Diabetes

Type 1 diabetes, type 2 diabetes, and gestational diabetes are the three main categories of diabetes. All types of diabetes share the inability to either make or use insulin.  In order to use the glucose you get from food for energy, your body needs the hormone insulin.  High blood sugars can occur without enough insulin as glucose stays in the blood.  There can be damage to the body’s organs over time, if blood sugars remain high.1

Type 1 diabetes occurs when the pancreas stops producing insulin, which typically starts in childhood.  Gestational Diabetes occurs when diabetes develops during pregnancy.  Type 2 diabetes typically develops in adulthood when insulin resistance occurs and the body can’t use the insulin that’s produced.   Type 2 diabetes can occur anytime in life and with the new epidemic of obesity, type 2 diabetes is being found more increasingly in teenagers.1

The following are some risk factors for developing type 2 diabetes1:

  • Age
  • Ethnic background
  • Family history
  • High blood pressure 
  • History of gestational diabetes
  • Impaired glucose tolerance or impaired fasting glucose
  • Insulin resistance
  • Obesity or being overweight
  • Polycystic ovary syndrome
  • Sedentary lifestyle

The following are diabetes health-related complications:

Eye

  • There is an increased risk for eye complications in those individuals with diabetes.2
  • Retinopathy, a disease of the retina, will occur in some form in most people with diabetes.2
  • There is a higher risk for blindness in individuals with diabetes than in individuals without diabetes.2
  • You are 40% more likely to suffer from glaucoma if you have diabetes, than if you do not have diabetes.  Glaucoma becomes more common the longer someone has diabetes and glaucoma risk increases with age.2
  • You are 60% more likely to develop cataracts if you have diabetes, then if you do not have diabetes.  You are also more likely to have cataracts progress faster and develop at a younger age, if you have diabetes.2
  • You are more likely to have retinopathy, the longer you have had diabetes and most people with type 1 and type 2 diabetes will develop nonproliferative retinopathy.

Feet, Nerve Damage, and Peripheral Neuropathy

Foot damage

  • In those individuals with diabetes, foot calluses build up faster and occur more often.  There can be infections and loss of limb, if calluses turn into ulcers and are neglected.2
  • Your feet are less able to fight infection and heal when there is poor blood flow.  Blood vessels of the foot and legs narrow and harden when you have diabetes.2
  • Foot or leg amputation is more common in those with diabetes, as many people with diabetes have artery disease which reduces the blood flow to the feet.  Many diabetics also have reduced sensation as a result of nerve disease.  Amputation can occur as a result of these conditions as they make it easier to get foot ulcers and infections. 2
  • Diabetic neuropathy is nerve damage caused by diabetes.  There is some form of nerve damage in about half of all people with diabetes.  There can be injury to the walls of tiny blood vessels that nourish your nerves, especially in the legs, which can happen over time if there is excess blood glucose.   Some of the nerves that can be damaged by this extended time of high blood sugars are those that tell your muscles when and how to move, those that control body systems that digest food and pass urine, and nerves that send messages to and from your brain about pain, temperature, and touch.2

Skin

  • At some time in their lives, as many as 33% of people with diabetes will have a skin disorder caused or affected by diabetes, and sometimes this may even be the first sign that a person has diabetes.2
  • People with diabetes will get skin conditions that anyone can have, but they get them more easily.  These conditions include itching, fungal infections, and bacterial infections.  Other skin conditions such as eruptive xanthomatosis, diabetic blisters, necrobiosis lipodidica diabeticorum, and diabetic dermopathy are skin problems that happen mostly to people with diabetes.2

Hypertension, Peripheral Artery Disease, and Heart Disease

  • High blood pressure is found in 2 out of 3 adults with diabetes.2
  • When blood vessels in the legs are narrowed or blocked by fatty deposits, which is known as peripheral arterial disease, blood flow to your feet and legs decreases.  In those individuals with diabetes over the age of 5, an estimated 1 out of every 3 have peripheral artery disease.2
  • There is an increased risk for heart attack and stroke if you have peripheral artery disease.2
  • Stroke, heart attack, and heart disease are more likely in those individuals with diabetes. In individuals with diabetes, 2 out of 3 die from stroke or heart disease.2

Hearing Loss

  • In those individuals with diabetes, it has been found that hearing loss is twice as common compared to those without diabetes.2
  • The rate of hearing loss is 30% higher in pre-diabetics than in those with normal blood sugar.2
  • Nerves and small blood vessels in the inner ear are what hearing depends on.  High blood glucose levels over time can damage these vessels and nerves, diminishing the ability to hear.2

Oral Complications

  • In those individuals with diabetes there is an increased prevalence of gum disease.2
  • It has been suggested that the relationship between diabetes and gum disease is twofold. Not only can blood glucose control be affected, contributing to the progression of diabetes due to serious gum disease, but those individuals with diabetes are more susceptible to serious gum disease.2
  • Gingivitis and periodontitis are oral health problems that individuals with diabetes are more at risk of. Individuals with diabetes are generally more susceptible to bacterial infection and have a decreased ability to fight bacteria that invade the gums, placing them at increased risk for serious gum disease.2

Blood sugar test

Gastrointestinal Complications

  • Food is delayed from leaving the stomach in gastroparesis, which is a type of neuropathy (nerve damage).  Long periods of high blood sugars can cause this nerve damage.2
  • The management of diabetes is made more difficult by delayed digestion, which can occur in gastroparesis and it can be more difficult to manage blood glucose.  Blood glucose levels rise when the food that has been delayed in the stomach finally enters the small intestine.2
  • Bacterial overgrowth can occur if the food stays too long in the stomach as the food becomes fermented.  Nausea, vomiting, and obstruction of the stomach can occur as the food can harden into solid masses called bezoars.2

Kidney Disease

  • Waste products are created when our bodies digest the protein we eat.  There are millions of tiny blood vessels (capillaries) in the kidneys with tiny holes in them, which act as filters.  Small molecules such as waste products squeeze through the holes, as blood flows through the blood vessels and thus waste products become part of the urine.  Useful substances such as protein and red blood cells stay in the blood, as they are too big to pass through the holes in the filter.  Kidneys filter too much blood when there are high levels of blood sugar.  The filters and thus the kidneys can be damaged with all this extra work.   As a result, the kidneys start to leak after many years of extra work and useful protein is lost in the urine, which is called microalbuminuria.2
  •  The kidneys eventually lose their filtering ability due to the stress of overwork and blood waste products begin to build up.  Ultimately the kidneys will fail and end stage kidney disease occurs.  Hemodialysis or kidney transplant must occur in end stage kidney disease.2

References

1. WebMD. (25, February 2010). Risk Factor s for Diabetes. Retrieved February 1, 2012, from http://diabetes.webmd.com/risk-factors-for-diabetes?page=2

2.American Diabetes Association.  (1, January 2012) Complications. Retrieved February 1, 2012, from http://www.diabetes.org/living-with-diabetes/complications/