Diabetes complications: what they are and how to lower the risk

Diabetes affects more than blood sugar. Over many years, high glucose can damage blood vessels and nerves, and that can show up in several parts of the body. The encouraging message from health agencies is that regular checks and steady care can lower the risk and help find problems early. This article gives an overview. Each topic has its own article for more detail.

What complications can occur?

The NHS says having type 2 diabetes increases your chance of getting other long-term health problems. It lists:

• Heart and blood vessels: damage that can lead to coronary heart disease and stroke
• Feet: ulcers and infections, which can sometimes lead to amputation
• Eyes: diabetic retinopathy and, in some cases, blindness
• Kidneys: kidney problems
• Gums: gum disease

The NIDDK adds nerve damage, called neuropathy, which affects about one-third to one-half of people with diabetes in its peripheral form. Over time, it also says, high blood glucose can affect the heart, nerves, kidneys, eyes, feet and gums.

Why they can go unnoticed

Many of these problems cause no symptoms in the early stages. The NIDDK says most people with diabetic kidney disease have no symptoms, and that early eye disease often causes none either. This is why routine checks are important, even when you feel well.

The checks that matter

The NHS describes these checks for type 2 diabetes:

• At least once a year: weight, BMI, cholesterol, blood pressure and kidney checks
• A foot check, every 2 years if the last one was normal, or yearly if needed
• Diabetic eye screening at diagnosis, then every 1 or 2 years
• An HbA1c test every 3 to 6 months

The NIDDK gives these points:

• A complete dilated eye exam once a year for most people
• Yearly kidney testing for people with type 2 diabetes, and for people with type 1 diabetes lasting more than 5 years
• A thorough foot exam at least once a year, and more often if you have loss of feeling or a history of ulcers
• An A1C test at least twice a year

Your own team will tell you which schedule applies to you.

What lowers the risk?

The NHS says to keep blood glucose as well controlled as possible, eat a balanced diet, exercise regularly, avoid smoking and attend all diabetes appointments and tests. The NIDDK says that managing blood glucose, blood pressure and cholesterol can help prevent future health problems, and lists quitting smoking, a meal plan, physical activity, a healthy weight, enough sleep and managing stress as part of care. It also lists a dentist, eye doctor, pharmacist and specialists as members of the wider care team.

Emergencies from very high blood sugar

The NHS warns that very high glucose can cause hyperosmolar hyperglycaemic state or diabetic ketoacidosis, both potentially life threatening.

Taking medicines and keeping appointments

The NIDDK advises taking medicines as prescribed, even when you feel well, and telling your team about cost problems or side effects. Ask about anything you do not understand. It also suggests bringing your blood glucose log and test results to each visit.

When to see a doctor

Speak to your GP or diabetes nurse about blisters or cracked skin on your feet, pain, tingling or numbness, sexual problems, constipation or diarrhoea, or any worsening of your vision.

Call for emergency help if you have frequent urination, intense thirst, nausea, confusion or drowsiness, or shortness of breath, as the NHS advises. Chest pain, signs of stroke or sudden vision loss also need urgent care. In an emergency, call your local emergency number (112 in India, 911 in the United States).

This article is for education only and does not replace advice from your own doctor.