ability completely. This is called kidney failure. If a person has kidney failure, he/she must either receive a kidney transplant or have the blood filtered by a machine, a process called dialysis. Symptoms of kidney disease can include swelling, loss of sleep, poor appetite, upset stomach, weakness, and difficulty concentrating. It is very important for a person with diabetes to see a doctor regularly to check kidney health and function.7

Foot issues

People with diabetes often have foot problems, which can happen because of neuropathy, poor circulation and other issues. Because the nerves are damaged, a person with diabetes may injure the foot but not be able to tell because of loss of feeling. The feet may become very dry due to changes in the skin of the feet, develop more calluses, and have poor circulation of blood. All of these can lead to an ulcer, or open sore on the foot. A person with diabetes may not be able to feel the ulcer and may not know it is there, which can lead to incomplete healing or infection. A severe infection of the foot can lead to foot or leg amputation. It is very important for a diabetic person to take good care of the feet and make sure to see a doctor for any related problems.6

Eye issues

People with diabetes are at higher risk for eye problems and even blindness. People with diabetes have a higher risk of developing glaucoma and cataracts. Another kind of eye problem, retinopathy, develops only in people with diabetes.

Glaucoma happens when pressure builds up in the eye and pinches the blood vessels that carry blood to the retina and optic nerve. The retina is the back of the eye and the optic nerve is the nerve which comes out of the eye and carries messages to the brain. When blood cannot get to these structures, the eye cannot work properly.

Cataracts happen when the lens of the eye becomes cloudy. As the lens of the eye becomes cloudy, the person will not be able to see as well and may need to have surgery to remove the cloudy lens and replace it with a new one.

Retinopathy means disease of the retina. In people with diabetes, the tiny blood vessels that take blood to the retina begin to swell and form pouches, restricting the amount of blood that gets to the retina and affecting vision. After a while, the blood vessels may close entirely so no blood gets to the retina and the person becomes blind.3

Skin Issues

There are several kinds of skin problems that may occur for a person with diabetes, including bacterial infections of the skin. Some examples are:

  • Styes (infections of the glands of the eyelid)
  • Boils
  • Folliculitis (infections of the hair follicles)
  • Carbuncles (deep infections of the skin and the tissue underneath)
  • Infections around the nails

A person with diabetes may have infections caused by a fungus. The most common fungus that infects diabetic people is Candida albicans. This is often called a yeast infection and can happen in folds of the skin, between fingers and toes, in the corners of the mouth, in the vagina, or around the groin.

People with diabetes may have skin itching for reasons other than infection. They may have dry skin or poor circulation.2

Ketoacidosis

Ketoacidosis Diabetic ketoacidosis, or DKA, is a complication of diabetes. A diabetic person can develop DKA for three main reasons: not enough insulin, not enough food or an insulin reaction, which can cause low blood sugar. This can happen if the person does not eat properly or if they take too much medication or insulin. When the blood sugar is very low, the cells cannot get the sugar they need for energy. The body begins to burn fat for energy and this produces ketones, which circulate in the blood. Many ketones in the blood means the blood becomes more acidic. High levels of ketones poison the body. Symptoms that the person has high levels of ketones in the blood are being very thirsty, urinating often, high blood sugar levels, high ketone levels in the urine. Later, the person will have other symptoms: constant feeling of being tired, dry or flushed skin, nausea, vomiting or abdominal pain, difficulty breathing, confusion or a fruity odor on the breath.

A diabetic person can check for ketones by using a test strip to check the urine, but having any of the symptoms of DKA mean the person should call the doctor or go to the emergency room. Diabetic ketoacidosis is serious and an emergency and is usually treated in the hospital.9

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