8 Complications of Diabetes

From health.usnews.com

Keep your blood sugar under control to help avoid these often serious complications.

Diabetes alone doesn't cause health complications – it's uncontrolled diabetes that causes health problems, says Lucille Hughes, a certified diabetes educator and director of diabetes education at South Nassau Communities Hospital in Oceanside, New York.

The health problems that can arise if your diabetes is uncontrolled can be serious: You could lose your vision or die from a heart attack or stroke. In fact, diabetes is the seventh-leading cause of death nationwide, according to the Centers for Disease Control and Prevention. What's scary is that you may not always know how high blood sugar is affecting your health. "Diabetes is called the silent killer for a reason," says Dr. Lorena Lewy-Alterbaum, an endocrinologist with Memorial Regional Hospital South who's also in private practice in Hollywood, Florida. "Patients feel relatively well with blood glucose in the 200 range, when the norm is 70 to 99." Your blood glucose, also known as blood sugar, is one measurement used to assess how well-controlled your disease is.

Here are more details on eight common diabetes complications.

Neuropathy. Neuropathy is another term for nerve damage, and it occurs in more than 50 percent of people with diabetes. Neuropathy can have a variety of symptoms; these symptoms often occur in your feet or legs – and sometimes your hands and arms – when you have diabetes. The symptoms include tingling, increased sensitivity to touch, pain, numbness and weakness. In its most extreme form, amputation of a limb may occur because of poor circulation or infections occurring when you have neuropathy, says Dr. Gregory Dodell, an assistant professor of endocrinology, diabetes and bone disease at Mt. Sinai School of Medicine, who is also in private practice at Central Park Endocrinology in New York.
Erectile dysfunction, which can be a complication of diabetes, is actually a form of neuropathy, Lewy-Alterbaum says.
Kidney disease. Kidney disease is a common complication because high levels of glucose cause the kidneys to filter too much blood, making them work extra hard, according to the American Diabetes Association. Waste products can build up and make the kidneys stop working. The effects of severe kidney disease are often devastating. "In the end stage, it requires a shunt in the arm for dialysis three times a week," Lewy-Alterbaum says. Part of a routine diabetes check is lab work to check for kidney function issues.

Vision problems. A condition called diabetic retinopathy can affect your vision over time when you have uncontrolled blood sugar levels. The excess glucose causes damage to the vessels in your retina, which is part of the back of the eye. Symptoms include blurry vision and poorer daytime and nighttime vision. Left untreated, diabetic retinopathy causes vision loss.

Heart disease. "Diabetes kills from the heart. The majority of patients will end up having some atherosclerosis-related event," Lewy-Alterbaum says. (Atherosclerosis is a hardening and thickening of the arteries.) She's treated patients who had heart trouble and only had vague or subtle symptoms. High blood glucose over time damages the heart – and those with diabetes are already more likely to have heart-related problems such as high blood pressure and high cholesterol.

Stroke. You're two to four times more likely to have a stroke when you have diabetes, the American Stroke Association reports. This is because excess glucose in the body can lead to more fatty deposits or clots in the walls of the blood vessels. The clots can cause narrowing or blockages in your blood vessels, which could eventually stop the flow of oxygen to the brain and cause a stroke.
Low testosterone levels. "I often tell patients that testosterone is a reproductive hormone, and if the body is focusing on dealing with other issues, it's not focused on reproductive function," Dodell says. "So, controlling diabetes and improving lifestyle will increase testosterone."

Gastroparesis. Gastroparesis is a condition where your stomach slows or stops the movement of food to the small intestine. Symptoms include nausea, vomiting, stomach pain and feeling full after just a few bites. Diabetes is the most common cause of gastroparesis, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
Sleep apnea. Sleep apnea is a common problem among patients with Type 2 diabetes; those who are overweight or obese are already more prone to sleep apnea. "I ask patients if they are exhausted during the day or if their significant other mentions that they snore so they can be assessed if indicated," Dodell says. "Treatment of sleep apnea can help control diabetes and daytime energy levels."

How to Avoid Complications From Diabetes

Regular checkups with your doctor can help avoid many diabetes complications. "When we see patients every three months, we can recognize blood sugar patterns, make lifestyle recommendations and intensify treatment before sugars get out of control," says Dr. Sarah R. Rettinger, an endocrinologist with Providence Saint John's Health Centre in Santa Monica, California.

Those regular checkups allow doctors to detect and treat early signs of problems. "With good control, patients should be able to live healthy, happy and long lives – without complications," she says.

It's important to start those regular checks early, when you're diagnosed with the disease. The earlier you can get your blood sugar under control, the more you can lower your risk for future complications, Lewy-Alterbaum says.

Lifestyle changes like a healthier diet, more physical activity and stress management all help reduce the risk of complications, Hughes says. Along with healthier choices, aim to get your hemoglobin A1C – an important blood sugar measurement – within your personalized healthy range, Dodell says. That's because research shows that healthy hemoglobin A1C goals can help you avoid complications in the first place.
It's also crucial to see not just see your primary care doctor or endocrinologist regularly, but also any other health professionals and specialists recommended to you, such as eye doctors, nutritionists and diabetes educators, Dodell says.

Although a diabetes diagnosis may seem overwhelming, Hughes focuses on the positive. She lets patients know that their diagnosis – and subsequent treatments and healthy changes – may help them avoid a lifetime of unexpected diabetes complications.

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