Diabetes complications

Having type 1 diabetes does not prevent you from living a normal life. People with type 1 diabetes can and do become elite athletes, corporate high-flyers, trapeze artists, medical professionals, teachers and everything in between. But having type 1 diabetes does mean you have to balance your diabetes management with your day to day life to avoid complications.

Complications can occur because over time persistent high blood glucose levels can damage the body’s organs. This damage is referred to as diabetes-related complications. It may be frightening to think about complications but it is important to understand all you can about living with type 1 diabetes and the affect your management has on your overall health.

If you can manage to keep your blood glucose levels, cholesterol and blood pressure within the normal range, the risk of damage to your body is reduced. With the support of your healthcare team you will be able to develop a daily self-management program that includes setting goals, taking responsibility and making positive lifestyle choices.

Effective diabetes care means taking charge of your diabetes management. Ask questions and request more information if you need to. The more you know the more confident you will become and the easier it will be to manage your diabetes. It is important that you follow the annual cycle of care to ensure you are constantly monitored for any complications.

When diabetes is left undiagnosed or unchecked for too long, it can be responsible for a number of diabetes related complications such as eye disease (diabetic retinopathy), nerve damage (diabetic neuropathy), kidney disease (diabetic nephropathy), heart disease and stroke. See below for more information on complications.

Complications

Hypos and hypers

Diabetes is a manageable condition, but key to successfully living with diabetes is balancing medication and insulin injections with food and activity. When that balance isn’t right, one of two things will happen: either blood glucose drops too low and hypoglycaemia (a hypo) results, or blood glucose rises too high and hyperglycaemia (a hyper) occurs. No matter how much you know about diabetes or how careful you are, if you are living with type 1 diabetes you are likely to experience some hypos or hypers.

Kidney disease

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 (diabetic nephropathy). You will not notice damage to your kidneys until it’s quite advanced, so it is important that you have the recommended tests to pick up any problems early.

If the kidneys fail, toxic waste products stay in the body, fluids build up and the chemical balance is upset. If the kidneys are unable to function properly, dialysis treatments or a kidney transplant will be needed. The risk of developing kidney problems is reduced by managing your blood glucose levels, having regular kidney and blood pressure checks and leading a healthy lifestyle. Early signs of kidney problems can be detected through a urine test. Finding out about early kidney damage is simple and painless. Treatment at this time can prevent further damage. Read more here.

Nerve damage and lower limb complications

Diabetic neuropathy is the medical name given to progressive damage to the nervous system caused by type 1 diabetes. Diabetic neuropathy can lead to a loss of feeling in the hands and feet. Reduced circulation resulting from high blood glucose impairs normal wound healing in the extremities, so minor damage can linger and develop into permanent injury. 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. For more information read here.

Heart disease and stroke

People with diabetes are at increased risk of heart disease and stroke due to raised blood glucose levels (BGLs), in association with high blood pressure and cholesterol. To read more follow this link.

Eye disease (diabetic retinopathy)

Diabetes can damage the back of the eye and affect vision. The development of diabetic 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 serious eye problems and blindness caused by retinopathy. Learn more here.

Oral health

Dental problems are more common in people with diabetes. Dental problems can include gum inflammation (gingivitis), infection and inflammation of the ligaments and bone that support the teeth (periodontitis), tooth decay (dental caries), dry mouth (xerostomia), fungal infections (oral thrush) and disturbances in taste.

Oral problems can occur in people with diabetes for a number of different reasons, which is why it is especially important to visit a dentist regularly and tell them about your diabetes. People with diabetes who have persistent high blood glucose levels are more likely to have dental problems. For more information on looking after your teeth and gums click here.
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Lipohypertrophy

Lipohypertrophy is a condition where there is a build up of fatty tissue under the skin which is known to commonly occur if insulin is repeatedly injected into the same site. For more information click here.

Coeliac disease

Type 1 diabetes and coeliac disease are both known as autoimmune diseases – conditions where the immune system attacks parts of the body. While the cause of both coeliac disease and type 1 diabetes is not fully known, there is a relationship between the two conditions. Between 4-10% of people with type 1 diabetes also have coeliac disease. To find out more click here.

Sexual health

While most people with diabetes, both male and female, are able to lead completely normal sex lives, diabetes may contribute to sexual problems for some people. To read more click here

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Hearing

While it unknown exactly why hearing loss is more common among people with diabetes some researchers believe prolonged high blood glucose levels may lead to hearing loss by affecting the supply of blood or oxygen to the tiny nerves and blood vessels of the inner ear. Over time, the nerves and blood vessels become damaged, affecting the person’s ability to hear.

Diabetic ketoacidosis (DKA)

Consistently high blood glucose levels can lead to a condition called diabetic ketoacidosis. This happens when a severe lack of insulin means the body cannot use glucose for energy, and the body starts to break down other body tissue as an alternative energy source. Ketones are the by-product of this process.

Ketones are poisonous chemicals which build up and, if left unchecked, and will cause the body to become acidic – hence the name ‘acidosis’. DKA generally develops over 24 hours but can develop more quickly particularly in young children. DKA develops when blood glucose levels are extremely high – often as a result of illness. For information on how to look after yourself when you are feeling unwell click here. DKA can develop rapidly and should be treated as a medical emergency at hospital.

Depression, distress and burnout

The demands of managing type 1 diabetes are considerable and diabetes burn-out, diabetes distress and diabetes depression are very real and recognisable problems. It is important that you don’t ignore your emotional wellbeing. Diabetes NSW has developed several useful information sheets that will provide you useful tips.

Persistent infections

Ongoing infections that don’t appear to clear up can lead to more serious consequences for people living with diabetes. If you get an infection, it is important that you contact your doctor or call Diabetes NSW and ask to speak to a diabetes educator on 1300 342 238.

Diabetes NSW & ACT - Live your life
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