Complications of diabetes are basically the scary things that can happen to your body over time when your blood sugar is not well-controlled. High blood sugar over long periods (months and years) causes damage to your nerves, feet, eyes, kidneys, heart, gums and more – all bad news!
But these complications of type 2 diabetes and type 1 diabetes can be staved off with a proactive approach to your care. In addition, there are lots of modern treatments that make living with chronic complications of diabetes much more bearable and comfortable.
Nobody likes to think about it, but you need to be informed about this stuff. Here’s an overview of the topics we’ve covered here at the ‘Mine over the years — often in our 411 Series that has touched on “all the info you need” on the topic at hand. You can expect us to expand on these periodically in our daily posts, as well as in our weekly Ask DMine advice column published each Saturday.
Probably the most deadly of diabetes complications are those affecting the heart: coronary artery disease, peripheral arterial disease, and stroke.
PWDs (people with diabetes) are two to four times more likely to suffer with cardiovascular disease, so listen up! There are several types of cardiovascular disease, with their own symptoms and treatments. Click above to read all about them.
Most of us probably didn’t plan on thinking about cholesterol until we were old and gray. But this waxy substance in your body that comes in good and bad forms (LDL and HDL respectively) is a huge determinant of heart attacks. There is quite a bit to know, though, on how to manage it, strategies for fixing it, and whether your test results are out of range.
Also quite damaging are the effects of high blood sugar on your small blood vessels – known as retinopathy, neuropathy, and nephropathy.
Most people are familiar with the “Big Bad” of diabetic eye disease: diabetic retinopathy. It’s the most well-known complication associated with the eyes, but there are actually seven different conditions that can affect a PWD’s eyes: Cataracts; Glaucoma; Dry Eye Disease; Cranial Nerve Palsy; Ischemic Optic Neuropathy; Retinal Vascular Occlusion and Retinopathy. Whew! Retinopathy actually has several stages of severity, ranging from “microscopic areas of blood vessel damage” to “small areas of bleeding and fluid leakage” to “abnormal blood vessel growth causing lots of bleeding and formation of scar tissue resulting in permanent vision loss.” Whoa.
Diabetic neuropathy, or diabetic nerve pain, is one of the most common diabetes complications, affecting 60 to 70 percent of us PWDs. Of course, it’s more likely to occur if your A1c (average blood glucose level) remains high over time, but simply having diabetes for decades can bring on diabetic neuropathy too. The highest rates of diabetic neuropathy occur in folks who’ve had diabetes for longer than 25 years.
Your kidneys, for those who missed that day in biology class, are powerful little guys about the size of your fist, located on either side of your spine, just below your rib cage. Kidneys are in charge of some very important procedures, including removing waste from the body, balancing the body’s fluids, releasing hormones that regulate blood pressure, producing a form of vitamin D that strengthens bones, and controlling production of red blood cells. Busy guys — probably why we have two of them. Approximately 30% of type 1 diabetics and up to 40% of type 2 diabetics will get some form of kidney disease in their lifetime, normally after 15 to 20 years of having diabetes.
Gastroparesis affects about one in five. In this case, it is a form of diabetic neuropathy, i.e. nerve damage that takes place in your stomach. Yuck! The term ‘gastroparesis’ literally means “stomach paralysis” because the stomach has difficulty emptying during digestion. Normally, digestion is aided by the vagus nerve, which helps churn your food into small pieces, before it’s mixed with enzymes and acid in your stomach to break the food down. But with gastroparesis, the vagus nerve is damaged, so the food is slooowly churned and digestion takes far longer than it should.
One of our correspondents, twenty-something Nick Gibson, took on something almost every single healthy, or unhealthy, male PWD deals with: Erectile Dysfunction (ED). Conversations about ED with our doctors are not always pleasant, as they can be uncomfortable, worrisome, and at times scary. Nevertheless, Nick writes: “Seriously guys, the earlier you bring this up with your medical professionals, the better by far. So, let’s talk.”
The thyroid is a little butterfly-shaped gland in the middle of your neck, and it’s part of the body’s endocrine system, where diabetes also dwells. This system controls your body’s metabolism. One of the thyroid’s primary responsibilities is to manage your metabolism by producing two thyroid hormones: T3 and T4. An overactive thyroid can cause weight loss, a quick heartbeat, and other signs that your body is “on the go” a little too much. The opposite, an underactive thyroid, leaves people feeling sluggish, and causes weight gain and slow heartbeat. Essentially, your body’s normal equilibrium slows down.
More on Thyroid: Hypothyroidism and Diabetes:
Take it a step beyond, and you get Hypothyroidism — which basically means the thyroid gland isn’t producing enough of the hormone needed to properly control your metabolism. Experts report that roughly 59 million Americans have a thyroid problem and a majority don’t even know it. Those of us in the Diabetes Community are more prone to thyroid issues (connected to our autoimmunity problems and overall metabolic issues). “Women are more prone than men, but that doesn’t exclude guys like me,” writes DiabetesMine managing editor Mike Hoskins, who lives with this himself.
Believe it or not, there are a LOT of potential diabetes skin complications, ranging from fairly common (20-30% of PWDs) to extremely rare (less than .5%). These include: bacterial infections, fungal infections, dry skin, extreme sunburn, diabetic dermopathy, digital sclerosis, diabetic blisters, and vitiligo (an autoimmune disorder affecting skin pigmentation). Ugh!
You might be wondering: ‘Diabetes affects my gums, too? Really?!” Really. And gum disease is not something you want to mess with. It is gross. Google it if you want proof. Gum disease (also called periodontal disease — same thing) takes form as gingivitis and periodontitis. In gingivitis, bacteria in plaque buildup in the gums around your teeth, making them swollen and red, and causes the gums to bleed when you brush your teeth.
Shoulder problems certainly aren’t the first thing that comes to mind when it comes to diabetes, but they’re actually one of several less-common complications of diabetes. Let’s face it, the effects of excess sugar in the bloodstream seem to know no bounds! Frozen shoulder, more formally called “adhesive capsulitis,” actually has nothing to do with cold weather but everything to do with the ligaments in your shoulder. Frozen shoulder occurs when your shoulder joint capsule sticks to the head of the humerus bone. This causes extreme pain and stiffness in the shoulder joint and eventually leads to immobility, followed by a long period of “thawing” in which the shoulder slowly returns to normal.
“Why in the world does diabetes affect your hearing?” I asked. “We know in kidney disease, visual problems and peripheral neuropathy, there are changes in the nerves themselves and we hypothesize that it’s the same process in the ears,” Dr. Yaremchuk explained. In the study conducted by her and her team, results showed that men and women with diabetes who had good glucose control had better hearing than those with poor control, but the good control group had worse hearing than those who didn’t have diabetes. The study also indicated that the differences in quality of hearing was more prominent in women with diabetes. Ugh again!
As you may know, carpal tunnel syndrome is a progressively painful hand and arm condition caused by a pinched nerve in your wrist. Specifically, it affects the median nerve, which runs through the “carpal tunnel” from your hand into your forearm. The median nerve provides feeling to the palm side of your fingers and is the muscle power that powers your thumb. When the median nerve is pinched from swelling of nerves or tendons in the carpal tunnel, numbness, tingling and pain can affect the hand and fingers. It can also lead to other symptoms, like poor circulation and loss of grip strength.
Diabetic mastopathy is one of the more uncommon effects of diabetes, and it’s rarely included in warning lists of potential diabetes complications. But it’s real and does occur in about 13% of pre-menopausal women with type 1 diabetes. Diabetic mastopathy is a benign (i.e. non-cancerous) “fibrous breast mass.” It mostly occurs in women (and sometimes men) who already have a pre-existing diabetes complication, like kidney disease or neuropathy.
Although not typically listed as a diabetes complication, it is well-documented that depression affects people with diabetes in large numbers. No surprise to us PWDs, considering all the crap we have to deal with: from guilt over blood sugars, to frustrating insurance battles, to the day-in and day-out weight of managing every tiny detail in our lives. We know full well that the hardest part of having diabetes may be the psychological side. Mental Health with diabetes is a real issue, folks!
There are some conditions that seem to pair with diabetes for mostly unknown reasons, and of course the life challenges that go along with growing old don’t make things any easier.
Report from a D-Mom in California who’s extremely determined to “get it” when it comes to understanding her young daughter’s reality with both type 1 diabetes and Celiac disease. She spent a week mimicking her daughter’s life in terms of managing diabetes and gluten intolerance, and was quite surprised at what she discovered.
This is a skin condition common in those of us who repeatedly inject ourselves – an accumulation of fat and scar tissue under the skin causing lumps that are not only unattractive, but interfere with insulin absorption, making it even harder for us to manage our condition. Ugh! It’s really hard to find good information on lipohypertrophy, even from the vendors whose products clearly cause it regularly.
Also known as Raynaud’s Phenomenon (or Raynaud’s Disease), this is a condition involving “periodic episodes of reduced blood supply in the extremities when exposed to cold or sudden temperature changes.” Meaning your fingers and toes go white and numb and become pretty much useless for a period of time. Uncomfortable, and sometimes quite scary!
Not everything that happens to you when you have diabetes is a complication, but sometimes it sure can make things complicated! For women with diabetes, the changes that menopause brings in your body can have unfortunate effects on diabetes management. Just like with your menstrual cycle, changes in the hormones estrogen and progesterone will affect how you respond to insulin.
The good news is that people with diabetes are living longer and healthier lives than ever. The life expectancy for PWDs has dramatically increased through the years (yay!), but that doesn’t mean our diabetes gets any easier. In fact, as the well-respected endocrinologist and person with diabetes (PWD) himself Dr. Irl Hirsch says, “We’re seeing more ‘geriatric PWDs’ these days and that presents a new host of issues that endocrinologists and patients traditionally hadn’t had to think about.”
The links between diabetes and brain disease are more serious and substantial than many once thought – even since a few years ago when the media reported that a new type of diabetes — type 3 — had been discovered. Now some researchers are speculating that Alzheimer’s is caused by insulin resistance and are declaring that Alzheimer’s is its own form of diabetes.
See also, these related resources from ‘Mine editor Amy Tenderich: