Diabetes is a complicated disease. But don’t confuse this thought with the term “diabetes complications”! Those things called “complications” are potentially serious health problems that can appear if diabetes is not well managed.
Diabetes complications generally occur after years of high blood glucose.The blood vessels become damaged unless you can keep your blood glucose levels in a healthy range most of the time. (Indeed, the goal of diabetes management is to keep your blood glucose levels under control to the greatest extent possible.) As blood travels throughout the body, a high blood glucose content damages the walls of the very smallest (microvascular) and largest (macrovascular) of blood vessels. Therefore, the key to both preventing and treating diabetes complications is good blood glucose control.
The range of diabetes complications span from being simply annoying to actually life threatening. The lesser conditions include dry and itchy skin, mild gum disease, a tendency to be more susceptible to colds and flu, and in women, yeast infections. The more serious diabetes complications—some life-changing or life-threatening—include eye disease, kidney disease, nerve disease and heart disease.
Microvascular complications: As small blood vessels become brittle and weak, the blood flow is restricted and causes damage to tissues and organs.
Eyes: Retinopathy is damage to the retina of the eye. This light-sensing lining at the back of the eye depends on small blood vessels to keep it nourished. If blood vessels are damaged by high blood glucose, then hemorrhaging, swelling and scar tissue all contribute to the failure of the retina. Eyesight depends on a healthy retina to reflect light for vision. If the damage is severe enough, blindness may result. Diabetic retinopathy is among the most common diabetes complications.
People with diabetes are also more likely to develop glaucoma and cataracts, and may develop cataracts sooner than people who don’t have diabetes. Glaucoma is damage to the optic nerve caused by increased pressure in the eye, and cataracts are a clouding of the lens of the eye.
Nerves: Nerve disease, or neuropathy, is damage to nerve cells throughout the body. Nerves that are affected include those that control movement and transmit sensation in the hands, feet, arms and legs; nerves that work to perform functions automatically such as digestion and sweating; and nerves that go unnoticed until damage is caused—including impaired sexual function, carpel tunnel syndrome or even a nerve in the eyelid that no longer functions.
When sensory nerves are initially being damaged, they send out pain signals that cause a burning and tingling sensation. However, not all nerves in the body will send out this “warning” if they are being damaged. If the damage continues, the nerve is eventually destroyed.
Gastroparesis: This is the result of damage to the vagus nerve. This nerve orchestrates the emptying of the stomach, and when it begins to fail, food either remains in the stomach for too long or gets emptied out too early. One result is that you can’t predict when your stomach will be digesting food, which can seriously hamper your ability to time some diabetes medicines and your blood glucose control. The best way to prevent permanent nerve damage is to have blood glucose levels as normal as possible as often as possible.
Kidneys: Kidney disease, or nephropathy, is the gradual inability of the kidneys to filter out toxins and waste from the blood. The body cannot survive without this important filtering system. If the kidneys fail completely, the body needs to be placed on a dialysis machine to do the filtering—or have a kidney transplant.
Macrovascular complications: These involve damage to the larger blood vessels, and the primary results are heart and cardiovascular disease.
Heart and cardiovascular: Heart disease is the result of the damage done to the large (macrovascular) vessels in your body. High blood glucose is one source of this damage, but there are others as well. People with diabetes are at high risk for having high cholesterol, high triglyceride levels, and high blood pressure (hypertension)—and all of these factors also contribute to heart disease.
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