The complications of diabetes and how to prevent them
The symptoms of diabetes – excessive thirst, frequent urination, increased hunger, weight loss, fatigue, blurred vision, increased infection – occur in all diabetics if blood sugar is not controlled. However, all the complications of diabetes do not occur in all diabetics. The more tightly a person with diabetes is able to control the levels of sugar in the blood, the less likely it is that complications will develop or become worse. In fact, the complications can be averted or reversed if blood sugar is maintained in the normal range.
The eyes, the ears, the mouth
The complications of diabetes effect every system of the body from head to toe – the brain, the eyes, ears, mouth, the stomach, the liver, the kidneys, the genito-urinary tract, the musculoskeletal system, the nervous system, the arterial system, the arms and legs, the hands and feet. I’ll begin with diabetic retinopathy. Diabetic retinopathy gradually destroys the eye’s retina, ultimately resulting in blindness. Most people are aware of this complication of diabetes. But other eye disease can also be complications of diabetes. For example, glaucoma and cataracts are more common in diabetics than in non-diabetics. Impairment of night vision is also more common in people with diabetes than in those without diabetes. Gum disease can be a complication of diabetes. Deafness can also be a complication. Diabetes can cause hearing loss because of nerve damage in the ears.
The kidneys and the liver
Diabetic nephropathy is a malfunction or reduced function of the kidneys. The symptoms of diabetic nephropathy include protein in the urine, high blood pressure, frequent urination (especially at night), leg cramps, edema (or puffiness) of the eyes, hands and feet, pruritus (excessive itching), nausea, weakness, and kidney failure. A recently discovered complication of diabetes affecting the liver is non-alcoholic steatohepatitis or NASH, a condition of fatty liver inflammation in people who drink little or no alcohol.
The nervous system
Diabetic neuropathy is a progressive degeneration of nerve function. There are two types: peripheral neuropathy and autonomic neuropathy. Peripheral neuropathy affects the extremities: the arms, legs, hands and feet. Autonomic neuropathy affects the organs controlled by the autonomic nervous system. The autonomic nervous system is our automatic pilot or cruise control system. It controls the nerves involved in the functioning of the cardiovascular system, the digestive system, the genito-urinary system, and the skin.
The symptoms of peripheral neuropathy are pins and needles, tingling or burning sensations, pain, numbness, balance problems, and muscle weakness.
The symptoms of cardiovascular neuropathy are orthostatic hypotension (abrupt drop in blood pressure upon standing), heart rhythm abnormalities, and loss of sensation in the nerves of the heart. This last symptom can result in what are called silent heart attacks in which the person feels no chest pain because the nerves of the heart have been destroyed and do not register pain.
The effects of neuropathy on the digestive system are constipation and diarrhea because of nerve damage affecting the intestines, and gastroparesis (delayed stomach emptying) because of nerve damage affecting the stomach. The symptoms of gastroparesis are nausea, vomiting, abdominal bloating, premature feelings of fullness, and weight loss.
Genito-urinary neuropathy is nerve damage affecting the bladder and reproductive organs. The symptoms are urinary tract infections, urinary incontinence, vaginal dryness, impotence, and decreased or increased urination.
The symptoms of diabetic neuropathy affecting the skin are increased perspiration of the trunk and face, decreased perspiration of the extremities, skin rashes and infections.
Next week’s article will be on the effect of diabetes on the arterial system, the musculoskeleton system, and the brain. It will also address how to avoid and/or reverse the complications of diabetes.
Mary Lou Williams, M. Ed., is a writer and lecturer in the field of nutrition. She welcomes inquiries. She can be reached at 267-6480.