"A lot of people don't really think it will happen to them," says David C. Ziemer, MD, director of the Diabetes Clinic at Grady Hospital in Atlanta. "For a lot of folks, the wake-up comes when they actually have a complication ... a bad infection in the foot. That's a nasty wake-up call."
Does the light touch of a bed sheet make your feet burn? Does your heart sometimes race when you’re resting? Do you have problems with sexual arousal?
As different as these symptoms are, they can all have the same cause: diabetic nerve damage, also known as diabetic neuropathy. About half of people with diabetes develop nerve damage. The two most common forms are:
peripheral neuropathy, which affects the nerves that serve the farthest reaches of the body, such as the legs and hands;
If you have uncontrolled diabetes, a serious and deep-seated foot infection can mean loss of a toe, foot, or leg -- amputation -- to save your life. Seriously.
How is this possible? Over time, high blood sugar slowly injures the blood vessels, nerves, and organs in your body. The higher your blood sugar is -- and the longer it stays high -- the worse the damage is. Smoking and alcohol ratchet up the damage several more notches.
"Damage is slow and occurs over a period of years -- but it probably begins when blood sugar is at mildly elevated levels," says Ronald Goldberg, MD, associate director of the Diabetes Research Institute at the University of Miami Medical Center. "You may not be diagnosed with diabetes, but the damage has already begun."
The damage from diabetes shows up a bit differently in everyone -- whether it attacks the nerves, eyes, or kidneys, Goldberg tells WebMD. "Genetics probably influence which complications you are more susceptible to."
The problem is, "many people have diabetes a lot longer than they realize," says Ziemer. "Most have diabetes an average of five to seven years before they're diagnosed."
Serious leg and foot infections, even gangrene and amputation, are due to poor blood circulation, lack of oxygen and nutrients to tissue, and nerve damage.
Kidney damage (diabetic nephropathy) is a common risk for people with diabetes.
The complications of diabetes are indeed serious -- but they are not inevitable, Ziemer tells WebMD. "Keeping blood sugar under control is the single the most important factor in preventing them. But people have a hard time grasping just how critical that is," he says. "It's hard to get them to tune into it."