When you were first diagnosed, you probably wondered how diabetes could cause problems in so many parts of the body. The reason is that diabetes damages nerves and blood vessels, and these are found everywhere in the body.
Diabetes complications fall into three general categories:
1. Nerve Damage (Neuropathy, pronounced Noo-RAW-pah-thee).
Diabetic neuropathies are a family of nerve disorders that lead to numbness and sometimes pain and weakness in the hands, arms, feet and legs. Neuropathy can also cause problems in your digestive system, heart, and sex organs.
Around 50% of people with diabetes have some degree of nerve damage, but not everyone experiences physical symptoms. Neuropathies are more common in people who have had diabetes for at least 25 years, who are overweight, have poor blood glucose control, and have high blood pressure. The most common type is peripheral neuropathy, which affects the arms and legs. This type of nerve damage causes numbness in the feet. This increases the chance of foot injuries, which, if left untreated, can lead to amputation.
2. Damage to large blood vessels (called Macrovascular disease)
High blood glucose causes hardening of the arteries (atherosclerosis), which can lead to a heart attack, stroke or poor circulation in the feet.
Heart disease is the leading cause of diabetes-related death. Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes. The risk of stroke is also 2 to 4 times greater for people with diabetes.
3. Damage to small blood vessels such as capillaries (called Microvascular disease)
High blood glucose also thickens capillary walls, makes blood stickier and can cause small blood vessels to 'leak'. Together, these effects reduce blood circulation to the skin, arms, legs, and feet. They can also change the circulation to the eyes and kidneys. Reduced capillary blood flow may cause some brown patches on the legs.
With good blood glucose control, many of these complications can be lessened. Your first priority should be to achieve HbA1c levels of 7% or less. Research has shown that for every 1% that you reduce your HbA1c level, the risk of heart attack drops by 14%, the risk of microvascular disease falls by 37% and the risk of peripheral vascular disease drops by 43%. Each additional 1% drop in your HbA1c score reduces the risk of complications even more.
If you already have a diabetes complication, take heart. Treatments are available for many diabetes-related problems. Ask your doctor if there are treatments that might be right for you.
Maintaining your long-term health
Doctors now believe that diabetes is not just a blood sugar problem.
That's why the American Diabetes Association's Standards for Diabetes Care look at the health of the whole body. Read the next page in this section to learn what you and your doctor can do to maintain your total health.