Diabetic Complications: The Invisible Damage Diabetes Does To Your Body

One of the largest chronic disease epidemics in human history, over 12% of global health expenditure is now directed to diabetes treatment.

Achieving optimal glucose control remains elusive for many.

There are several long-term diabetes complications of poorly-controlled blood sugar levels that can cause considerable deterioration in the quality of life.

Some of them are:

Diabetes & your eyes

Diabetic retinopathy is a highly specific complication of both type 1 and type 2 diabetes, and the duration of diabetes is a significant risk factor for the development of retinopathy.

The National Eye Institute (NIH), USA, explains that diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in patients of diabetes.

Research shows that after 20 years of diabetes, nearly all patients with type 1 diabetes and more than 60% of those with type 2 diabetes have some degree of retinopathy.

Chronic high blood sugar from diabetes damages the tiny blood vessels in the retina, leading to diabetic retinopathy.

Diabetic retinopathy usually affects both eyes. Collateral health and medical problems significantly increase a risk for the development and progression of diabetic retinopathy. These factors include pregnancy, chronic hyperglycemia, hypertension, kidney disease, and hyperlipidemia.

Symptoms of diabetic retinopathy

• Blurry vision
• Dark areas (loss of some vision)
• Poor colour vision
• Spots or dark strings
• Flashes of light

Talk to your eye doctor if you have any of these symptoms.

Nerve damage or Diabetic neuropathy

Yet another complication due to diabetes is nerve damage is called neuropathy or nerve damage. High blood sugar is the root of nerve damage.

The National Institute of Diabetes and Digestive and Kidney Diseases, USA, states that neuropathies are a group of nerve problems, which often develop in people with diabetes over time.

Nerve damage can be without symptoms or people can feel pain, numbness, or tingling in their feet, hands, arms, and legs and this damage can happen in any part of the body because it can affect any organ.

Chances of nerve damage go up with age. It is also more common in overweight people with higher levels of cholesterol and blood pressure.

According to Diabetes Daily, an educational source of diabetes information, the most common type affecting people with diabetes is Peripheral Neuropathy and can be felt as pain, tingling, burning, prickling, numbness and complete loss of feeling in the extremities.

Despite many recent advances in diabetes treatment, neuropathy remains common.

Another kind of diabetic neuropathy is Autonomic Neuropathy, which affects digestion, bowel and bladder function, perspiration, sexual response, nerves that serve the heart and manage blood pressure and nerves that serve the eyes and lungs.

This type of neuropathy may also cause hypoglycemia unawareness where a person with diabetes cannot sense any low blood sugar symptoms.

How high blood sugar affects kidneys

Having diabetes for a long time increases your chances of kidney damage. The best way to slow or prevent diabetes-related kidney disease is to try to reach your blood glucose and blood pressure goals.

Healthy lifestyle habits and taking your medicines as prescribed can help you achieve these goals and improve your health overall. Keep your blood glucose in your target range.

The earliest symptoms of kidney damage due to diabetes is the presence of small amounts of albumin in the urine, called microalbuminuria (an increase in the level of urine albumin).

According to the guidelines of the American Diabetes Association, here are the four ways of self-care when it comes to managing your blood glucose for better functioning of your kidneys:

• Lose weight, eat less salt, avoid alcohol and tobacco, and get regular exercise.
• Certain medicines called ACE inhibitors may be able to lower blood pressure. Studies suggest that ACE inhibitors slow kidney disease in addition to lowering blood pressure.
• Some doctors recommend a low-protein diet. A low-protein diet can decrease protein loss in the urine and increase protein levels in the blood. Always consult a certified nutritionist.

Diabetes and heart damage

People with diabetes are more likely to develop heart disease. In fact, in a 2016 study on 700,000 people, the researchers at the University of Leeds, UK, has found that having diabetes increases the risk of dying from the effects of a heart attack by around 50%.

The study, published in the 'Journal of Epidemiology and Community Health', also notes that managing diabetes effectively can reduce the risk of developing cardiovascular disease.

It happens like this: Because the glucose absorbed from the food remains in the blood instead of entering into the cells to be transformed into energy, there's an excess of blood sugar.

Over a period of time, the high sugar in the blood leads to complications in coronary arteries. The coronary arteries provide the heart with the oxygen and nutrients necessary for its functioning.

Excess of blood sugar weakens the wall of the arteries. This promotes the formation of plaque, which is deposited on the wall of the arteries. This plaque called atherosclerosis, consisting mainly of cholesterol, damages the wall, reduces the diameter of the coronary arteries, slowing down the blood circulation.

In the long run, because the poorly irrigated parts don't receive enough oxygen for normal functioning, the tissues are damaged. This is coronary heart disease.

High blood sugar in diabetes also contributes to the premature ageing of the arteries and hastens the process of atherosclerosis. Atherosclerosis or plaque formation is the cause of most cardiovascular issues like stroke and heart attack.

Like most complications of diabetes, the heart complications develop gradually and show no symptoms in the early stage. That is why it is important to regularly monitor your cardiovascular functions through cardiac tests in order to check for any complications and to limit their aggravation.

Diabetes and foot problem

Foot problems are common in people with diabetes and, if ignored, can lead to serious complications such as diabetic foot.

Because diabetes can cause nerve damage and poor blood circulation to the legs and feet, people with diabetes are less likely to feel a foot injury. Diabetes can make these injuries difficult to heal.

If untreated, even small foot injuries can quickly become infected, potentially leading to amputation.

Managing a diabetic foot has three main strategies: Identifying the 'at-risk' foot, treating the acutely diseased foot, and preventing further problems.

It also makes sense to adopt foot-healthy habits:

• Try wiggling your toes and moving your ankles for a few minutes a couple of times a day to improve blood flow.
• Avoid sitting in the same position or crossing your legs for long.
• A regular 30-minute walk, too, can work wonders to your circulation.
• Avoid smoking because it affects circulation and healing adversely.
• Get periodic foot exams to help prevent the foot complications of diabetes.

Diabetes and hearing loss

Hearing loss may be an under-recognised complication of diabetes. Over time, high blood sugar levels can damage small blood vessels and nerves in the inner ear.

Low blood sugar over time can damage how the nerve signals travel from the inner ear to your brain. Both types of nerve damage can lead to hearing loss.

A 2008 study by the U.S. National Institutes of Health (NIH) that appeared in the 'Annals of Internal Medicine', found that hearing loss is about twice as common in adults with diabetes compared to those who do not have the disease.

According to the Centers for Disease Control & Prevention (CDC), even people with prediabetes have a 30% higher rate of hearing loss than people with normal blood sugar levels.

The CDC recommends the following to protect your ears:

• Keep your blood sugar as close to your target levels as possible.
• Get your hearing checked every year.
• Avoid other causes of hearing loss, including loud noises.
• Ask your doctor whether any medicines you're taking can damage your hearing and what other options are available.
• You should have your hearing tested by an audiologistexternal icon (a health care professional who evaluates your hearing for medical problems) when you first find out you have diabetes and then every year after. Make it part of your diabetes care schedule. If you think you have hearing loss, talk to your doctor. They can help you decide if you should see an audiologist.

Diabetes and gum disease

If you have diabetes, you are at higher risk for gum problems. According to the Centers for Disease Control & Prevention (CDC), if the sugar level is high in your blood, it's high in your saliva too.

Here's a quick look at how diabetes can take its toll on your oral health:

• Dry mouth: Uncontrolled diabetes can decrease saliva flow, resulting in dry mouth. Dry mouth can further lead to soreness, ulcers, infections and tooth decay.
• Gum inflammation (gingivitis) and periodontitis: Besides weakening white blood cells, another complication of diabetes is that it causes blood vessels to thicken. This slows the flow of nutrients to and waste products from body tissues, including the mouth. The body slowly loses its ability to fight infections. People with uncontrolled diabetes have more frequent and more severe gum disease.
• Poor healing of oral tissues: People with uncontrolled diabetes don't heal quickly after oral surgery or other dental procedures because blood flow to the treatment site can be damaged.
• Fungal infections: People with diabetes who frequently take antibiotics to fight various infections are especially prone to developing a fungal infection of the mouth and tongue.

Research says that the relationship between serious gum disease and diabetes is two-way. If you have diabetes there are higher chances of you getting a gum issue.

On the other hand, serious gum disease may have the potential to affect your blood glucose control. Watch out for oral health issues like gingivitis and periodontitis.

Tips to prevent dental problems

• Control your blood glucose level. Good blood glucose control can also help prevent or relieve dry mouth caused by diabetes.
• Take good care of your teeth and gums.
• Have regular check-ups every six months.
• Avoid smoking.
• If you wear dentures, remove and clean them daily.

The stress-diabetes link

Research shows a link between emotional stress and diabetes, with roots in the brain's ability to control anxiety.

The control lies with the brain's executive functions, processes that handle attention, inhibition, working memory and cognitive flexibility and are also involved in reasoning, problem-solving and planning.

The study, published in the journal 'Psychoneuroendocrinology', establishes a metabolic chain reaction that starts with low inhibition or attention control, which leaves a person vulnerable to tempting or distracting information, objects, thoughts or activities.

Previous studies have shown that such vulnerability can lead to more frequent anxiety, and anxiety is known to increase inflammation.

When people are anxious, they are more likely to avoid treatment and use unhealthy habits like smoking or unhealthy diets that raises their blood glucose. Managing diabetes can be highly stressful, too. It's a vicious cycle with disastrous consequences.

Conclusion

You can take active, positive steps to reduce the risk of diabetes-related complications.

The best way to prevent them is to keep your blood glucose levels as close to normal as possible.

Focusing on the daily goal of controlling your blood glucose will help you stay positive about your long-term future with diabetes.