Your Guide to Complications with Diabetes (Type 2)

For many, being diagnosed with type 2 diabetes is a scary phenomenon. But really, it’s only scary because of the complications with diabetes.

You can’t usually ‘feel’ high blood sugar, but you sure can feel foot pain. And if you consider an elevated level of sugar in your blood, it isn’t all that worrisome, but considering blindness is.

While it’s easy to get overwhelmed, the good news is we know that by controlling blood glucose, we can drastically reduce risk of complications.

In fact, a 1% reduction in A1c is associated with a 21% reduction in diabetes related death, 14% reduction in heart attacks and 37% reduction in microvascular complications. This means if you are able to move your A1c from 8 to 7 or 7 to 6, that is significant progress by way of improving long term outcomes!

That’s just 1%, so you can imagine your risk reduction if you can reduce it even more.

To help inform you of all the complications with diabetes, here are the most common ones.

Cardiovascular Disease

Cardiovascular disease (CVD) is the leading cause of death in many Western countries with ⅔ of people with diabetes dying as a result of it.

Cardiovascular complications include: coronary artery disease, chest pain, heart attack, stroke, and atherosclerosis (clogged arteries).

Preventative care includes getting your lipid levels (cholesterol values, triglycerides etc) checked regularly and be attentive to a healthy diet.

A heart attack occurs when blood supply to the heart is cut off.  If you experience chest pain of any kind that doesn’t go away upon resting, get emergency help right away. Because diabetes causes nerve damage (see below), heart attacks can be ‘silent’ – meaning there aren’t clear physical symptoms.

Stroke is a condition in which blood supply to the brain is cut off due to a clot. This causes brain damage very quickly. Those who have suffered from strokes may have trouble speaking, difficulty with memory, or numbness. Signs you may be having a stroke include: weakness on one side of the body, slurred speech, sudden confusion or dizziness, or loss of balance. Again seek help immediately–addressing symptoms early can reduce severity or permanence of damage.

Congestive heart failure is another cardiovascular complication in which there is a buildup of fluid in the body, including the lungs making it difficult to breathe. Often times there is swelling of the extremities as well such as the ankles called edema.

Neuropathy

Neuropathy, or nerve damage, occurs with chronic glucose elevation in the blood, which is why you need to keep your blood sugar levels under control.

What happens is the excess sugar in the blood damages the walls of the capillaries (super tiny blood vessels) that supply blood to nerve cells.

Symptoms of neuropathy can be silent initially, but often cause tingling, numbness, burning or pain over time. It is more commonly first felt in the hands and feet, then legs and arms. In both men and women this can lead to various forms of sexual dysfunction over time.

There is also central neuropathy, which causes damage to more major blood vessels feeding the heart, stomach and other organs.

Nephropathy

Nephropathy, or kidney damage, occurs as these organs diligently work to filter and excrete excess glucose.

The kidneys contain millions of tiny blood vessels that are very easily damaged by high levels of sugar passing through over time. Kidney damage is very gradual, stage 3 being much more serious than stages 1 or 2. At this point much stricter diet restrictions must be followed than a typical diabetic diet, such as limiting phosphorous, potassium, sodium, and sometimes fluids.

And stage 5 is considered kidney failure and requires dialysis to sustain life. Dialysis involves going to a center, usually 3 days a week, to connect to a machine that filters your blood for you.

Retinopathy

Retinopathy is a type of eye damage that occurs from excess sugar destroying tiny blood vessels in the back of the eyes. This can be gradual or rapid and can lead to blindness over time if not addressed.

Cataracts and glaucoma are other eye diseases people with diabetes are at higher risk for. It is very important to have your eyes checked by an ophthalmologist every year to screen for potential damage.

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Infections

Infections are more common in people with diabetes because immune function is often lower. These can be systemic infections such as the cold or flu, or local infections such as ulcerated feet or tooth infections.

It is recommended to get an annual flu vaccination as well as pneumococcal vaccine if appropriate – ask your physician because guidelines vary based on age and medical history. It is important to check your feet daily for any cuts, blisters, or abnormalities. Have a foot exam at every office visit, and make a podiatrist appointment every year to maintain healthy feet and detect infection early.

Diabetes is the top cause of foot amputations in Western countries, most if not all of which can be prevented by good blood sugar control and early treatment. Finally, be sure to schedule dental cleanings twice a year and be aware that diabetes increases risk for skin problems due to bacterial or fungal infections.

Diabetic Ketoacidosis

Diabetic Ketoacidosis (DKA), along with a similar condition abbreviated (HHNS), are acute conditions of extremely elevated blood glucose, requiring hospitalization to normalize levels. Both are very dangerous and can result in a diabetic coma or even death if left untreated.

Excess levels of ketones in the blood and urine are signs of the body breaking down fat because there isn’t enough insulin to burn the glucose as energy. Symptoms include: excessive thirst, nausea, vomiting, abdominal pain, unexplained weight loss, very elevated blood sugars (sometimes over 1,000!), and ketones in the urine.

Medical treatment for these symptoms is often how people first learn they have diabetes. DKA or HHNS can rear their ugly heads during times of illness and with insufficient insulin. So be sure to check your blood sugar more frequently when sick and if you take insulin. Be diligent with your timing and dosage, making sure your insulin isn’t expired.

If your blood sugars are over 350, or there are ketones in your urine (this is a very simple test using a strip similar to your blood glucose meter), seek medical attention right away.

Mental Health

Mental health problems are higher in diabetes, most commonly: depression, anxiety, or stress.

There are a wide range of emotions people feel during the course of diabetes including: anger, denial, guilt, shame, discouragement, confidence, hope, uncertainty, bewilderment and many others. These are very normal feelings. But it is important to monitor them and be sure you don’t stay in the negative ones too long.

Clinical depression can be very serious and anxiety can elevate sugar levels even more. If you think you might be depressed, talk with your physician about possible solutions. It is also noted that Alzheimer’s disease is much more closely linked with diabetes than once thought. While there is still a bit of mystery involved, it may be the case that either diagnoses can cause the other.

How to Reduce Complications With Diabetes

If you’re feeling discouraged at this point, remember, a 1% reduction in A1c is associated with a 21% reduction in diabetes related death, 14% reduction in heart attacks and 37% reduction in microvascular complications.

That’s just 1%, so you can imagine your risk reduction if you can reduce it even more.

What this means is that the degree to which you experience complications are directly tied to your proactivity. How proactive are you being in taking steps to ensure your blood glucose is well managed and controlled?

You might also find this info helpful:

• How to reduce A1C
• How to control blood sugar naturally through diet
• Diabetes friendly food list
• 5 steps to putting a low carb diet into practice

The key message here is that the more empowered you are, the better shot you have at minimizing, delaying or preventing any of the complications associated with diabetes.

Don’t stick your head in the sand. Do what you can everyday to take good care of yourself and live your best life!

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