Diabetes is a lifelong condition that requires constant care. If you do not manage your diabetes well, blood sugar can stay at unhealthy levels and can harm your body.
There are two main types of diabetes. In both types, there is a problem with insulin. Insulin is made in the pancreas to help move glucose (blood sugar) to the cells. The cells then use the sugar as fuel.
In type 1, the immune system has destroyed cells that make insulin. Little or no insulin is released into the blood. People with type 1 diabetes need to take insulin daily to control blood sugar levels.
Type 2 is the most-common form. In this case, the body can't use insulin effectively. This is called insulin resistance. Eventually, the pancreas stops making enough insulin. Age, obesity and inactivity are just some of the risk factors for developing type 2 diabetes.
Some people with type 2 diabetes may be able to control blood sugar levels with diet and exercise. In many cases, diet and exercise alone aren't enough. You may also need to take pills or insulin, or a combination of both. Doctors also may add non-insulin injectable medicines to the mix.
What diabetes does to your body
If insulin can't move sugar from your blood to your cells, your blood sugar levels will rise. Over time, chronic high blood sugar levels take a toll on your body. You may face a host of health problems. Over time, diabetes that is not controlled can affect you from head to toe. Some examples:
Heart. Chronic high blood sugar levels can lead to fatty buildup in your blood vessels. This restricts blood flow and can cause blood vessels to harden. If a blood clot forms, a heart attack can occur.
Brain. As with blood vessels in the heart, chronic high blood sugar levels can affect blood vessels that carry blood to the brain. This can lead to a stroke. A stroke can cause permanent damage or death. Two out of three people with diabetes die of a stroke or heart disease. People with diabetes also are at higher risk of developing dementia.
Eyes. Over time, uncontrolled diabetes can cause blood vessel damage throughout the body, including in your eyes. Your retina has tiny, fragile blood vessels on it. These blood vessels can swell, weaken and clog. This is called "diabetic retinopathy". In some cases, this can lead to blindness. People with diabetes are also more likely to get cataracts and glaucoma.
Ears. Hearing loss is more common in people with diabetes. It is perhaps because of blood vessel and nerve damage, but studies aren't conclusive.
Mouth. Periodontal, or gum, disease may be worse in people with diabetes. Doctors are still studying possible causes of this.
Skin. You are more at risk of developing skin conditions, such as infections. About a third of people with diabetes have a skin problem at some point.
Nerves. Chronic high blood sugar levels can damage nerves in your arms, legs and vital organs. This is called "diabetic neuropathy". It can cause tingling, numbness or loss of feeling. It can be painful and lead to serious problems, such as infection or amputation. More than half of people with diabetes will have nerve damage.
Kidneys. Chronic high blood sugar levels can impair the blood vessels in the kidneys. These blood vessels filter out waste products. Having high blood sugar makes your kidneys work harder. The filtering system may begin to work poorly. If it stops working, the kidneys fail. Diabetes is the main cause of kidney failure.
Stomach. When nerve damage occurs in the stomach, it can cause gastroparesis. With this condition, your stomach cannot properly move food through the digestive tract. Food sits in your stomach for an unpredictable amount of time. That makes blood sugar levels hard to manage.
Bladder. Uncontrolled diabetes can damage the nerves that control bladder function. You may feel the need to urinate often or have some leakage. Other problems may include poor control of sphincter muscles or the inability to fully empty the bladder. More than half of men and women with diabetes have bladder problems.
Reproductive organs. Damage to nerves and blood vessels can lead to sexual problems. Men with uncontrolled diabetes are at risk for erectile dysfunction. They may also have retrograde ejaculation. This can affect fertility, as semen goes into the bladder instead of out through the penis. Women can experience vaginal dryness, pain during sex or a reduced sexual response. Studies also have found lower testosterone levels in men with diabetes. But obesity could be a factor, too.
Legs. Blood vessel damage can lead to narrow or blocked arteries in the legs. This causes a painful condition called peripheral arterial disease (PAD). Not only does PAD cause leg discomfort, but it's also dangerous. PAD increases your risk for heart attack and stroke.
Feet. People with uncontrolled diabetes often have nerve damage and poor blood flow (circulation). Nerve damage can make you lose feeling in your feet. If you step on something sharp, you can get hurt and not know it. Poor circulation makes it difficult for blood to get to your feet to fight off infections. Sometimes, amputation is needed if people have severe foot infections.
How to stay healthy
The above list may alarm you. But many of these health issues can be prevented or minimized. The key is keeping careful control of your blood sugar levels. Your doctor will work with you to develop a personalized plan.
Here are some tips for staying healthy:
- Eat nutritious foods. Follow the meal plan created by your doctor or nutritionist.
- Get regular exercise with your doctor's permission. Aim for at least 150 minutes of moderate-intensity aerobic exercise each week. Resistance training at least two times a week is also recommended for people with type 2 diabetes unless you have a condition or symptom that makes this inadvisable.
- Test your blood sugar as often as recommended by your doctor and keep a record of your readings.
- Take your medicine as prescribed. This may include pills, insulin or non-insulin injectable medication. You may also need blood pressure medicines and cholesterol drugs.
- Brush and floss your teeth. Brush your teeth with fluoride toothpaste at least twice a day. Floss at least once a day. See your dentist twice a year for regular checkups.
- Check your feet each day for scrapes, sores or blisters and report any problems promptly to your doctor. Once a year — or more often if you have foot problems — ask for a comprehensive foot exam. It should include inspection, checking of foot pulses and testing for loss of sensation.
- Don't smoke. If you do, get help from your doctor to quit.
- See your doctor as often as suggested for checkups. Follow through on recommended tests. And visit an eye doctor annually for a dilated eye exam. Your medical doctor may recommend that you also see other specialists regularly.
- Get your immunizations. Talk with your doctor about an annual flu shot. Also ask whether you need a pneumonia shot.
Emily A. King contributed to this report.
Created on 05/18/2011
Updated on 04/01/2013
- American Diabetes Association. Complications.
- American Diabetes Association. Standards of medical care in diabetes–2013. Diabetes Care. 2013;36:s11-s66.
- National Diabetes Information Clearinghouse. Complications of diabetes.
- National Diabetes Information Clearinghouse. Diabetes overview.