Complications from Diabetes

How does diabetes affect the body?

If the blood sugar (glucose) is not controlled, it can lead to a number of complications:

• Eye problems
• Heart disease
• Stroke
• Kidney failure
• Nerve damage
• Loss of limbs
• Tooth and gum problems

Blood vessel Injuries

• Diabetes injures the blood vessels that serve a number of key body organs
  • This can go on to damage your vision, your heart, your kidneys
  • It can delay or prevent tissues from healing
  • If wounds do not heal, it can lead to amputation
• Blood vessel injury can lead to:
  • Heart attacks and heart failure
  • Stroke
  • Loss of vision, even blindness
  • Poor kidney function, even kidney failure
  • Poor wound healing, including minor injuries
  • Poor circulation
  • Amputation, usually of toes, feet or lower legs, can result from poor circulation and poor wound healing

Poor circulation

• Poor circulation prevents nutrients and oxygen from reaching the cells to help heal wounds and infections
• Cells without oxygen or nutrients die
• The affected area becomes numb or tingly or sometimes painful
• Sometimes the poor, slow circulation causes blockage in a blood vessel
  • Blood that cannot flow through an artery can become a clot which can cause a heart attack, stroke or other blockage
• Infections
  • A cut or wound will not heal well or quickly if there is high blood sugar
  • The germs feed off the sugar and multiply
  • The damaged blood vessels are not able to transport enough infection-fighting cells, natural antibodies, antibiotic medicine or nutrition to the wound to heal well

Heart disease

• Heart disease is one of the most common complications of diabetes.
• Diabetes causes increased risk of:
  • Chest pain (angina)
  • Coronary artery disease (blockages of arteries in the heart)
  • Heart attack
  • Congestive heart failure
• Factors which increase the risk of heart disease in diabetics:
  • High blood sugar
  • High blood pressure
  • High cholesterol

High blood pressure

• One of the common illnesses that develops when you have diabetes is high blood pressure
• The high pressure with each beat of the heart damages the heart and blood vessels
• Eventually it can weaken the heart muscle, causing congestive heart failure
• If the pressure becomes really high, it can also cause a stroke

Cholesterol

• Cholesterol damages arteries, too
• It plugs them up with fatty deposits
• This narrows the openings and slows down blood flow
• This increases the likelihood of heart attacks, strokes and poor circulation to the legs
• Smoking makes all of this worse by further narrowing the arteries

Kidney

• The kidney acts as a filter for bloodpassing small waste into the urine and keeping large nutrients (protein and sugar) for bodys use
• When blood sugar is not controlled, the high sugar in the blood damages the kidneys, leaving holes in the tiny filters that make up the kidney
• When filters are damaged, it lets protein and sugar cells into the urine
• The presence of protein in the urine can mean there is kidney damage

Kidney failure

• End stage renal disease (ESRD) is the medical term for kidney failure (when the kidneys can no longer function)
• Kidney dialysis is then used to do the work formerly done by the kidneys
• Many persons with ESRD must use dialysis about three times a week to clean their blood
• Renal (kidney) dialysis
  • A special machine is used to remove waste from the bloodlike a kidney does
  • Smaller machines might also be used at home by some patients who are trained and can do their own dialysis
  • A family member might also be trained to do this dialysis at home

Vision

• Retinopathy (blurred vision/blindness) occurs when the tiny blood vessels that nourish
• Weakened blood vessels can break and bleed, causing blindness
• Laser treatments are often used to repair weakened or broken blood vessels
• Timely eye exams and laser treatments can prevent blindness

Nerve damage

• Neuropathy (damage to the nerves) is a common complication of diabetes, especially when the blood sugar is not controlled
• Blood vessels that feed the cells are tiny and have very narrow passages
• When blood vessels become damaged from the high sugar levels, oxygen and nutrients cannot be delivered to the cells, damaging the nerve cells

Dental

• The poor circulation can also affect the blood vessels that supply oxygen and nutrients to the gums and bone which hold the teeth in place
• Gums and jawbone that are unable to get the nutrients and oxygen are more likely to develop infection or become loose
• Loose gums can mean lost teeth
• Gum infections make blood sugar control very difficult

Amputation

• Most amputations occur when wounds are not healing and become life threatening
• It becomes life threatening because the infection can spread and affect the body's total blood stream and important organs like the heart, the brain, etc.
• When the wound becomes serious, tissues become damaged and infection can't be controlled, it becomes necessary to remove the affected part to save the life
• Depending on the size and location of the incurable infection or wound, the surgery may mean removing one toe or up to the ankle, it may mean removing the foot, etc.
• Special shoes or a special prosthesis may be used to help with walking
• A wheel chair may be used if the amputation removes much of the leg and no artificial limb is possible for medical or personal reasons.

Sexual dysfunction

• Because nerves and blood vessels are damaged by high blood sugar, diabetes can lessen sexual desire
• Both men and women can be affected
• Diabetes can also lead to impotence (also called erectile dysfunction or ED). This is when the man is unable to have an erection (the penis can't get hard enough to allow intercourse to occur). Medicine may be helpful for this
• Many native people do not talk about this, but they should feel okay about talking to their doctors about this concern

Tobacco (Manufactured / Commercial) Smoking

• Smoking is a known cause of heart disease and stroke
• Smoking (nicotine) causes the small blood vessels everywhere in the body to constrict (get narrow), which decreases oxygen to tissues
• Smoking also makes the blood sludgy, making it more likely to clot and cause heart attacks and strokes
• Smoking (even without diabetes) also causes gum disease
• Smoking worsens all the negative effects of diabetes on the body