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Diabetes Complications

Medically Reviewed by Minesh Khatri, MD on February 15, 2020

If it is not controlled, diabetes can cause a host of complications that can affect nearly every organ in the body. Diabetes complications include:

Heart Disease

Heart disease is one of the most common diabetes complications. In office visits, your doctor may perform various tests to check for heart disease and help you prevent any serious heart-related problems. At every visit, your health care provider will check your blood pressure by placing a cuff around your upper arm that tightens to read the flow of blood through your arteries. They'll also take a small blood sample from your arm to check levels of LDL cholesterol and triglycerides.

A baseline EKG should also be obtained as part of a complete medical record. Learn more about personal risk factors you have for heart disease, such as a family history or whether you smoke, and work out a prevention plan that includes weight loss, regular exercise, and stress management, as well as keeping your blood pressure, cholesterol, and triglycerides at normal levels.

Stroke

Signs and symptoms of stroke include sudden weakness on one side of the face or body; numbness in the face, arm, or leg; difficulty speaking; trouble seeing with both eyes; or dizziness. If you have any of these symptoms, see a doctor immediately. You may be referred to a neurologist or other stroke specialist. Read more about the warning signs of stroke and also be aware of ways to prevent this serious problem from happening to you.

Diabetic Nephropathy (Kidney Disease)

If you have diabetes, urine testing should be performed yearly to look for diabetic nephropathy -- kidney disease. A baseline creatinine blood test should also be done to determine your kidney function. You may need to be tested more often if you're likely to get kidney disease because of high blood pressure, heart disease, or a family history of kidney failure.

Your doctor will check a sample of your urine for albumin, a blood protein that can end up in your pee if your kidneys are damaged.

They'll also take a sample of your blood to check your glomerular filtration rate (GFR), a measure of how well your kidneys are doing their job of filtering waste in your blood.

Your health care provider will also check your blood pressure regularly, because control of high blood pressure is essential in slowing kidney disease. Your reading should be less than 130/80.

Diabetic Neuropathy (Nerve Damage)

Over time, diabetes can cause nerve damage that produces symptoms of numbness, burning, or pain in your hands, feet, or legs. If your skin becomes numb, you may not notice small wounds that could grow to become bigger health threats. Check your feet and hands daily for redness, calluses, cracks, or skin breakdown. If you notice any of these symptoms before your next scheduled visit, notify your health care provider immediately.

To check for these problems, your doctor will thoroughly examine your feet at least once a year. They'll tap on them with a tool similar to a nylon hairbrush bristle or prick your feet with a small needle. If you don't feel it, you may have nerve damage.

If you're diagnosed with peripheral diabetic neuropathy, you'll need thorough foot exams at every doctor's visit.

Diabetic Retinopathy (Eye Damage)

To protect your vision, all people with diabetes should see an ophthalmologist (an eye doctor) at least yearly. As part of the eye exam, the doctor will dilate your eyes so that they can see the back of the eye (the retina) and determine if the diabetes is causing damage. For this test, your doctor puts drops into your eyes that temporarily make your pupils get bigger. Then, they use a special magnifying lens to check your retina and optic nerves. They'll also test your eye pressure, side vision, and distance vision.

The test is painless. But since you'll be sensitive to light and your vision will remain blurry for a few hours, it's a good idea to bring sunglasses and get someone else to drive you home.

In people with type 1 diabetes, these annual exams should start within three to five years of diabetes once the patient is age 10 or older. People with type 2 diabetes should have their first eye exam once they are diagnosed. Those with eye complications may need to see their ophthalmologist more frequently. Women with diabetes who become pregnant should have a comprehensive eye exam during the first trimester and close follow-up with an eye doctor during their pregnancy. (This recommendation does not apply to women who develop gestational diabetes.)

Gastroparesis

Diabetes increases your risk of gastroparesis. With gastroparesis, the nerves to the stomach are damaged and stop working properly. This causes the stomach to take too long to empty its contents and makes it difficult to manage blood glucose levels. Sometimes, changing your diet can help. There are some medications and treatments for gastroparesis.

You may need one or more of these tests:

  • Upper gastrointestinal endoscopy
  • Upper GI series
  • Gastric emptying scintigraphy
  • SmartPill
  • Gastric emptying breath test

These tests mostly involve eating or drinking something or getting an imaging test (like an X-ray) to help doctors check if your digestive system is working well.

Talk to your doctor about ways to prevent diabetes complications. Ask for information on early warning signs so you can seek treatment when it is most effective.

Erectile Dysfunction

Diabetes increases the chance of developing erectile dysfunction, or impotence. For some men, adopting a healthier lifestyle, such as quitting smoking, exercising regularly, and reducing stress, may be all that is needed to resolve erectile dysfunction. It's important to talk to your health care provider about your erectile dysfunction, as your doctor can recommend other remedies -- including medications, a vacuum constriction device (VCD), and other erectile dysfunction aids -- that can help.

Skin Problems

As many as a third of people with diabetes will have a skin condition related to their disease at some time in their lives. High levels of glucose in the blood provide an excellent breeding ground for bacteria and fungi and can reduce the body's ability to heal itself. Fortunately, most skin conditions can be prevented and successfully treated if caught early. If your skin is not cared for properly with type 2 diabetes, a minor skin condition can turn into a serious problem with potentially severe consequences.

Infection

Type 2 diabetes slows down your body's ability to fight infection. High blood glucose leads to high levels of sugar in your body's tissues. When this happens, bacteria grow and infections can develop more quickly. Common sites of infection are your bladder, kidneys, vagina, gums, feet, and skin. Early treatment of infections can prevent more serious complications.

Dental Problems in Diabetes

People with diabetes face a higher than normal risk of serious dental and oral health problems. The more uncontrolled the blood sugar, the more likely dental and oral health problems will arise. This is because uncontrolled diabetes impairs white blood cells, which are the body's main defense against infections that can occur in the mouth. Over time, untreated plaque can lead to tooth decay, gum disease (gingivitis), periodontitis, and tooth loss. So keep an eye out for signs of gum problems, including swollen, tender, or bleeding gums. Whether you have diabetes or not, be sure to brush, floss, and rinse with antiseptic mouthwash daily. See your dentist for regular cleanings and checkups to prevent serious dental problems.

Other Tests for Diabetes Complications

A1c blood test

Most diabetes complications are linked to blood sugar levels that are too high or too low. An A1c blood test is a key way to check that your blood sugar levels aren't out of whack.

Until your blood sugar levels are stable, your doctor may do an A1c test four times a year. From then on, you'll get tested twice a year.

Your doctor will take a sample of blood from your arm or finger to measure your average blood sugar levels over the past 3 months.

If you take insulin or have blood sugar levels that are out of control, your doctor may also recommend that you test yourself at home as often as several times every day. You'll prick your finger and place a drop of blood on a disposable test strip that feeds into a portable blood glucose meter.

Diabetic ketoacidosis (DKA) test

When your cells don't get enough glucose, they start to burn fat for energy, which makes things called ketones. High ketone levels signal that your diabetes is out of control or that you're getting sick. This can lead to diabetic ketoacidosis (DKA), a dangerous complication.

Your doctor may suggest you take a sample of your urine at home and check ketone levels with a special test strip if:

  • Your blood sugar levels are high (usually over 240 mg/dL)
  • You're sick
  • You have signs of DKA, including dry mouth and frequent need to pee

Thyroid tests

Diabetes is linked to a condition called hypothyroidism. This is when your thyroid gland doesn't make enough of the hormones that control your metabolism.

To check for this, about once every 5 years, your doctor will take a sample of your blood to test your thyroid hormone levels.

You may get tested every 1 to 2 years if you have a higher chance of getting hypothyroidism because you're a woman over 40 or you have a family history of thyroid disease.

WebMD Medical Reference

Sources

SOURCES:

American Diabetes Association: "Type 2 Diabetes Complications," "Checking Your Blood Glucose," "Diabetes Complications," "DKA (Ketoacidosis) & Ketones," "Gastroparesis."

National Institute of Diabetes & Digestive & Kidney Diseases: "Complications of Diabetes."

American Academy of Ophthalmology: "What to Expect When Your Eyes Are Dilated."

Diabetes New Zealand: "Diabetes and Your Thyroid."

Duntas, L. Clinical Endocrinology, February 2011.

Mayo Clinic: "Diabetic Hypoglycemia."

National Institutes of Health: "Diabetes, Gum Disease, & Other Dental Problems," "Diabetes, Heart Disease & Stroke," "Diabetic Eye Disease," "Diabetic Kidney Disease," "Low Blood Glucose (Hypoglycemia)," "Nerve Damage (Diabetic Neuropathies)," "Preventing Diabetes Problems," "The A1C Test & Diabetes."

FDA: "Blood Glucose Monitoring Devices."

UpToDate: "Patient Education: Preventing Complications in Diabetes Mellitus."

Wang, C. Journal of Diabetes Research, April 2013.

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