In addition to managing your blood sugar, eating smart, and exercising, you should also maintain appropriate cholesterol and blood pressure levels. It is also important to not smoke. Smoking increases blood sugar and can contribute to the development of medical complications. It is important that you take care of yourself daily and keep all of your doctor appointments. Type 2 diabetes may be a lifelong condition however, you can still live a healthy, happy, and long life with good care.
Many people with diabetes also have high cholesterol and high blood pressure. These three factors combined—diabetes, high cholesterol, and high blood pressure, increase the risk of developing a variety of serious medical complications. Some of the symptoms may be obvious, while others may be subtle and develop over time. It is important that you monitor yourself for signs and symptoms of medical complications and complete all screenings recommended by your doctor. Report any concerns to your doctor promptly. The following paragraphs describe some of the medical complications associated with type 2 diabetes.
Heart and Cardiovascular System
Type 2 diabetes is associated with an increased risk of coronary artery “heart” disease, heart attack, and stroke. Heart disease is the leading cause of diabetes related death in the United States. Coronary artery disease causes the vessels that carry blood to your heart to narrow. They can also become completely or partially blocked by fatty deposits. A heart attack occurs when the heart does not receive blood or does not receive enough blood. A stroke occurs when the brain does not receive blood or does not receive enough blood. A heart attack or stroke can be fatal. They can also cause permanent or temporary impairments and disability.
Kidney and Renal System
Kidney disease, also called nephropathy, can also be caused by diabetes. Your kidneys remove waste products from your blood. Diabetes can damage the filtering system in the kidneys resulting in kidney disease or kidney failure. Persons with kidney failure need dialysis, a process in which a machine filters the blood. Some people may even need a kidney transplant.
People with diabetes have a higher risk of eye problems and blindness than those who do not have diabetes. A long history of diabetes and older age are factors associated with developing glaucoma. Glaucoma occurs when pressure builds up in the eye and causes gradual vision loss. People with diabetes tend to develop cataracts at a younger age and at a quicker rate than people without diabetes. Cataracts cause the clear lens in the eye to become cloudy, diminishing vision.
Diabetic retinopathy or retinal disorders can also be caused by diabetes. The retina is the part of your eye that receives images. Nonproliferative retinopathy is a condition that affects the capillaries in the retina. Retinal swelling can cause vision loss. In some people, retinopathy progresses to a more serious condition called proliferative retinopathy. The blood vessel damage caused by proliferative retinopathy causes scarring and eventual retinal detachment destroys vision.
Nerves and Neurologic System
Nerve damage caused by diabetes is called diabetic neuropathy. Nerves carry messages between your brain and body about pain, temperature, and touch. They also control your muscle movements and organ systems, such as the processes for food digestion and urination. Sensorimotor neuropathy and autonomic neuropathy are two common types of nerve damage.
Sensorimotor neuropathy affects sensation and movement. It may cause your feet and hands to feel weak, tingly, numb, or painful. Autonomic neuropathy affects the nerves that regulate involuntary functions or actions that you cannot directly control, such as your heartbeat. Of great concern, it can cause a loss of the typical warning signs of a heart attack or low blood glucose levels. Autonomic neuropathy can cause dizziness or faintness. It can also create problems with digesting food; vomiting, diarrhea, or constipation; bladder function; sex; increased or decreased sweating; and changes in the way the eyes function in the dark or light.
Diabetes can often lead to nerve damage called peripheral neuropathy. Peripheral neuropathy is a condition in which nerve function deteriorates in the limbs. This leads to a gradual loss of feeling in the hands, arms, legs, and feet. This is often problematic because pain is what enables you to know when something is wrong. Without pain, you may not realize that you have bruises, cuts, blisters or burns and seek medical treatment. It is important that people with diabetes receive medical treatment for foot sores because diabetes-related circulation problems can lead to more medical conditions.
Conditions of the Feet
The feet are very vulnerable to diabetes-related complications. There are a variety of foot problems that can occur. Foot problems are the leading reason for diabetes-related hospitalization. Further, diabetes is the leading cause of lower leg and foot amputation. Diabetes-related foot conditions are most frequently caused by poor blood circulation, infection, and nerve damage that can result in ulcers or sores, deformities, and trauma.
Peripheral vascular disease is a common diabetes-related circulation disorder. Poor circulation results in reduced blood flow to the feet. It can restrict the delivery of oxygen and nutrients that are required for normal wound maintenance and repair. As a result, foot injuries, infections, and ulcers may heal slowly or poorly. Minor skin problems on the feet can become worse and lead to infection.
Wounds and injuries can be difficult to heal if diabetes is uncontrolled. This can be especially true of wounds in the feet. Infections tend to get worse or remain undetected, especially in the presence of diabetic neuropathy or vascular disease. Neuropathy can cause you to be unaware of wounds. Additionally, the increased pressure from the feet carrying the body weight aggravates foot wounds. Further, shoes can cause skin friction, rubbing, and tearing. The hot moist environment of shoes is favorable to infection and foot ulcers. Foot ulcers are sores caused by skin breakdown. They can be exacerbated by infection. Foot ulcers tend to develop over areas of high pressure, such as bony prominences or foot deformities.
Foot deformities are another common problem associated with diabetes. They occur when the ligaments and muscles that stabilize the foot bones deteriorate. This can cause the bones to shift out of position or an arch to collapse.
A hammertoe deformity is a common condition that occurs most frequently in the second toe, although it can be present in more than one toe. Increased pressure on the tips of the toes and the lack of muscle stability causes a joint in the toe to become permanently flexed with a claw-like appearance. The toe deformity and pressure displacement makes the toe susceptible to skin ulcers.
Charcot foot is another common foot deformity associated with diabetic neurogenic arthropathy. Neurogenic arthropathy is a progressive degenerative arthritis that results from nerve damage. Charcot foot most frequently affects the metatarsal and tarsal bones located in the midfoot and forefoot.
Charcot foot causes the foot muscles, ligaments, and joints to degenerate or break down. Without support, the foot becomes wider and deformed. Without joint stability, the foot becomes unstable, making walking difficult. Inflammation and pressure eventually can cause bone dislocation.
People with Charcot foot have impaired or absent abilities to feel pain, temperature, and trauma. They may not be able to sense the position that their foot is in. This makes them vulnerable to injury, such as fractures, sprains, joint dislocation, bone erosion, cartilage damage, and foot deformity. They may even continue to walk on a broken bone without knowing it, because they cannot feel it.
People with diabetes are generally more prone to skin infections and skin disorders compared to those without the disease. People with diabetes have a greater tendency to get bacterial infections, fungal infections, and itchy skin. Some skin problems happen mostly to or only to people with diabetes.
Bacterial infections tend to manifest as sties on the eyelid, boils, infected hair follicles, deep infections under the skin, and nail infections. Bacterial infections cause the skin to become hot, swollen, red, and painful. Fungal infections are caused by yeast-like organisms that can grow and spread in diabetics whose sugar levels are uncontrolled. They create itchy rashes in moist areas of the skin. Common fungal infections include jock itch, athlete’s foot, ringworm, and vaginal infections. Both bacterial infections and fungal infections can be treated with prescription medication.
Diabetic dermopathy and necrobiosis lipoidica diabeticorum (NLD) are similar skin disorders caused by changes in the blood vessels. Both conditions cause brown spots to appear on the skin. Diabetic dermopathy is harmless, but NLD can cause the skin to crack and bleed. NLD is a rare condition affecting mostly adult women. Open sores need to be treated by a doctor.
People with diabetes tend to get atherosclerosis at a younger age than people without diabetes. Atherosclerosis causes the arteries to thicken, narrowing the route for blood flow. It results in skin changes. The skin becomes hairless, thin, cool, and shiny. The toes become cold, and the toenails thicken and discolor. Atherosclerosis can also cause wounds to heal more slowly or become infected because of a lack of blood flow.
People with type 2 diabetes can experience gastroparesis, a stomach disorder in which the movement of food is slowed or stopped. Gastroparesis occurs when high blood glucose levels damage the vagus nerve and the nerves that regulate stomach functioning over a period of time. The muscles in the stomach and intestines stop working properly. Signs and symptoms of gastroparesis include heartburn, nausea, vomiting, feeling full early when eating, weight loss, bloating, erratic blood glucose levels, lack of appetite, reflux, and stomach spasms.
If food stays in the stomach too long it can be dangerous. Delayed stomach emptying can lead to bacterial overgrowth and stomach or intestinal obstructions. Medications and nutritional changes can treat gastroparesis. In severe cases, a feeding tube may need to be inserted to deliver nutrients to the small intestine.
Mental and Psychological
Finally, people with diabetes have a greater risk of depression than people without diabetes. Depression is a real medical condition that can be treated. Depression is not a “normal part” of every ay life. Symptoms of depression include continually feel sad, irritable, tired, and uninterested in activities that you used to find enjoyable. Other common symptoms of depression include changes in appetite, having difficulty getting a good night’s sleep, moving the body at a much slower pace, and not being able to remember things or concentrate as easily as before.
Doctors are not exactly sure why people with diabetes are at risk for developing depression. They suspect that people cope with diabetes management differently. Additionally, some of the symptoms of low or high blood sugar can cause symptoms that look like depression. You should discuss your concerns with your doctor in order to receive appropriate diagnosis and treatment.
Wear a MedicAlert bracelet and carry a MedicAlert card in your wallet. In the case of an emergency, the MedicAlert information will be helpful to the healthcare professionals treating you. Because the medical complications associated with diabetes can be serious and life-threatening, people that develop type 2 diabetes need to diligently manage their disease to remain healthy. The following are suggestions for preventing complications from diabetes.
Monitor your blood glucose levels carefully, and treat yourself with insulin daily, as instructed by your doctor. Make sure that your write down the time that you tested your blood and the result. Take your logbook to each of your appointments. See a physician regularly to prevent and stay on top of any problems that might develop.
Eat a balanced diet and consult a nutrition expert for help with meal planning. Exercise regularly and reduce your weight if you are overweight. Even losing small amounts of weight is helpful for diabetes management.
Monitor your blood pressure. Ask your doctor what your blood pressure should be, and contact your doctor when it is out of range. You should also keep your cholesterol within normal limits. Have regular cholesterol checks throughout the year, and follow your doctor’s instructions for lowering cholesterol.
People with diabetes should have an eye exam at least once a year. The eye examination should include screening for glaucoma, cataracts, and diabetic retinopathy.
Attend all of your scheduled medical appointments. Your feet should be inspected at every visit. Discuss any concerns about depression with your doctor as well.