Systemic complications

If you think you have been experiencing any symptoms of diabetes, or if you have a family history of this disease, speak to your family physician.  Knowing you have this disease is the first step in management and prevention of the following complications.

HEART AND CIRCULATORY DISORDERS

Diabetics are at higher risk for heart disease and poor circulation, which leads to a higher incidence of stroke, heart attack,  high blood pressure and high cholesterol. Canadian adults with diabetes are 3.5 times more likely to die of cardiovascular disease than the general population. Poor circulation in a person with diabetes can lead to a host of other complications, including slow healing of wounds, lower limb amputation, vision loss, impotence and more.

Medical experts are not sure why, the higher blood sugar levels seem to damage the veins and arteries that carry the blood, as well as cause plaque to build up along artery walls, blocking circulation.  Proper management of blood sugar levels can help minimize these problems and prevent further damage to the heart and blood vessels.

NERVE DAMAGE OR NEUROPATHY

Constantly elevated blood sugar levels can result in peripheral neuropathy, or nerve damage. Damage to the nerve endings causes a gradual loss of feeling in the hands and feet. There are many theories as to why nerve damage occurs, but the fact are that almost 75 percent of all people with diabetes are affected by this complication.  The most common and significant change is the loss of feeling and touch. Some diabetics may develop a burning and painful type of neuropathy.  Neuropathy occurs after several years of having diabetes.  People who have unknowingly been living with diabetes may actually realize they have the disease when their hands and feet start becoming numb and tingling, prompting a doctor’s visit.

The resulting nerve damage can lead to serious problems in the feet, since the loss of sensation can result in a wound being overlooked.  Proper diabetes management can decrease the risk of nerve damage and prevent further complications associated with it.

A chiropodist/podiatrist can  perform 2 simple sensation tests as a screening examination to assess your ability to feel pressure and vibration. Both of these sensations will protect you from skin breakdown. The 1st test uses a thin filament to test the protective skin sensation. If you can't feel the filament your are at a high risk for skin ulceration. Vibration testing will also be used to test your sensation. If you can't feel vibration from a tuning fork held against you skin you will be at high risk for skin breakdown leading to ulceration.

Perkins BA, Olaleye D, Zinman B, et al. Simple screening tests for peripheral neuropathy in the diabetes clinic. Diabetes Care. 2001;24:250-256.

VISION LOSS

Many people with diabetes have minor eye disorders, including blurred vision, that occurs when there is poor blood sugar control. In addition, diabetes is the leading cause of new cases of blindness each year. Vision problems and blindness occur as uncontrolled blood glucose levels damage the blood vessels that supply the eye’s retina with oxygen. Fortunately, experts report that 98 percent of legal blindness from diabetes can be prevented if blood sugar levels are kept as close to normal as possible. Routine eye examinations are also recommended.

KIDNEY DISEASE

More than 30 percent of people with type 1 diabetes will develop kidney disease, or diabetic nephropathy, compared to 10 percent of those with type 2 diabetes.  If you have diabetes, you are 6.5 times more likely to have chronic kidney disease leading to dialysis as compare to the general population. Despite the risk difference, it is important for all people with diabetes to have regular medical checkups and laboratory tests to determine if their kidneys are working properly. Unfortunately, kidney disease often shows no symptoms until it is very far along.  Keeping blood sugar levels close to normal can prevent kidney damage.

SEXUAL DYSFUNCTION

Both men and women can experience changes in sexual function, including erectile dysfunction, impaired ejaculation, decreased vaginal lubrication, difficulty reaching orgasm and lack of libido. This is primarily due to circulation problems that are common in diabetes, as proper blood flow is important in all of the above functions.