Diabetes: Long-Term Problems

When you have diabetes, you are at risk for having other health problems. As a rule, the higher your blood sugar levels are, and the more time that they stay high, the greater your chance of having other health problems. The closer to normal your levels are, the lower the risk of complications.

What are some of the health problems caused by diabetes?

Diabetic retinopathy

Diabetes can damage the small blood vessels in the retina, which is the part of the eye that sends images to your brain. This is called retinopathy, and it can lead to poor vision or blindness.

Retinopathy does not usually cause symptoms at first. When you do have symptoms, they can include blurred or distorted vision or having a hard time reading. You may have floaters, which are shadows or dark objects that "float" across your vision. You may see flashes of light. Because you may not have symptoms until retinopathy is severe, see your eye doctor on a regular basis. The sooner you know about it, the easier it is to treat it, and the more likely you are to prevent vision loss. Diabetic retinopathy has no cure, but controlling diabetes can help stop it from getting worse. If your retina is not badly hurt, laser treatment or surgery can help prevent more vision loss.

Diabetic neuropathy

Over time, high blood sugar from diabetes can damage your nerves. This is called diabetic neuropathy. It can affect the following nerves.

The nerves that give you the sense of touch, heat, and position, mainly those in your feet and legs. The longer the nerve is, the more likely it is to be damaged by diabetes. This can lead to serious foot problems, such as sores, infection, and bone and joint deformities. It is the most common form of neuropathy. You may:

  • Have tingling, tightness, or burning, shooting, or stabbing pain in the feet, hands, or other parts of the body.
  • Have numbness or less feeling, most often in the feet.
  • Feel weak and lose balance and coordination.

The part of the nervous system that you do not control. This includes the nerves that control your heart rate, blood pressure, body temperature, vision, digestion, and other functions. If these nerves are damaged, you may:

  • Notice digestion problems like bloating, heartburn, or diarrhea.
  • Sweat a lot at night or while eating certain foods. You may also sweat only a little, especially in your feet and legs.
  • Not know when you have to urinate.
  • Have sexual problems, such as erection problems in men and vaginal dryness in women.
  • Feel dizzy and weak when you stand up or sit up.
  • Not know your blood sugar is low.

One nerve or group of nerves. This can cause muscle weakness and pain, mainly in the wrist, thigh, or foot. It may also affect the nerves of the back and chest and those that control the eye muscles. This rare form usually occurs suddenly. You may:

  • Have pain or weakness in one part of your body, such as a wrist, thigh, or foot.
  • Have pain in and around one of your eyes, difficulty moving your eyes, and double vision.

There is no cure for diabetic neuropathy, but you can keep it from getting worse by keeping your blood sugar within a target range. Your doctor may suggest medicine or physical therapy for pain. Take good care of your feet to help avoid foot infections.

Diabetic kidney disease

Diabetic kidney disease is kidney damage caused by having high blood sugar for a long time. This affects how the kidneys filter fluids, and it lets protein that should stay in the blood pass into the urine. If not treated, this can lead to kidney failure. To help find it early, your doctor may do tests that check how well your kidneys are filtering your blood and how much protein is in your urine.

You have no symptoms at first. A little bit of protein in the urine is the first sign of kidney damage. When your kidneys work poorly, your blood pressure may go up and you may have swelling, at first in your feet and legs. Medicine that lowers blood pressure and protects the kidneys can help. To prevent kidney damage or keep it from getting worse, eat healthy foods, exercise, limit alcohol, don't smoke, and keep your blood sugar within a target range. Also, talk to your doctor or dietitian about how much protein is best for you.

Heart disease

Experts do not fully understand how diabetes affects the heart. Many things can lead to heart disease, including high blood sugar, insulin resistance, high cholesterol, and high blood pressure. But genetics and lifestyle may also affect a person's risk. For example, if you smoke, you are at a higher risk for heart and blood vessel disease than someone who does not smoke. To help prevent or delay heart disease, take the medicine your doctor suggests, exercise, don't smoke, control your blood pressure, and eat healthy.

How can you reduce your risk?

The most important thing you can do is keep your blood sugar under control. To do this, take your insulin or other diabetes medicines as your doctor tells you, check your blood sugar level often, follow your diet for diabetes, exercise, and see your doctor on a regular basis. Seeing your doctor is very important because you may have no symptoms from these problems. The earlier you can treat them, the more likely you can avoid complications and prevent the problem from getting worse.