Over time persistent high blood glucose levels (BGLs) can damage the body's organs. This damage is referred to as 'diabetes-related complications'. While these complications are serious and can be life-threatening, with appropriate lifestyle changes and attention to blood glucose control, people with diabetes can greatly reduce the risk of these complications.
Heart disease and stroke
People with diabetes are at increased risk of heart disease and stroke due to raised BGLs, in association with high blood pressure and cholesterol. You should discuss your individual risk factors and how to reduce them with your doctor or diabetes educator. In general terms, the risk of heart disease in diabetes can be reduced by:
- being physically active
- losing weight if you are overweight
- not smoking
- managing blood fats
- managing high blood pressure
- taking medication as prescribed.
For more information speak to your doctor or specialist or contact the Australian Diabetes Council Customer Care Line on 1300 DIABETES or 1300 342 238 and ask to speak to a Diabetes Educator.
High Blood Pressure
As well as being a risk factor for developing diabetes, high blood pressure can also be a complication of diabetes. Diabetes changes the body chemistry to increase the risk of high blood pressure. As having high blood pressure in diabetes further increases the risk of other complications of diabetes, it is important that it is adequately monitored and, if necessary, controlled. You should get your blood pressure checked every time you go to the doctor, and at least:
- every 6 months for people with normal blood pressure
- 3 months for people with high blood pressure
- every 4-8 weeks if your blood pressure medication is being changed.
Damage to the small blood vessels and nerves common in people with diabetes can cause very dry skin. This can lead to small cracks in the skin. When you have dry skin, overwashing, excessively hot water, exposing your skin to the sun and not moisturising can make the problem worse. To help improve the condition of dry skin:
- use warm water rather than hot water for washing
- use a ph balanced soap or minimise the amount of soap you use
- limit the time you spend bathing - don't linger as you are just washing the oils out of your skin
- take a few extra minutes after your skin has been exposed to water and before bed, to moisturise your entire body with an intensive moisturising cream
- seek medical advice promptly for skin damage that has become inflammed, painful or has exudate (pus).
Legs and feet
Diabetes can cause nerve damage and poor blood supply from damaged blood vessels which may lead to leg ulcers and serious foot problems from which lower limb amputation may result. Personal daily foot checks and thorough annual foot examinations conducted by your doctor or podiatrist will help to reduce your risk of lower limb complications. Act quickly if your think you have a problem with your feet.
To protect your feet:
- have your feet checked at least once a year by your doctor or other health professional
- hash, dry and check your feet every day. Check for redness, swelling, cuts, pus discharge, splinters or blisters, being especially careful to look between toes, around heels and nail edges and at the soles of the feet.
- cut your toenails straight across
- moisturise your feet daily to avoid dry skin
- never use over-the-counter corn cures
- cover your feet with a clean sock or stocking without rough seams
- don’t wear tight socks or stockings
- protect your feet in a shoe which fits well
- keep your feet away from direct heat such as heaters, hot water bottles and electric blankets
- get medical advice early if you notice any change or problem.
Eyes, nose and mouth
Your nerves control the glands that keep the mucous membranes in your eyes, nose and mouth moist and healthy. In type 1 diabetes, the immune system mistakenly attacks the beta cells in the pancreas and may also attack other parts of the body including the mucous membranes which can cause problems.
If you suffer from:
- dry eyes, use artificial tears and a prescribed eye cream in the evening
- a dry nose, try a saline nasal spray which will make your nose more comfortable
- a dry mouth, you may find that artificial saliva (a product available at pharmacies which can be used orally to substitute for natural saliva), simply rinsing your mouth or chewing diet gum will help to keep your saliva flowing. Diet gums usually contains sweeteners that aren't absorbed by the body so it doesn't affect blood glucose levels or body weight. However, if used excessively, the non-absorbed sugars ferment in the gut and can cause gas and diarrhoea, so these products should be used in moderation.
Dry membranes are not just uncomfortable; they can also lead to long-term changes in the eyes, nose and mouth which can cause further damage to these sensitive membranes.
If you are having problems with dryness to the eyes, nose or mouth, talk to your doctor who can offer further advice
People with poorly controlled diabetes have a higher risk of tooth problems and gum disease. It is important to pay particular attention to your oral health and control your blood glucose levels. Visit your dentist regularly for advice about how to keep your teeth and gums healthy.
Diabetic retinopathy (damage to the back of the eye) is the leading cause of blindness in Australians aged under 60. Diabetes can also cause cataracts and other eye problems. The development of retinopathy is strongly related to the length of time diabetes has been present and the degree of blood glucose control. Regular checks and treatment can prevent blindness.
To look after your eyes and help prevent vision loss:
- have your eyes checked regularly, at least every two years, to pick up early signs of damage
- control your blood glucose levels
- maintain a healthy blood pressure and cholesterol levels
- if your vision has been affected, seek treatment from your doctor to stop it from getting worse.
Bladder and kidneys
Your kidneys help to clean your blood. They remove waste from the blood and pass it out of the body as urine. Over time, diabetes can cause damage to the kidneys which causes them to leak protein into the urine. You won't notice damage to your kidneys until it's quite advanced, so it is important you have the recommended tests to pick up any problems early. Annual kidney health checks are recommended.
People with diabetes are at risk of bladder and kidney infections; however, maintaining good blood glucose control and keeping your blood pressure at a healthy level will reduce this risk. For women, in particular, it is also important to ensure the bladder is fully emptied, especially after sexual intercourse.
Up to 50% of people with diabetes are thought to have a mental illness such as depression or anxiety. Diabetes more than doubles the risk of depression. People with diabetes and depression may have increased risk of other complications from diabetes, as they may find it harder to manage everyday tasks, and their diabetes may become neglected.
If there are concerns about a person with diabetes developing mental health issues, it is important they discuss this with their doctor and seek help. Sane Australia have also developed a booklet on depression and mental illness specifically for people with diabetes.
Both men and women with diabetes may lose their sexual desire when their blood glucose levels are high. Men with diabetes are at a higher risk of erectile dysfunction, or impotence, especially if their diabetes is not well controlled. Men who notice a change in sexual functioning should consult their doctor to determine the cause and discuss treatment options.
Last reviewed: September 2016