The complications associated with long-term diabetes afflict a significant proportion of diabetics: approximately 4 in 10 suffer from it, regardless of the type of diabetes.
A rate of glucose blood (or blood sugar) is too high, even periodically, can lead over time to serious health problems.
The earlier diabetes occurs, the greater the risk of complications. However, it is quite possible to delay or prevent the majority of complications by strict control of blood glucose.
Undiagnosed or poorly controlled diabetes can also lead to serious acute complications, which are medical emergencies.
Acute complications of diabetes
Diabetic ketoacidosis Hyperosmolar state |
Long-term complications
Virtually every part of the body can be affected by poorly controlled diabetes: the heart, blood vessels, kidneys, eyes, nervous system, and so on. As many organs can be affected because, over time, hyperglycemia weakens the walls of small blood vessels that supply all tissues with oxygen and nutrients.
Eye disorders. Diabetes can lead to progressive deterioration of vision. It can also lead to cataracts and glaucoma, even to loss of sight. Eye disorders are the most common complication of diabetes. Virtually everyone with type 1 diabetes develops it, while it affects 60% of type 2 diabetics. The retina is the part of the eye that is most commonly affected, but other parts can be affected as well. .
Neuropathy. Neuropathy is the name given to conditions that affect the nerves and can be quite painful, whatever the cause. It is formed in the first 10 years of diabetes in 40% to 50% of people with type 1 or 2 diabetes. The neuropathy stems from poor blood circulation (and therefore inadequate oxygen supply to the nerves) and low blood pressure. High glucose that alters the structure of the nerves. Most often, the subject feels tingling, loss of sensitivity and pain which first appear at the end of the toes or fingers, then progressively rise along the affected limbs. Neuropathy can also affect the nerves that control digestion, blood pressure, heart rate, sexual organs, and bladder.
Sensitivity to infections. The rise in blood sugar and the fatigue sometimes caused by the disease make diabetics more at risk for periodic infections that are sometimes difficult to cure. It can be infections of the skin, gums, respiratory tract, vagina or bladder. In addition, diabetes can slow down the healing process, which can cause recalcitrant infections in wounds. Foot infections are the most common. Partly due to neuropathy, they can be accompanied by ulcers, and sometimes even require amputation of the foot in case of gangrene .
Nephropathy. The term nephropathy comes from the Greek anaphors = kidney. The kidney tissue is made up of a multitude of tiny blood vessels that form a filter whose role is to eliminate toxins and waste products from the blood. Because diabetes causes vascular disorders, small kidney vessels can be affected to the point of causing progressive kidney deterioration that will manifest itself in a variety of conditions, from kidney failure to irreversible kidney disease. It should be noted that hypertension is also a major contributor to nephropathy.
Cardiovascular diseases. Diabetes contributes to the emergence of cardiovascular diseases. They are 2 to 4 times more common in diabetics than in the general population. A high level of glucose in the blood helps to coagulate the blood. Over time, the risk of obstruction of blood vessels near the heart (infarct) or brain (stroke) increases. The age, the heredity, the hypertension, the overweight and smoking also increase the risk. Type 2 diabetics often have a profile that initially makes them more at risk for this type of disease.
On average, people with type 2 diabetes will die 5 to 10 years earlier than those without diabetes. This is mostly due to cardiovascular disease.
Either of these symptoms may occur.
Eye disorders
- Black dots in the visual field, or areas without vision.
- Poor color perception and poor vision in the dark.
- A dryness of the eyes.
- A tangled view.
- A loss of visual acuity, which can go as far as blindness. Usually, the loss is done gradually.
Sometimes, there are no symptoms. Consult an ophthalmologist regularly.
Neuropathy (affections to the nerves)
- A decrease in sensitivity to pain, heat and cold in the extremities.
- Tingling and burning sensation
- Erectile dysfunction.
- A slowing of the emptying of the stomach, causing bloating and regurgitation after a meal.
- An alternation of diarrhea and constipation if the nerves of the intestine are affected.
- Bladder that does not empty completely or sometimes urinary incontinence.
- Orthostatic hypotension, which manifests as dizziness when moving from a supine position to a standing position and can cause falls in the elderly.
Sensitivity to infections
- Various infections: skin (especially on the feet), gums, respiratory tract, vagina, bladder, vulva, foreskin, etc.
Nephropathy (kidney problems)
- Hypertension sometimes announces the beginning of kidney damage.
- The presence of albumin in the urine, detected by a laboratory test (normally the urine is free of albumin).
Cardiovascular illnesses
- Slow healing.
- Chest pain during an effort (angina pectoris).
- Calf pain that hinders walking ( intermittent claudication ). These pains disappear after a few minutes of rest.
People at risk
- All people with diabetes are at risk for long-term complications.
- Hereditary baggage influences the degree of risk.
Risk factors
- Have a glucose (glucose) level often above normal.
- Suffer from hypertension
- Have a high cholesterol level.
- Smoking the cigarette.
Basic preventive measures |
People with diabetes can prevent or at least slow down the development of diabetes complications by monitoring and controlling 3 factors: blood sugar , blood pressure, and cholesterol .
On a daily basis, some tips to prevent or delay complications
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Medical treatments for complications of diabetes
Eye disorders . The conventional treatment consists of various surgical procedures, usually performed by laser.
Neuropathy (affections to the nerves). To reduce pain, doctors offer no steroidal anti-inflammatory drugs (NSAID) such as acetylsalicylic acid (aspirin) or ibuprofen (Advil, Motrin. Treatment usually includes the administration of a tricyclic antidepressant that can, somehow, help fight the intense pain associated with neuropathy. However, these drugs are not without adverse effects and their use, especially in the elderly, is disputed by some experts. Other types of antidepressant drugs that have fewer side effects may include: selective serotonin reuptake inhibitors (eg, fluoxetine (Prozac) and sertraline (Zoloft) or inhibitors of reuptake of serotonin and norepinephrine (eg, venlafaxine (Effexor).
Anticonvulsants, such as gabapentin (Neurontin) or carbamazepine (Tegretol), or opioid analgesics may come to the rescue in some cases, but they are not free of side effects.
Sensitivity to infections . Infections will usually be controlled with antibiotics or fungicides (which fight fungi), as appropriate.
Nephropathy (kidney problems) . In the first line, the doctor will usually prescribe medication to control blood pressure and will make certain dietary recommendations. In the end, kidney dialysis or transplantation may be unavoidable.
Cardiovascular diseases . See our Cardiovascular Disorders sheet for typical treatments for these diseases.