Diabetes Health Problems

The health risks of having diabetes are caused by the high glucose levels damaging blood vessels such as the heart, also the nerves, eyes and kidneys.

How Does Diabetes Effect Your Risk Of Death?

Diabetes increases your chance of dying and reduces your life expectancy. Here are some statistics:

People with type 2 diabetes aged 35 to 54 years have over three times the mortality rate of those without the condition.
Across all age groups, type-2 diabetes sufferers were found to be twice as likely to die compared with healthy individuals.

Short Term Problems With Glucose Control

High glucose levels in the blood (Hyperglycemia) from uncontrolled or poorly controlled diabetes causes thirst, increased urine volume causing you to go to the toilet more, especially at night; and weight loss. Very high glucose levels can be fatal, and can be brought about by infections which cause the blood glucose levels to rise, or from Type 1 Diabetics forgetting to dose themselves with insulin. Controlling blood glucose levels when you are ill is very important in diabetes. Blood glucose testing with a blood glucose meter can be important for many diabetics and your doctor will guide you on this.

Low glucose levels in the blood (Hypoglycemia) are caused by taking too high a dose of tablets, or using too high a dose or repeating a dose of insulin. Medication errors like this can be serious, and can lead to fainting, loss of consciousness and coma, which is especially dangerous while you are in bed at night when this is less obvious to anyone else, and so you may not get the help you need to bring you round. High levels of exercise can also cause this. Low blood glucose levels are called hypoglycemia and can be fatal. Blood glucose testing with a blood glucose meter can be important for many diabetics who are in danger of low blood glucose and your doctor will guide you on this.

Long Term Complications Of Diabetes

Glucose is a very reactive molecule in the body and can react with other body tissues in two ways. Firstly it can directly combine with other molecules to form glucose compounds, such as with haemoglobin in the blood to form glycosylated haemoglobin, which is used as the best measure of long term glucose control in blood glucose testing for diabetes . Secondly it is able to generate free radicals , which damage other molecules and other body tissues.The body's natural antioxidants are there to neutralise these free radicals, but when glucose is present in higher concentrations damage will occur, one example being the oxidation of cholesterol to form oxidised cholesterol which can attack the lining of your blood vessels leading to atherosclerosis and heart disease .

Long term complications of diabetes aren't just due to blood glucose because even with the tightest blood glucose control there are other health problems caused by the different way the body now works. It is therefore essential to look at all the health risk factors that you have, because they are now more likely to cause major health problems. This is the magnifying effect that diabetes has on poor health. The level of glycosylated haemoglobin (A complex formed by haemoglobin and glucose over time) in the blood is a much better predictor of long-term complications than isolated blood glucose readings. (See Blood Glucose Testing ).

Heart and circulation problems are the commonest complication of diabetes leading to an increased risk of heart attack and stroke. Preventing heart attacks is so important that controlling blood pressure and cholesterol as risk factors are even more important than tight control of blood glucose levels to a diabetic. Heart and circulation problems are the commonest cause of death for diabetes causing 75% of all deaths, with heart attacks accounting for 30% of all deaths. Diabetes causes damage to the lining of the blood vessels causing hardening, thickening, narrowing and a greater tendency to clots forming on the walls of the blood vessels which can break off and block the blood supply to vital organs such as the heart, brain and lungs (atherosclerosis. Homocysteine levels are also increased in Type 2 diabetes due to the high insulin levels reducing its breakdown, this in turn poses an extra risk factor for heart attack and stroke. High blood sugar levels also damage the heart itself, producing the same marker proteins in the blood as are released in a heart attack.

Nerve damage is a common long term complication of diabetes and is made worse by poor blood sugar control. About half the people with Type 1 or Type 2 diabetes have some nerve damage after 20 years, which tends to be in the longer nerves such as those going to the feet. This is why diabetics must be particularly careful about foot care and look out for a loss touch and pain sensation, which usually happens progressively in both feet at the same time, and can lead to severe ulceration and damage to the foot if it is rubbed by the shoe or a piece of grit. In severe cases this can lead to amputation being necessary. The effects on the hands causes problems holding things and the possibility of being burned without feeling it. However the main problem is usually the nerve pain that accompanies this nerve damage.

Impotence is another common side effect for men caused by nerve damage to the penis.

Eye damage is also common, and damage to the back of the eye (diabetic retinopathy) is the commonest cause of blindness in the under 60s. After 20 years most people with Type 1 diabetes and 60% with Type 2 will have some degree of eye damage, though this happens more quickly in old age and in men, hence eye tests are important for diabetics.

Kidney damage (nephropathy) is another serious complication of diabetes, and about a quarter of Type 1 or Type 2 diabetics have this after 25 year. However there are other factors that can increase the rate of kidney damage including high blood pressure and genetics, with people of a non-white genetic background with Type 2 diabetes being at greater risk. Urine tests for the protein albumin are important to check for kidney damage.