Complications associated with diabetes

Complications of diabetes can involve a range of body systems, including the eyes, kidneys, feet, mouth, heart and blood vessels. However, the risk of complications can be reduced by keeping blood glucose and blood pressure at healthy levels. In addition, regular check-ups and following general lifestyle measures such as maintaining a healthy body weight, having regular exercise, good diet and not smoking are also important.

Avoid high readings over long periods

Many of the complications of diabetes are much more likely to occur if you have high blood glucose levels or high blood pressure over long periods of time. Keeping both your blood glucose level and your blood pressure in as healthy a range as you can is your best defence against developing the complications of diabetes.

Every improvement helps lower risk

Remember that every improvement you make to your blood glucose level or blood pressure will reduce your risk of developing complications. You don't have to be in the target range to reduce your risks; although you will get the best improvement the closer your blood pressure and blood glucose are to target levels.

Eyes

Diabetes has been the leading cause of people developing blindness in New Zealand. However you can to do a lot to cut down the chance of developing eye problems. Existing damage can often be halted, or prevented from getting worse. Diabetes eye damage must be picked up early for it to be successfully stopped or treated. It's very important that you have a full diabetes eye check when you first know you have diabetes, and regular eye checks after that.

Kidneys

In the past quite a large number of people with Type 1 diabetes and Type 2 diabetes developed kidney disease. Now that people are able to monitor and improve their own blood glucose levels it's thought that a lot less people will develop this problem. In addition, recent advances in the treatment of high blood pressure in those with diabetes should cut these rates even further. See also: Diabetes and kidney disease

Feet

People with diabetes are more likely to develop foot problems. Problems are very often in the form of nerve damage and/or damage to your blood vessels. It is possible to prevent foot problems developing. Prevention depends on you taking good care of your feet every day, maintaining healthy blood glucose and blood pressure levels and keeping in close contact with your doctor or foot specialist.

Men's sexual health

Although very common in men with diabetes, erectile dysfunction (impotence) is one of the least talked-about complications. Erectile dysfunction is when a man has problems either getting or sustaining an erection. The good news is that it is often possible to treat. But talking about it with your partner and healthcare professional is an important first step.

Women's sexual health

To a lesser extent women may also experience changes in their sexual health when they have diabetes. Women may have problems such as decreased vaginal lubrication, and be more prone to yeast infections. It is important to use the best form of contraception for your health needs and to plan any pregnancies - talk about these issues and any sexual health concerns you may have with your doctor or diabetes specialist.

Skin conditions

Diabetes can affect your skin. Some skin conditions only occur in people with diabetes, but most of them also occur in the general population (for example, bacterial and fungal conditions, and itching). Skin problems are likely to be more severe in people with diabetes. Luckily, most skin conditions can be prevented or easily treated if caught early. Keeping your blood sugar level in the normal range should help prevent skin conditions. See your doctor for early diagnosis and treatment of skin conditions, and to prevent or treat infection.

Gum, teeth and mouth problems

People with diabetes tend to have more gum disease and mouth infections. High blood glucose levels make gum problems more likely. Gum disease can start at any age. However, there's a lot you can do to fight gum disease, for example, brushing your teeth twice a day, flossing your teeth every day, looking for early signs of gum disease, and visiting your dentist at least twice a year.

Nerve damage (neuropathy)

A common complication of diabetes is neuropathy. Neuropathy means damage to the nerves that run throughout the body. Nerves connect your brain and spinal cord to the whole of the rest of your body. There is a range of different neuropathies that people with diabetes can develop. Lowering blood glucose levels may improve early neuropathy.

Most doctors say that people with neuropathy should do three things: reach an ideal weight, follow a regular exercise programme, and aim to have healthy blood glucose and blood pressure levels.

Heart and blood vessel problems

People with diabetes are at more risk of developing heart and blood vessel disease (also known as cardiovascular disease). They have an increased risk of developing heart attack, stroke, and problems related to poor circulation.

You can do a lot to improve your cardiovascular health and lower your risk of these problems happening: Exercise, quit smoking, and eat a low-fat diet. Aim for healthy blood glucose and blood pressure levels. See your doctor regularly. There are ways to treat heart disease, but a healthy lifestyle is by far your best defence.

Thyroid

Although not a direct result of diabetes (and so, not a complication as such), people with diabetes are more likely to develop problems of the thyroid gland. The thyroid manufactures hormones that help regulate the activity of the cells in your body. Problems associated with the thyroid are Hyperthyroidism (too much thyroid hormone is circulating in the body) or Hypothyroidism (too little thyroid hormone circulating in the body).

Infections

When you have diabetes you have more chance of developing a range of infections. These can make your blood glucose levels difficult to control. Such infections include those associated with the bladder, kidneys, teeth and gums, feet, skin and vagina. Most infections can be effectively treated by antibiotics.

Get Checked programme

All people in New Zealand with diabetes are entitled to a free diabetes check-up with their GP or GP practice nurse once a year. Your GP may put you on a recall system to remind you when your check-up is due. A special form is used, which lists specific health checks that need to have been done, or be scheduled to be done; for example, eye check, kidney function, cholesterol level, blood pressure, feet circulation and sensation checks. It serves as a reminder to both yourself and your GP that nothing important has been missed out of your diabetes care for the year.

The free annual check-up is also used to collect nationwide information about the numbers of people with diabetes and the state of their health (your privacy is protected). These statistics are then available to health planners and groups keen to lobby for better services in diabetes care.

Original material provided by Diabetes New Zealand, 2008. Edited by everybody, June 2011.