Even when diabetes is well controlled, it raises the risk of other.
High blood glucose levels are damaging to blood vessels and can increase the likelihood of them narrowing through atherosclerosis. This damage also leads to poor supply of blood to nerves.
Poorly controlled hyperglycemia persisting for years can lead to complications affecting small blood vessels, large blood vessels or both.
Microvascular Complications – those resulting from damage to small blood vessels – are the most common complications of diabetes and include:2
Diabetic retinopathy is an eye complication caused by disease of the tiny blood vessels supplying the retina (the light-sensitive back of the eye).
Early detection and preventive action are important. As symptoms do not appear before damage is done, anyone with diabetes – whether type 1 or type 2 – should have their eyes regularly checked by an optometrist or ophthalmologist.
Diabetic neuropathy – a disease of nerves – is also a complication caused by damage to small blood vessels. In this case, it involves capillaries supplying nerves.
Complications affecting the foot – often referred to as “diabetic foot” – result from neuropathy, nerve damage that causes tingling sensations, burning or stinging pain, weakness or loss of feeling. The nerves become damaged due to restricted blood supply.
The phenomenon can also affect the hands, but it is the feet that are most commonly affected. If left unnoticed, this condition can lead to infection and even gangrene and potential amputation.
Nerve damage leads to skin changes, making the foot dry and prone to cracking or peeling. Poor circulation to the feet caused by vessel narrowing can also mean that any infections or wounds heal less readily.
Seeking medical attention for any problems is important, as is getting the feet checked by a health care professional, such as a podiatrist, at least annually. practical measures include:3
- Keeping the feet clean and dry
- Ensuring the nails are well-maintained
- Wearing socks and shoes that fit comfortably and do not rub or squeeze the feet.
Disease of the large blood vessels caused by diabetes can lead to angina, transient ischemic attacks or stroke, heart attack and peripheral arterial disease. Macrovascular disease also contributes to the risk of the heart disease cardiomyopathy.
Screening, history and physical examination diagnose macrovascular disease, and treatment includes tight control of blood sugar levels as well as lipid- and blood pressure-lowering therapies.
Other strategies include smoking cessation, aspirin and drugs known as ACE inhibitors.
Adults with diabetes are two-to-four times more likely to have heart disease or a stroke than those without diabetes. A number of risk factors in people with diabetes contribute to macrovascular complications:
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