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Complications
By Mayo Clinic staffType 1 diabetes can affect major organs in your body, including heart, blood vessels, nerves, eyes and kidneys. Keeping your blood sugar level close to normal most of the time can dramatically reduce the risk of many complications.
Long-term complications of type 1 diabetes develop gradually, over years. The earlier you develop diabetes — and the less controlled your blood sugar — the higher the risk of complications. Eventually, diabetes complications may be disabling or even life-threatening.
- Heart and blood vessel disease. Diabetes dramatically increases your risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke, narrowing of the arteries (atherosclerosis) and high blood pressure.
- Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Poorly controlled blood sugar could cause you to eventually lose all sense of feeling in the affected limbs. Damage to the nerves that affect the gastrointestinal tract can cause problems with nausea, vomiting, diarrhea or constipation. For men, erectile dysfunction may be an issue.
- Kidney damage (nephropathy). The kidneys contain millions of tiny blood vessel clusters that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, which requires dialysis or a kidney transplant.
- Eye damage. Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma.
- Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can become serious infections. Severe damage might require toe, foot or even leg amputation.
- Skin and mouth conditions. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections. Gum infections also may be a concern, especially if you have a history of poor dental hygiene.
- Osteoporosis. Diabetes may lead to lower than normal bone mineral density, increasing your risk of osteoporosis.
- Pregnancy complications. High blood sugar levels can be dangerous for both the mother and the baby. The risk of miscarriage, stillbirth and birth defects are increased when diabetes isn't well controlled. For the mother, diabetes increases the risk of diabetic ketoacidosis, diabetic eye problems (retinopathy), pregnancy-induced high blood pressure and preeclampsia.
- Hearing problems. Hearing impairments occur more often in people with diabetes.
References
- Diabetes mellitus (DM). The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec12/ch158/ch158b.html#sec12-ch158-ch158b-1105. Accessed Sept. 30, 2012.
- Standards of medical care in diabetes — 2013. Diabetes Care. 2013:36:S1.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Sept. 23, 2012.
- Your guide to diabetes: Type 1 and type 2. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/type1and2/index.htm. Accessed Sept. 23, 2012.
- What people with diabetes need to know about osteoporosis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/Conditions_Behaviors/diabetes.asp. Accessed Sept. 30, 2012.
- Bainbridge KE. Diabetes and hearing impairment in the United States: Audiometric evidence from the National Health and Nutrition Examination Survey, 1999 to 2004. Annals of Internal Medicine. 2008;149:1.
- Before pregnancy. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/complications/pregnant-women/before-pregnancy.html. Accessed Sept. 30, 2012.
- A1C. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/a1c/?keymatch=a1c. Accessed Oct. 1, 2012.
- Bergenstal RM, et al. Effectiveness of sensor-augmented insulin pump therapy in type 1 diabetes. New England Journal of Medicine. 2010;363:311.
- Stem cell information. National Institutes of Health. http://stemcells.nih.gov/info/scireport/chapter7.asp. Accessed Feb. 24, 2011.
- Elleri D, et al. Closed-loop insulin delivery for treatment of type 1 diabetes. BMC Medicine. http://www.biomedcentral.com/1741-7015/9/120. Accessed Oct. 1, 2012.
- Take charge of your diabetes. Centers for Disease Control and Prevention. http://www.cdc.gov/diabetes/pubs/tcyd/vaccin.htm. Accessed Sept. 30, 2012.
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