What Are Complications of Diabetes?
Both T1D and T2D create high blood sugar levels, called hyperglycemia. Over years, hyperglycemia damages the retina of the eye, blood vessels of the kidneys and other organs, and the nerves.
- Damage to the retina from diabetes (diabetic retinopathy) is the leading cause of acquired blindness.
- Damage to the kidneys from diabetes (diabetic nephropathy) is the leading cause of acquired kidney failure.
- Damage to the nerves from diabetes (diabetic neuropathy) is a major cause of foot wounds and ulcers. It remains the leading cause of nontraumatic amputations of feet and legs.
- Damage to the nerves in the autonomic nervous system can lead to paralysis of the stomach (gastroparesis), chronic diarrhea, and an inability to control heart rate and blood pressure during postural changes (dysautonomia).
- Diabetes accelerates atherosclerosis, (the formation of fatty plaques inside the arteries), which can lead to blockages or a clot (thrombus). Such changes can then lead to heart attack, stroke, and decreased circulation in the arms and legs (peripheral vascular disease).
- Diabetes predisposes people to elevated blood pressure (hypertension), high levels of cholesterol and triglycerides. Both independently and together with hyperglycemia, these conditions increase the risk of heart disease, kidney disease, and other blood vessel complications.
Diabetes can contribute to a number of acute medical problems. Acute means coming on suddenly rather than developing slowly over time (chronic).
- Many infections are associated with diabetes. Infections are frequently more dangerous in someone with diabetes because the body’s normal ability to fight infections is impaired. Infections may worsen glucose control, which further delays recovery from infections.
- Hypoglycemia or low blood sugar occurs intermittently in most people with diabetes. It can result from receiving too much diabetes medication or insulin (an insulin reaction), missing a meal, exercising more than usual, drinking too much alcohol, or taking certain medications for other conditions. You should recognize hypoglycemia and must be prepared to treat it at any time. Headache, feeling dizzy, poor concentration, tremor of the hands, and sweating are common symptoms of hypoglycemia. A person can faint or lose consciousness with a seizure if blood sugar level becomes too low.
- Diabetic ketoacidosis DKA is a serious condition in which uncontrolled hyperglycemia causes dehydration and inadequate insulin allows buildup of blood ketones (acidic waste products). High acid and altered salt levels in the blood can threaten life. DKA typically occurs at the initial diagnosis of T1D and in people with poor glucose control. DKA can be precipitated by infection, stress, trauma, missing medications like insulin, or medical emergencies such as a stroke or heart attack.
- Hyperosmolar hyperglycemic nonketotic (HONK) syndrome is a serious condition in which high blood sugar level leads to severe dehydration. When the body tries to rid its excess sugar via the urine, this can cause severe dehydration leading to seizures, coma, and even death. HONK syndrome typically occurs in people with T2D who are not controlling their sugar levels, who have become dehydrated, or who have stress, injury, stroke, or are taking certain medications, like steroids.
Diagnosing Diabetes-Related Complications
A person with diabetes should be checked regularly for early signs of diabetic complications. A primary health care professional can order some tests. Other tests require referral to a specialist.
- People with diabetes who have entered or passed puberty should have their eyes checked at least once a year by an eye specialist (ophthalmologist) to screen for diabetic retinopathy, a leading cause of acquired blindness.
- The urine should be checked for protein (microalbumin) on a regular basis, at least once annually. Urinary protein is an early sign of diabetic nephropathy, a leading cause of acquired kidney failure.
- Sensation in the legs should be checked regularly using a tuning fork or a monofilament device. Diabetic neuropathy is a leading cause of lower extremity ulcers in individuals with diabetes and the leading contributor to nontraumatic amputations of the feet or legs.
- The health care professional should check the feet and lower legs of adult diabetic patients at every visit for cuts, scrapes, blisters, or other lesions that could become infected. Adults with diabetes should check the soles of their feet and their legs daily with a hand-held mirror or camera, either themselves or with the assistance of a relative or caretaker.
- The adult patient should be screened regularly for conditions that may contribute to heart disease, such as high blood pressure and high cholesterol.