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Diabetes: Long Term Problems

Complications

Diabetes can cause other health problems. Sometimes these problems are referred to as complications (COM-pli-KAY-shuns). Long-term problems may develop when you have diabetes for a long time, especially when diabetes is not in good control. You can reduce your chances of developing long term problems when you keep your blood glucose, blood pressure and cholesterol levels in a good range. 

In case of emergency, you should always wear a form of medical identification (ID). Examples are ID bracelets and necklaces. To reduce your risk of getting other health problems from diabetes, you need good control of your blood glucose (sugar). Good control means keeping blood glucose at certain levels. To learn more about good control and healthy blood glucose numbers, see the UPMC patient education sheet Diabetes: Your Management Plan.

This patient education sheet tells you about long-term problems, what to do for them, and how to prevent them. High blood glucose over a long time can lead to:

  • Kidney damage
  • Eye damage
  • Nerve damage
  • Hardening of the arteries

Kidney Problems

The name for kidney damage is nephropathy (nef-RAW-pith-ee). High blood glucose can damage the blood vessels in the kidneys. The damaged blood vessels cannot filter all the waste products from your blood. So some waste remains in your blood. And protein that should stay in your body leaks into the urine and leaves your body.

If kidney damage continues, in time your kidneys will fail to work at all. If this happens, you will need to have dialysis (dye-AL-ih-sis). Dialysis is a process that removes the waste products from your blood. Some people may need to have a kidney transplant.

Good control of blood glucose helps reduce your chance of getting kidney disease. To see if you have early kidney disease, your doctor should test your urine. The best way to prevent or control kidney disease is to keep your blood glucose and blood pressure normal. Your doctor also may prescribe medicine to help prevent or control these problems.

Eye Problems

Diabetes can cause three major eye problems. They are retinopathy (RET-ih-NAW-pithee), cataracts (CAT-er-ax), and glaucoma (glaw-CO-muh). These eye problems can lead to blindness. If detected early, these problems can be helped. You should see an eye specialist at least once a year.

Retinopathy is the eye problem that diabetes causes most often. The blood vessels in the retina (RET-in-uh) of the eye become damaged. A special eye exam can detect it early. The doctor will put drops into your eyes. The eyedrops dilate (DYElate), or open up, the pupils. The doctor can then see the retina of your eyes better. This exam is called a dilated eye exam. It is important to have this exam every year.

Nerve Problems

High blood glucose damages the nerves. Nerve damage is called neuropathy (neh-RAW-pith-ee). Neuropathy can effect your heart, stomach, intestines, bladder, and sexual organs. Symptoms may include pain in feet and hands, trouble digesting food, and trouble with bladder or bowel control. Or there may be no symptoms.

The best treatment for nerve damage is to keep your blood glucose in good control and see your doctor regularly. Sometimes doctors can detect nerve damage before you notice any symptoms. Your doctor may prescribe medicine or treatment that may be helpful.

Feet and legs

Nerve damage usually happens in the feet and lower legs. You may get numbness, tingling, burning, or pain. You may even lose all feeling in your feet. Blood flow to your feet and lower legs may be poor. As a result, you can hurt your feet without knowing it. Foot sores can become serious very fast. These sores also are hard to heal. Call your doctor right away if you have any of these symptoms or an injury.

To prevent serious foot problems, inspect your feet every day. Daily foot care is very important. Ask your doctor or diabetes educator to show you how to inspect and care for your feet. You can learn more about foot care from the UPMC patient education page Diabetes: Health Care Tips.

Stomach

Nerve damage in the stomach makes food digest more slowly. The stomach also empties more slowly after a meal. You may feel bloated or get nausea or vomiting after you eat. Nerve damage in the intestines may lead to constipation or diarrhea. It gets harder to keep your blood glucose in a good range. Your doctor may prescribe medicine that can be helpful.

Bladder

When the bladder has nerve damage, you cannot feel if you have emptied your bladder. You can get infections when your bladder does not completely empty. Signs of infection are a burning feeling when urinating, strong-smelling urine, or constant urge to urinate. If you have these or other unusual symptoms, call your doctor.

Sex

Men and women may have sexual problems. It may be difficult for men to get or maintain an erection. Women may have problems with lubrication or sensation. Ask your doctor about possible treatments.

Hardening of the Arteries

High blood glucose can raise the blood cholesterol levels. Cholesterol can narrow and clog the insides of blood vessels. This problem is sometimes called hardening of the arteries. Another name is atherosclerosis (ATH-eroh-skler-OH-sis). Hardening of the arteries makes it difficult for blood to reach all parts of the body. It also causes high blood pressure. Your risk of heart attack and stroke increase. Healthy eating, exercise, and medicines can help control these problems. Your doctor should check your blood cholesterol, other blood fats, and blood pressure regularly. For more information, see the UPMC patient education sheet Diabetes and Heart Disease.

If You Have Questions

If you have any questions, call a member of your diabetes health care team.

                                                                                                                             Reviewed July 2013

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