Diabetes management is not only about controlling high blood sugar levels, but it is also about avoiding the complications associated with the condition. People with diabetes are prone to several problems including cataracts, chronic kidney disease, urinary tract infection, infertility and much more.
According to Dr Haroon H, consultant, internal medicine, KMC hospital, Mangaluru, hyperglycemia (high blood sugar) for prolonged period leads to the formation of advanced glycation end products (AGEs), which occurs when excess glucose in the blood interacts with protein and lipid molecules. These AGEs damage the inner lining of the blood vessels (endothelial cells) which results in multiple cardiovascular co-morbidities of diabetes including heart attack.
Happiest Health lists the ten most common complications associated with diabetes:
1. Heart disease
“Diabetes increases the risk of heart disease by two to three times,” says Dr Manoj Khandelwal, consultant, Endocrinology, Fortis Escorts Hospital, Jaipur. High blood sugar increases plaque formation in the blood vessels which can narrow the arteries leading to cardiovascular disease, he adds.
Dr Khandelwal says that diabetes increases the risk of inflammatory markers like C-reactive protein and interleukin that destroy the endothelial cells (lining of the blood vessels) and causes plaque formation in the blood vessels, which ultimately leads to thrombosis (blockage of the blood vessels).
He adds, diabetes can lead to dyslipidemia that increases bad cholesterol (such as low-density lipoprotein and triglycerides) and reduces good cholesterol, further increasing the risk of cardiovascular diseases.
2. Diabetic foot ulcer
Dr Khandelwal says, high blood sugar increases the risk of foot ulcer due to damage to the blood vessels leading to poor blood supply to the lower limb. Diabetic foot ulcer can also lead to amputation if not treated early, he adds.
“Due to nerve damage, there is a loss of sensation in the feet which makes it difficult to detect an injury,” said Dr Haroon. Experts recommend people with diabetes to not walk barefoot and restrain from wearing tight shoes.
3. Diabetic retinopathy
“Diabetic retinopathy is the second most common cause of blindness after cataract,” says Dr Khandelwal. Basically, it occurs due to high blood sugar levels that can damage the small blood vessels in the retina. He adds, if the high blood sugar persists for more than five years, the risk of diabetic retinopathy increases.” Other eye problems due to diabetes include glaucoma, cataract and diabetic macular edema.
4. Diabetic nephropathy
“Diabetes is the most common cause of chronic kidney disease or kidney failure,” said Dr Khandelwal. High blood sugar levels damage the small blood vessels in the kidneys, which affects their ability to function properly, he adds.
He further explains that due to high blood glucose levels, there will be degeneration of the glomerulus (the functional unit of kidney) which will lead to the high creatinine levels, causing kidney damage.
5. Skin infections
Experts say people with diabetes are more likely to get skin infections because high blood sugar levels cause infections to spread more quickly. Dr Khandelwal says, “Lack of blood supply to the distal parts of the limbs causes blackening and necrosis of the tissue.” Some serious skin conditions can also occur because of peripheral nerve damage due to high sugar levels, he adds.
6. Diabetic neuropathy
Uncontrolled blood sugar level over a long period of time can cause nerve damage in multiple areas of the body, says Dr Haroon. Due to this, people have loss of sensation in legs and feet, he adds. Excessive blood glucose levels can damage the blood vessels that supply oxygen and nutrients to your nerves. As a result, the nerves stop functioning properly. Diabetic neuropathy is among the common causes for foot complications.
7. Erectile dysfunction or infertility
Dr Khandelwal says that uncontrolled diabetes increases the risk of erectile dysfunction and impotence.
Dr Haroon explains, “appropriate functioning of genital organs is dependent on proper blood supply.” When the blood vessels or nerves that are responsible for proper functioning of genital organs are affected, it can lead to sexual disorders such as erectile dysfunction, he adds.
8. Urinary tract infections
Dr Haroon says, diabetes can affect the immune system, making it difficult for the body to fight off infections. “When the immune system is affected by diabetes, the propensity to develop urinary tract infections is much higher,” he adds.
Dr Khandelwal adds that in people with diabetes, excess glucose can spill into the urine, creating a favourable environment for bacteria to grow which further increases the risk of genital tract infections.
9. Hearing loss
According to experts, when the nerve in the ear is damaged due to high blood sugar, it affects the nerve signals travelling from the inner ear to the brain, leading to difficulty in hearing. Dr Haroon says that people with diabetes are more prone to ear infections. Poor blood flow and weak immune system make diabetics more susceptible to infections, he adds.
10. Gum or dental problems
Diabetes can lead to several dental problems or oral infections, say experts. “People with diabetes are prone to caries,” said Dr Haroon. High blood sugar levels can lead to a build-up of plaque on the teeth, which can erode the enamel and cause cavities. Uncontrolled blood sugar levels can also cause xerostomia (dry mouth), a condition where salivary glands do not produce enough saliva.
Takeaways
People with chronic diabetes are at higher risk of associated complications. However, experts say that those who are newly diagnosed are also at risk. It is important for individuals with diabetes to manage their blood sugar levels and follow a healthy lifestyle to prevent or delay the onset of diabetes.
