Table of Contents

I. Diabetes and Eye Damage

i. Diabetic Retinopathy Symptoms

ii. Preventing Diabetic Retinopathy

II. Diabetes and Kidney Function

i. Kidney Disease Symptoms

ii. Preventing Kidney Disease

III. Diabetes and Heart Disease

i. Symptoms of Heart Disease

ii. Preventing Heart Disease

IV. Diabetes and Nerve Damage

i. Diabetic Peripheral Neuropathy Symptoms

ii. Preventing Diabetic Neuropathy

V. Diabetes and Mental Health

VI. Take-Away Tips

Getting diagnosed with type 2 diabetes can feel overwhelming. Along with managing blood sugar levels, you now face the possibility of developing other health issues down the road.

However, it is important to understand that while a type 2 diabetes diagnosis may open the door to complications, it doesn't mean that they are inevitable. By understanding your risks and taking preventive action, you can minimize their chance of occurring.

In this article, we will explore some of the most common complications associated with type 2 diabetes and provide practical tips to help minimize your risk. Topics will include heart disease, nerve damage, kidney disease, eye damage, and mental health.

Diabetes and Eye Damage

Diabetic retinopathy is a complication of diabetes that can lead to vision loss or blindness. It occurs when high blood sugar levels cause damage to blood vessels in the retina, the light-sensitive tissue at the back of the eye. The retina acts like film in a camera, capturing images that are relayed to the brain. {{1}}

When the blood vessels in the retina are damaged, they may leak blood and other fluids into the eye. This can blur and distort vision. New abnormal blood vessels may also grow on the surface of the retina. These new blood vessels are fragile and can rupture and bleed easily. If left untreated, diabetic retinopathy can cause severe vision loss and even blindness. {{1}}

Diabetic Retinopathy Symptoms

Diabetic retinopathy often develops silently over time, with no obvious symptoms in the early stages. This progressive eye condition affects blood vessels in the retina at the back of the eye. Without regular diabetic eye screening, diabetic retinopathy can reach an advanced stage before being detected, when vision loss may already be occurring. {{2}}

During a diabetic eye exam, photographs of the retina can reveal early signs of diabetic changes before you notice anything wrong with your vision. {{2}} Contact your doctor right away if you have any of the following symptoms, which may indicate diabetic retinopathy but can also signal other eye problems:

Vision that is getting worse gradually
Sudden loss of vision
Floaters or spots in your field of vision
Blurry, fuzzy, or patchy vision
Eye pain or redness
Increased difficulty seeing in low light {{2}}

While these symptoms don't necessarily mean you have diabetic retinopathy, it is crucial to get them evaluated promptly. Catching diabetic retinopathy early maximizes the chances of preventing vision loss through timely treatment and control of diabetes. {{2}}

Preventing Diabetic Retinopathy

Maintaining good eye health is crucial for individuals with diabetes. It is recommended to schedule an eye exam annually, unless advised otherwise by your eye specialist. Regular eye check-ups are essential in reducing the risk of vision loss, as changes in your vision may not always be immediately noticeable. Early detection of any issues can lead to effective treatment. {{1}}

During the exam, your eye doctor will dilate your pupils and carefully examine the back of your eyes using a special magnifying tool. They are looking for any signs of damage to the retina caused by diabetes. {{1}}

You can take steps in between eye exams to prevent retinopathy or stop it from worsening. The main things are keeping your blood sugar, blood pressure, and cholesterol at healthy levels. Follow the ABCDEs for controlling your diabetes:

A - Get your A1C down to 7% or lower (or your doctor's recommended target). The A1C test shows your average blood sugar over the past 3 months.

B - Keep your blood pressure below 130/80 mmHg (or your doctor's goal).

C - Aim for an LDL cholesterol level below 2 mmol/L.

D - Take any prescribed drugs to protect your heart health. Ozempic (semaglutide) is one drug that helps control blood sugar and reduces cardiovascular risks.

E - Exercise regularly and eat healthy foods to maintain a healthy weight.

S - Get regular screenings to check for complications with your heart, feet, kidneys, and eyes.

S - Stop smoking {{1}}

Diabetes and Kidney Function

illustration of kidney on a man's back

If you have diabetes, it's important to know that you are at risk of developing kidney disease, also known as nephropathy. In fact, up to 50% of people with diabetes will experience signs of kidney damage during their lifetime. {{3}}

Your kidneys are crucial organs that filter waste from your blood and regulate fluid and salt levels in your body. They also play an important role in controlling blood pressure. {{3}}

However, high blood sugar levels can damage the small blood vessels in your kidneys, leading to poor filtration. This can lead to progressively worsening issues over time:

Microalbuminuria: This is a condition where tiny particles of protein enter your urine.

Proteinuria: As kidney disease progresses, proteinuria may occur, where larger amounts of protein spill into the urine. {{3}}

Eventually, waste products will begin to accumulate in your blood as your kidneys can no longer function properly, leading to end-stage renal failure. At this stage, dialysis or a kidney transplant may be required. {{3}}

Kidney Disease Symptoms

Many people with chronic kidney disease do not realize they have it. The kidneys can lose function gradually without producing obvious symptoms until they are nearly failing. In fact, approximately 90% of people with chronic kidney disease are unaware of their condition. This is why regular testing is so important, especially if you have diabetes or other risk factors like high blood pressure. {{4}}

The only way to know for sure if kidney damage is present is through medical tests. If you have diabetes, you are at increased risk for kidney disease, so it's important to get screened annually. {{4}}

In between checkups, be on the lookout for potential signs of kidney problems:

Fatigue: Kidney dysfunction can lead to a buildup of toxins in the blood, resulting in feelings of fatigue, weakness, and difficulty concentrating. Anemia, a common complication of kidney disease, can also contribute to fatigue.

Dry, itchy skin: Kidneys play a role in regulating mineral levels in the body. Dry and itchy skin may indicate mineral and bone disease associated with advanced kidney dysfunction.

Increased urination: Damage to the kidneys' filtering system can lead to frequent urination.

Blood in urine: Healthy kidneys typically retain blood cells in the body, but damaged filters can allow blood cells to leak into the urine.

Foamy urine: Excessive bubbles in urine, resembling foamy egg whites, suggest the presence of protein in the urine, a common indicator of kidney issues.

Swollen feet and ankles: Reduced kidney function can lead to sodium retention, causing swelling in the lower extremities.

Muscle cramps: Electrolyte imbalances resulting from impaired kidney function, such as low calcium levels, can lead to muscle cramping. {{4}}

Preventing Kidney Disease

High blood sugar, high blood pressure, and smoking are three factors that can contribute to kidney disease. The most effective ways to prevent or delay kidney damage include:

Keeping your blood sugar and blood pressure under control
Avoid smoking
Monitor your cholesterol and get it checked annually
Follow a balanced diet
Exercise regularly
Get screened annually {{3}}

If you already have kidney damage or disease, your doctor may recommend limiting foods high in potassium, phosphorus, or sodium. This prevents waste products from building up in your body. {{3}}

Diabetes and Heart Disease

man holding red heart in front of his chest

In individuals with diabetes, the risk of developing heart disease and stroke is significantly heightened. Research shows that those with diabetes may experience heart disease up to 15 years earlier than those without the condition. {{5}}

Heart disease encompasses various heart-related conditions, with coronary artery disease being the most prevalent in individuals with diabetes. This condition occurs when the arteries supplying the heart with blood become narrowed or blocked due to the accumulation of fatty deposits. If the arteries leading to the brain are obstructed, it can result in a stroke. Moreover, reduced blood flow can trigger a heart attack. {{5}}

Diabetes contributes to the development of multiple risk factors that can increase the likelihood of experiencing a heart attack or stroke, including:

High blood glucose
Being overweight (particularly with excess abdominal fat)
Physical inactivity
High blood pressure
High cholesterol {{5}}

Symptoms of Heart Disease

Sometimes heart disease can progress without obvious symptoms, remaining undiagnosed until a serious cardiac event occurs. When the heart disease manifests in this "silent" manner, the first sign may be a heart attack, abnormal heart rhythm, or heart failure. {{6}}

When these events occur, some common symptoms to watch for include:

Heart attack: Upper back or neck pain, chest pain, heartburn, nausea, vomiting, fatigue, dizziness, and shortness of breath.

Arrythmia: You may feel fluttering in your chest.

Heart failure: Shortness of breath, fatigue, and swelling of feet, ankles, legs, abdomen, or neck veins. {{6}}

Preventing Heart Disease

You can lower your risk of heart disease and stroke by carefully managing all your risk factors. These include:

Engage in regular exercise and follow a nutritious diet to maintain a healthy weight.
Take all medications as prescribed by your doctor.
Lower your LDL cholesterol.
Ensure your doctor checks your blood pressure at every visit.
Control your blood pressure by moderating salt and alcohol intake.
Have your A1C checked every three months.
Stop smoking. {{5}}

Diabetes and Nerve Damage

Diabetic peripheral neuropathy is one of the long-term complications of diabetes. High blood sugar levels over time can damage the peripheral nerves that go to the arms, hands, legs, and feet. This nerve damage prevents nutrients from reaching the extremities, causing the nerves to malfunction or degenerate. {{7}}

If left untreated, diabetic peripheral neuropathy can lead to serious issues:

Gangrene: Because people with nerve damage in their feet and toes often cannot feel minor injuries like cuts, sores or blisters, these small wounds can quickly become infected and lead to gangrene.

Amputation: If gangrene is left untreated, amputation of toes or even the entire foot may be necessary. This is done to prevent gangrene from spreading to other areas of the body. {{7}}

Diabetic Peripheral Neuropathy Symptoms

Nerve damage can lead to a range of symptoms that vary depending on the location of the affected nerves. {{7}} Some of the most common symptoms occur in the toes and feet. These include:

Sharp and shooting pains
Burning sensation
Tingling (pins and needles)
Throbbing or pulsating pain
Numbness {{7}}

Preventing Diabetic Neuropathy

There are many effective ways to delay the onset of diabetic peripheral neuropathy:

Care for your feet
Monitor your blood sugar levels
Get regular foot check-ups
Discuss medication options with your doctor {{7}}

If you currently have diabetic neuropathy, the unfortunate news is that there is no cure. {{7}} However, you can delay the progression of the disease by:

Examining your feet and legs regularly for cuts, sore or other injuries and treat them promptly.
Maintaining your nails regularly.
If your feet are dry, apply lotion (avoid the areas between your toes).
Wearing properly fitted shoes to avoid irritation.
Avoiding hot baths. {{7}}

Diabetes and Mental Health

upset woman speaking with therapist

Living with diabetes can be challenging, often leading to feelings of anxiety and distress due to its constant demands. This can take a toll on mental health, resulting in sadness and anxiety for many. It is crucial to acknowledge these emotions and communicate with your support system, including friends, family, and your diabetes health-care team, about how you are feeling. {{8}}

Two common mental health issues associated with diabetes are anxiety and depression.

Anxiety can manifest as excessive worry about life circumstances, particularly related to uncertainties about diabetes and its potential complications. Taking control of your health, educating yourself about diabetes, and learning how to prevent complications can help alleviate anxiety and fears.

Depression is twice as prevalent in those with diabetes. While some sadness after a diabetes diagnosis is normal, prolonged feelings of sadness indicate depression. If you feel depressed, please talk to your doctor about how to get help. {{8}}

Accepting the realities of living with diabetes is a gradual process that may require time and support. However, once you come to terms with your diagnosis, you may find it easier to start making lifestyle changes that will not only improve diabetes management but also your day-to-day life. {{8}}

Take-Away Tips

Living with diabetes requires diligent self-care and management to prevent complications. With so many daily tasks and appointments, it can be challenging to stay organized and remember everything you need to do. Using a diabetes checklist can make it easier.

We have included a diabetes checklist below to help you stay on track:

Daily tasks:

Test your blood glucose
Take all prescribed medications
Eat healthy
Exercise
Check your feet for sores or cuts
Check your mouth for bleeding gums, swelling, or tenderness {{9}}

Annual tasks:

Foot exam
Urine test to check for protein
Blood test to check for serum creatinine, cholesterol, and triglycerides
Visit an eye doctor
Get your A1C checked every three months {{9}}

Effective diabetes management requires diligence and teamwork with your healthcare providers. While the responsibility ultimately lies with you, your doctors and diabetes educators are there to support you and answer any questions that may come up.

Type 2 Diabetes

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