Long Term Complications of Diabetes

Type 2 diabetes can be easy to ignore, especially in the early stages when you’re feeling fine. But diabetes affects many major organs, including your heart, blood vessels, nerves, eyes and kidneys. Controlling your blood sugar levels can help prevent these complications.

Although long-term complications of diabetes develop gradually, they can eventually be disabling or even life-threatening. Some of the potential complications of diabetes include:

· Heart and blood vessel disease. Diabetes dramatically increases the risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke, narrowing of arteries (atherosclerosis) and high blood pressure.

· Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Poorly controlled blood sugar can eventually cause you to lose all sense of feeling in the affected limbs. Damage to the nerves that control digestion can cause problems with nausea, vomiting, diarrhea or constipation. People who drink large amounts of alcohol can have similar nerve damage. Long-term Metformin (diabetes treatment) use (over three to five years) can increase your risk of vitamin B12 deficiency, and doctors will sometimes test for this.

· Kidney damage (nephropathy). The kidneys contain millions of tiny blood vessel clusters that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, which often eventually requires dialysis or a kidney transplant.Screening is very important. Kidney damage can be diagnosed early by detecting microalbumin (very small amounts of protein) in the urine. Everyone with diabetes should have a urine check for microalbumin at least once a year. Your doctor will also monitor your kidney function, including estimated glomerular filtration rate (e-GFR), with a blood test.

· Eye damage. Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma.

· Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can become serious infections, which may heal poorly, ulcers and structural foot problems.

· Hearing impairment. Hearing problems are more common in people with diabetes.

· Skin conditions.People with diabetes may experience very dry skin due to damage to the small blood vessels and nerves. A common problem for people with diabetes is very dry skin on the feet, but this may be more generalized.There are also other skin conditions related to diabetes. High blood glucose levels over time can affect the health of the skin. The skin acts as a barrier to protect our bodies from infection so it is important to keep the skin as healthy as possible. If the skin becomes dry, it can lead to cracks and possibly infections.

· Teeth and gum problems and diabetes:People with poorly managed diabetes are at increased risk of tooth decay and gum infections. This is due to damage to the small blood vessels supplying the gums and teeth. Dental and gum infections can also lead to high blood glucose levels.

· Mental health and diabetes: Living with and managing either type 1 or type 2 diabetes can lead to stress, anxiety and depression. This can affect your blood glucose levels and how you manage your diabetes in general. Over time, this can affect your health.It is important to talk to your doctor if you are going through times of stress, depression or anxiety. Your doctor can refer you to a counsellor, psychologist or psychiatrist by providing a diabetes mental health plan.Diabetes, particularly type 2, has been linked with Alzheimer’s disease and vascular dementia. Brain changes, resulting from reduced blood supply to the brain over time, appear to be associated with an increased risk for development of these conditions.

· Sexual dysfunction and diabetes:Reduced blood supply and nerve damage can affect sexual function. Erectile dysfunction (impotence) in men is the persistent inability to achieve or maintain an erection sufficient for satisfactory sexual performance. This is a common problem for men of all ages and is more common in men with diabetes.

· Diabetes and infections: Your immune system helps to prevent and fight infection. High blood glucose levels slow down the action of infection-fighting white blood cells. This makes it more difficult for the immune system to do its job.

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