Diabetes can cause many complications involving virtually every organ of the body. Most of these complications develop gradually, thus chronic diabetic complications. You have more chances of developing these if you have long duration of diabetes and especially if your sugar level is not under control. These complications can be very disabling and sometimes life threatening as well.

 

Good news is that if you control your sugar well, you can prevent / delay these complications.

 

Common complications-

 

1. High Cholesterol–

Uncontrolled diabetes can cause a rise in bad cholesterol. This gets deposited in your blood vessels and cause narrowing of the vessel (called atherosclerosis).

 

Tips

1. Check your cholesterol every year.
2. Stop smoking
3. Lose extra weight
4. Physical activity
5. Diet control (low fat, low cholesterol diet with lot of vegetables and fruits).
6. Cholesterol lowering medicine if prescribed by your doctor.

 

2. High blood pressure– High blood pressure increases the risk of heart disease and stroke.

Remember–

High blood pressure may be asymptomatic ( not producing any symptoms) in as many as 50% patients with it. So, it is very important to get it checked from a doctor during every visit.

 

Tips–

1. Reduce salt intake in your diet. Best way is to avoid added salt in your diet (for example avoid salt in curd, salad, avoid pickles, salted lassi etc).
2. Loose weight
3. Stop smoking
4. Reduce alcohol intake
5. Take regular medicines as suggested by your doctor.

 

3. Heart disease–

Diabetes increases the chances of developing heart attack and chest pain (angina). Diabetics can even get silent heart attacks (means they may not feel chest pain even at the time of an attack). Heart disease is the most common cause of death in diabetics.

Symptoms can be chest pain or discomfort, pain in the arms, back, jaw, neck or stomach, shortness of breath, sweating, nausea, dizziness, tiredness or light-headedness. Because diabetes causes nerve damage, so a heart attack can be painless and asymptomatic also.

Tips-

1. Stop smoking
2. Lose extra weight
3. Physical activity
4. Diet control (low fat, low cholesterol diet with lot of
   vegetables and fruits).
5. Cholesterol lowering medicine if prescribed by your doctor.
6. Good sugar and blood pressure control.
7. Regular check up.

 

4. Stroke–

Diabetes also increases the chance of getting stroke (paralysis) due to atherosclerosis (leading to formation of blood clot and blockage) of blood vessels supplying brain.

Note–

Risk increases further if –

1. You are >55 years old
2. You have a history of stroke in past or in family
3. You have Heart disease, High cholesterol or High blood pressure
4. You are overweight
5. You smoke
6. You are not physically active

Symptoms can be sudden onset of difficulty in moving hands and legs (involving one side of the body), numbness, memory loss, depression or difficulty in speaking/ understanding, difficulty in swallowing, loss of balance, loss of coordination or sudden severe headache.

 

Tips–

1. Good blood sugar, blood pressure and cholesterol control.
2. Physical activity
3. Stop smoking

 

5. Kidney damage (Nephropathy)–

Kidneys help in filtering waste material from our blood. To do this, kidneys have many small blood vessel clusters called glomeruli. Diabetes can damage these glomeruli. This leads to kidney failure. In severe cases, patient may even require dialysis and kidney transplant.

 

Note-  

Symptoms may not develop until most part of the kidney has been damaged. Even if symptoms develop, they are not specific. They include swelling of the feet or around the eyes, loss of appetite, nausea, loss of sleep, weight gain from edema, itching etc.

 

Tips

1. Good blood sugar control.
2. Blood pressure control.
3. Regular check up by your doctor and investigations like urine for protein, kidney function and cholesterol.

 

6. Nerve damage–

Nerves are also supplied by many small blood vessels that can be damaged due to uncontrolled diabetes. About 50% people suffering from diabetes develop neuropathy. It usually starts from the nerves supplying your legs. Symptoms like numbness, tingling, burning feet sensation or pain can occur. These symptoms usually start from feet and gradually move upward. This can ultimately lead to complete loss of all sensation and thus patient becomes unaware of any injury in the foot. This increases the risk of developing ulcers over foot.

Nerve damage can involve other parts of the body also. Damage to nerves of digestive system can cause constipation, diarrhea, indigestion, bloating sensation, nausea or vomiting. Sexual dysfunction (erectile dysfunction) can occur in men.

Tips- 

1. Good blood sugar control is very important to delay/ prevent the onset of neuropathy.
2. Good feet care is required to avoid injuries.

 

7. Diabetic foot problems–

Foot complications in diabetics occur due to many reasons- most important being the nerve damage that causes unawareness to injuries. Other reasons are poor blood flow to the feet, increased risk of infections, improper footwear, walking bare foot etc. This can lead to cuts or blisters. If not treated timely, these can become severe and may even require amputation.

Tips-

1. Examine your feet daily for cuts/breaks/ injuries that you may not feel due to neuropathy.
2. Use a mirror to see the bottom of your feet.
3. Use hands to feel for dry skin, hot or cold spots.
4. Check for corns/calluses/blisters/red areas/ swelling/ toenail infections
5. Use a moisturizer if skin is dry (Don’t apply it in between the toes).
6. Wear shoes and socks that fit well, all the time.
7. If required, you can get special shoes.

 

8. Gastroparesis-

 

This is a problem due to neuropathy involving a nerve ( called vagus) supplying your gastrointestinal tract (stomach and intestines). This causes slow emptying of the stomach or fast emptying. So you may have symptoms like bloating, fullness, nausea and constipation.

 

Tips-

1. Good sugar control
2. Small and frequent meals

 

9. Eye damage (retinopathy)-

Diabetes can affect small vessels of eye also and can cause many eye problems like cataract (clouding of the lens of the eyes), glaucoma (increased pressure in the eye) and infections. The most feared complication is retinopathy (changes in the retina at the back of eye). Retinopathy, if not treated, can even cause blindness. Most diabetic patients have some form of eye disease.

Note-

Most patients with diabetic retinopathy do not notice any change in eyesight till they reach advanced stage. By that time it is very late for the treatment.

Symptoms that may occur are blurred vision, spots or lines in your vision, watering from the eyes, discomfort in the eye and loss of vision.

 

Tip-

 You should get your eyes checked up regularly by an eye specialist (at least once in a year if normal and more frequently if abnormal).

 

10. Skin problems–

Diabetes increases the chances of developing skin infections especially fungal (candida, ringworm, athlete’s foot) and bacterial (styes, boils, folliculitis, carbuncles) skin infections. Other skin problems that can occur are diabetic dermopathy, blisters, xanthomatosis and necrobiosis lipoidica diabeticorum.

 

11. Mental health –

Diabetes can lead to depression and memory loss.

 

 

Remember- 

1. You should get yourself regularly evaluated for these complications.
2. Maintaining your A1c (blood sugar), blood pressure and cholesterol in the normal range can help in preventing / delaying diabetic complications.