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Complications of Diabetes

Diabetes is a set of related diseases in which the body cannot regulate the amount of sugar (glucose) in the blood.  Glucose in the blood gives you energy—the kind you need when you walk briskly, run for a bus, work in the garden, and for your day to day chores.

Glucose in the blood is produced by the liver from the foods you eat.  In a healthy person, the blood glucose level is regulated by several hormones, one of which is insulin. Insulin is produced by the pancreas, a small organ near the stomach that also secretes important enzymes that help in the digestion of food.

Insulin allows glucose to move from the blood into liver, muscle, and fat cells, where it is used for fuel. People with diabetes either don't produce enough insulin (Type 1 diabetes) or cannot use insulin properly (Type 2 diabetes), or both. In diabetes, glucose in the blood cannot move into cells, and stays in the blood. This not only harms the cells that need the glucose for fuel, but also harms certain organs and tissues exposed to the high glucose levels.

About 17 million Americans are believed to have diabetes. About one third of those do not know they have it. About 1 million new cases occur each year, and diabetes is the direct or indirect cause of at least 200,000 deaths each year. The incidence of diabetes is increasing rapidly. This increase is due to many factors, but the most significant are the increasing incidence of obesity and the prevalence of sedentary lifestyles.

Complications of diabetes
Both forms of diabetes ultimately lead to high blood sugar levels, a condition called hyperglycemia. Over a long period of time, hyperglycemia damages the retina of the eye, the kidneys, the nerves, and the blood vessels—particularly arteries.

Damage to the retina from diabetes (diabetic retinopathy) is a leading cause of blindness.  Damage to the kidneys from diabetes (diabetic nephropathy) is a leading cause of kidney failure and hypertension. Damage to the nerves from diabetes (diabetic neuropathy) is a leading cause of foot wounds and ulcers, which frequently lead to foot and leg amputations.

Diabetes accelerates atherosclerosis or “hardening of the arteries”, which can lead to blockages or clots (thrombus), which can then lead to heart attack, stroke, and decreased circulation in the arms and legs (peripheral arterial disease).

Diabetes predisposes people to high blood pressure and high cholesterol and triglyceride levels. These independently and together with hyperglycemia increase the risk of heart disease, kidney disease, and other blood vessel complications.  In the short run, diabetes can contribute to a number of acute (short-lived) medical problems.  Many infections are associated with diabetes, and infections are frequently more dangerous in someone with diabetes because the body's normal ability to fight infections is impaired.  To compound the problem, infections may worsen glucose control, which further delays recovery from infection.

Hypoglycemia, or low blood sugar, occurs from time to time in most people with diabetes. It results from taking too much diabetes medication or insulin (sometimes called "insulin reaction"), missing a meal, doing more exercise than usual, drinking too much alcohol, or taking certain medications for other conditions. It is very important to recognize hypoglycemia and be prepared to treat it at all times. Headache, feeling dizzy, poor concentration, tremors of hands, and sweating are common symptoms of hypoglycemia. You can faint or have a seizure if blood sugar level gets too low.

If you have diabetes, you would be wise to make healthful lifestyle choices in diet, exercise, and other health habits. These will help to improve glycemic (blood sugar) control and prevent or minimize complications of diabetes.

Diet

A healthy diet is key to controlling blood sugar and preventing diabetes complications.  If you are obese and have had difficulty losing weight on your own, talk to your health care provider. He or she can recommend a dietitian or a weight modification program to help you reach your goal.  Eat a consistent, well-balanced diet that is high in fiber, low in saturated fat, and low in concentrated sweets.

Exercise

Regular exercise, in any form, can help reduce the risk of developing diabetes. Activity can also reduce the risk of developing complications of diabetes such as heart disease, stroke, kidney failure, blindness, and leg ulcers.  As little as 20 minutes of walking 3 times a week has a proven beneficial effect. Any exercise is beneficial; no matter how light or how long, some exercise is better than no exercise.  If you have complications of diabetes (eye, kidney, or nerve problems), you may be limited both in type of exercise and amount of exercise you can safely do without worsening your condition. Consult with your health care provider before starting any exercise program.

Smoking

If you have diabetes, and you smoke cigarettes or use any other form of tobacco, you are raising your risks markedly for nearly all of the complications of diabetes. Smoking damages blood vessels and contributes to heart disease, stroke, and poor circulation in the limbs. If you need help quitting, talk to your health care provider.

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For more information about diabetes, treatement and prevention see American Diabetes Association.

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