The long-term effects of diabetes include damage to large and small blood vessels (macrovascular), which can lead to heart disease, stroke, eye problems, and problems with the kidneys, feet, and nerves. These long-term complications can be episodic (e.g., foot ulcers or infections) or progressive (e.g., nephropathy and retinopathy). The risk of these complications can be reduced by maintaining a healthy weight, eating healthily, exercising regularly, avoiding smoking, and taking medication such as metformin, pioglitazone, or GLP-1 receptor agonists like liraglutide or liraglutide.
Untreated diabetes can lead to many dangerous complications
It is essential to know these complications' symptoms so they can be treated promptly. Acute complications develop suddenly and need immediate medical attention, whereas chronic complications develop slowly over years or decades. Regular screening is recommended so that these problems can be detected early. This can be done by getting a routine eye test, dental examination, and body mass index check-up. It is also essential to get regular blood pressure, HbA1c, and cholesterol checks. Learn about the complications of diabetes in this comprehensive informational article.
Hypoglycemia (Low Blood Sugar)
This happens when your blood sugar drops too low for the body to use as energy. It's often a side effect of insulin or diabetes medications and can be life-threatening. Symptoms include shakiness, fast heartbeat, and confusion. It can also cause you to pass out or become unconscious. Severe hypoglycemia requires immediate treatment.
Glucose, which comes from carbohydrates in food, is the primary energy source for most cells in the body and brain. Insulin helps move glucose from the bloodstream into cells, but if you take too much insulin, miss meals, or exercise more than usual, your glucose levels may stay high. Other causes of low blood sugar include eating too little, drinking too much alcohol, or having some endocrine issues like adrenal or pituitary gland disorders such as Addison's disease, or a rare condition called non-islet cell tumor hypoglycemia (NICTH), which occurs when a tumor in the pancreas releases excess insulin-like growth factor 2 (IGF-2).
Repeated episodes of low blood sugar can lead to hypoglycemic unawareness, where the body and brain stop producing the signs and symptoms of low blood sugar, such as shakiness and fast heartbeat. People with this condition need to check their blood sugar more often, and if they experience symptoms, they need to treat them immediately.
Hyperglycemia (High Blood Sugar)
Blood sugar is usually higher than normal when you have diabetes. This happens when your body doesn't use the glucose (sugar) from food and drinks as it should. This can lead to many problems.
In the short term, high blood sugar can cause diabetic ketoacidosis (DKA). This is an emergency that needs treatment at a hospital. It happens when your blood sugar is too high, and you don't have enough insulin. The body breaks down fat for energy and produces chemicals called ketones, which make the blood acidic. DKA can lead to a coma or death.
High blood sugar can also damage the kidneys, nerves, and eyes. It can cause blindness from diabetic macular edema, which causes fluid buildup in the macula (the part of the retina that helps you see faces and details). Nerve damage can lead to numbness or tingling in the feet, legs, and arms. It can also cause infections, like sores and wounds that won't heal. It can also cause a buildup of protein in the eye, which leads to cataracts or glaucoma.
Cardiovascular Complications
In people with diabetes, high glucose levels in the blood can damage blood vessels and nerves that support the body's tissues. This may lead to cardiovascular disease and other heart problems.
Cardiovascular complications are the leading cause of death in people with diabetes. This is due to high blood sugar, high blood pressure, and high cholesterol.
Neuropathy Nerve Damage
Nerve damage, called neuropathy, affects the parts of your body outside your brain and spinal cord (peripheral nerves). These nerves carry sensory data, instructions, and other messages from the central nervous system to your fingers and toes. Neuropathies can be mild to severe and cause tingling, numbness, or pain in your arms, legs, feet, or hands.
Diabetic neuropathy is the most common type of neuropathy, and it happens when your blood sugar levels are high for a long time. It causes numbness and tingling that usually starts in the tips of your toes or fingers and moves up your body. It can also cause problems with walking, balance, and digestion.
Retinopathy Eye Complications
Diabetes can damage the retina (the light-sensitive tissue that lines the back of the eye). Over time, high glucose levels in the blood block tiny blood vessels that nourish the retina. As a result, the blood vessels may leak fluid or bleed, and the retinal tissue swells. This can blur your vision. The condition is called diabetic retinopathy and can lead to blindness.
Diabetic retinopathy is divided into two stages: nonproliferative and proliferative retinopathy. In the early stage, fluid can leak from damaged blood vessels in the retina and cause macular edema (swelling of the central part of the retina that makes it hard to see). The fluid may also contain yellowish deposits known as lipid exudates.
You can prevent or slow the progression of diabetic retinopathy by having regular healthcare check-ups, especially at least once a year. Reasonable control of your blood sugar also delays the onset and slows the progress of retinopathy. It can also lessen the need for laser surgery or other procedures to treat severe retinopathy.
Nephropathy Kidney Disease
Affecting about half of individuals with diabetes, CKD is a severe and disabling condition.
Several mechanisms contribute to the development of diabetic nephropathy, including the altered function of renal podocytes, proteinuria, and progressive reduction in GFR. Podocytes are highly specialized terminally differentiated cells that cover the glomerular basement membrane (GBM), form its charge barrier, and shape the nephron capillary loop.
In addition, hyperglycemia leads to the formation of tubulointerstitial fibrosis, which reduces capillary surface area and causes glomerular hypertension, resulting in albuminuria and reduced glomerular filtration rate. The formation of this fibrosis is believed to involve the activation of inflammatory cells and secretion of various mediators.
Moreover, the progression of CKD to stage five is accelerated by obesity. This is partly because adipose tissue promotes insulin resistance, lipid abnormalities, systemic inflammation, and endothelial dysfunction, all of which are major risk factors for diabetes-associated CKD.
The Bottom Line
Symptoms of low blood glucose often begin gradually and may include increased urination, fatigue, or blurred vision. A doctor should check these symptoms immediately, as they can be life-threatening if left untreated.
Over time, high blood glucose levels can damage small and large blood vessels and impair the function of blood vessels in the skin (microvascular disease), causing poor circulation and wound healing that can lead to ulcers and infection, particularly in the lower extremities. Hyperglycemia also impairs immune system function, making people with diabetes more susceptible to bacterial and fungal infections, such as urinary tract infections and yeast infections.
In addition to high blood sugar levels, people with diabetes risk developing health complications affecting the heart and blood vessels, eyes, nerves, kidneys, and feet. Tight control of blood glucose and intelligent diet and exercise behaviors can help reduce the frequency of these health problems and prevent or delay their onset.
