Diabetes increases your risk for many serious health problems. With the correct treatment and recommended lifestyle changes, many people with diabetes are able to prevent or delay the onset of complications
By keeping your blood glucose level in a healthy range through meal planning, physical activity, and medications, you can avoid long-term complications of diabetes.
These complications develop over many years and they all relate to how blood glucose levels can affect blood vessels. Over time, high blood glucose can damage the body’s blood vessels, both tiny and large.
Damage to your tiny blood vessels causes microvascular complications; damage to your large vessels causes macrovascular complications.
Microvascular Complications: Eye, Kidney, and Nerve Disease
You have small blood vessels that can be damaged by consistently high blood glucose over time. Damaged blood vessels don’t deliver blood as well as they should, so that leads to other problems, specifically with the eyes, kidneys, and nerves.
Eyes: Blood glucose levels out of range for a long period of time can cause cataracts and/or retinopathy in the eyes. Both can cause loss of vision.
To avoid eye problems associated with diabetes, keep your blood glucose within range and have yearly eye check-ups that include a dilated eye examination with an eye doctor to monitor your eye health.
Kidneys: If untreated, kidney disease (also called diabetic nephropathy) leads to impaired kidney function, dialysis and/or kidney transplant. Uncontrolled (or poorly controlled) diabetes can cause the kidneys to fail; they’ll be unable to clean the blood properly.
To prevent diabetic nephropathy, you should be tested every year for microalbuminuria, which is a condition that’s an early sign of kidney problems. The test measures how much protein is in the urine. This test is easily done with a urine sample. When the kidneys begin to have problems, they start to release too much protein. Medications can help prevent further damage, once microalbuminuria is diagnosed.
Nerves: Nerve damage caused by diabetes is also known as diabetic neuropathy. The tiny blood vessels “feed” your nerves, so if the blood vessels are damaged, then the nerves will eventually be damaged as well.
In type 2 diabetes, some people will already show signs of nerve damage when they’re diagnosed. This is an instance where getting the blood glucose level under control can prevent further damage.
There are various forms of diabetic neuropathy: peripheral, autonomic, proximal, and focal. Diabetic peripheral neuropathy is the most common form of nerve damage, and it most often affects the nerves going to the hands and feet.
People who have had type 2 diabetes for a very long time and who haven't done well managing their blood glucose may lose sensation in their feet. They may also experience pain, weakness, or tingling.
One serious complication of diabetic peripheral neuropathy in the feet is that people may not realize when they have a sore on their foot. The sore can become infected, the infection can spread, and left untreated, the foot may need to be amputated to keep the infection from spreading more. It is important to have regular foot exams done by a podiatrist, but you should also have your healthcare provider examine your feet every time you have an office visit.
Macrovascular Complications: The Heart, Brain, and Blood Vessels
Type 2 diabetes can also affect the large blood vessels, causing plaque to eventually build up and potentially leading to a heart attack, stroke or vessel blockage in the legs (peripheral vascular disease).
To prevent heart disease and stroke as a result of diabetes, you should manage your diabetes well, but you should also make heart-healthy choices in other areas of your life: don’t smoke, keep your blood pressure under control, and pay attention to your cholesterol.
It is important to have your cholesterol checked annually. Your doctor should check your blood pressure every office visit. Also at every office visit, the doctor should check the pulse in your feet to make sure there is proper circulation.
Type 2 diabetes comes with certain short- and long-term complications, but if you maintain good blood glucose control, you can avoid them.