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Heart Disease and Stroke
If you have diabetes, you are at least twice as likely as someone who does not have diabetes to have heart disease or a stroke. People with diabetes also tend to develop heart disease or have strokes at an earlier age than other people. Two-thirds of people with diabetes die of heart disease.
This is because high blood glucose levels over time can lead to increased deposits of fatty materials on the insides of the blood vessel walls. These deposits may affect blood flow, increasing the chance of clogging and hardening of blood vessels (atherosclerosis).
This complication occurs in the retina of the eye, resulting from damages to the tiny blood vessels in the retina. The disease develops slowly. First, these tiny blood vessels swell and weaken. Some blood vessels then become clogged and do not let enough blood through. At this stage, you might not have any loss of sight from these changes, but they can be detected by a dilated eye exam.
As the problem gets worse, new blood vessels grow. These new blood vessels are weak. They break easily and leak blood into the vitreous of the eye. The leaking blood keeps light from reaching the retina. You may see floating spots or almost total darkness. Sometimes the blood will clear out by itself. But you might need surgery to remove it.
Over the years, the swollen and weak blood vessels can form scar tissue and pull the retina away from the back of the eye. If the retina becomes detached, you may see floating spots or flashing lights. You may feel as if a curtain has been pulled over part of what you are looking at. A detached retina can cause loss of sight or blindness if you don't take care of it right away.
Chronic Kidney Disease (CKD)
Each year in the United States, more than 100,000 people are diagnosed with kidney failure, a serious condition in which the kidneys fail to rid the body of wastes. Kidney failure is the final stage of chronic kidney disease (CKD).
Diabetes is the most common cause of kidney failure, accounting for nearly 44 percent of new cases. Even when diabetes is controlled, the disease can lead to CKD and kidney failure. Most people with diabetes do not develop CKD that is severe enough to progress to kidney failure. Nearly 24 million people in the United States have diabetes, and nearly 180,000 people are living with kidney failure as a result of diabetes
The function of the kidney is to filter the blood, remove the wastes, and excrete the wastes in the urine. The kidney disease takes many years to develop. In some people, the filtering function of the kidneys is actually higher than normal in the first few years of their diabetes. This process is called hyperfiltration.
Over several years, people who are developing kidney disease will have small amounts of the blood protein albumin begin to leak into their urine. This first stage of CKD is called microalbuminuria. The kidney’s filtration function usually remains normal during this period.
As the disease progresses, more albumin leaks into the urine. This stage may be called macroalbuminuria or proteinuria. As the amount of albumin in the urine increases, the kidneys’ filtering function usually begins to drop. The body retains various wastes as filtration falls. As kidney damage develops, blood pressure often rises as well.
Overall, kidney damage rarely occurs in the first 10 years of diabetes, and usually 15 to 25 years will pass before kidney failure occurs. For people who live with diabetes for more than 25 years without any signs of kidney failure, the risk of ever developing it decreases.
Diabetic neuropathies are a family of nerve disorders caused by diabetes. People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbness—loss of feeling—in the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs.
About 60 to 70 percent of people with diabetes have some form of neuropathy. People with diabetes can develop nerve problems at any time, but risk rises with age and longer duration of diabetes. The highest rates of neuropathy are among people who have had diabetes for at least 25 years. Diabetic neuropathies also appear to be more common in people who have problems controlling their blood glucose, also called blood sugar, as well as those with high levels of blood fat and blood pressure and those who are overweight.
Hypoglycemia is a disease in which the blood glucose level drops too low to provide enough energy for the body's activities. Its symptoms include hunger, nervousness and shakiness, sweaty, dizziness, confusion, sleepiness, feeling anxious or weak. For people with diabetes (high blood glucose level), hypoglycemia can be caused by excessive doses of blood-glucose lowering medications (such as insulin), insufficient food, or increased activities.
Erectile Dysfunction (ED)
Erectile dysfunction is the inability to get or keep an erection firm enough for sexual intercourse. ED can be a total inability to achieve an erection, an inconsistent ability to do so, or a tendency to sustain only brief erections.
ED is sometimes called impotence, but that word is being used less often so that it will not be confused with other, nonmedical meanings of the term.
The National Institutes of Health estimates that ED affects as many as 30 million men in the United States. Incidence increases with age: About 4 percent of men in their 50s and nearly 17 percent of men in their 60s experience a total inability to achieve an erection. The incidence jumps to 47 percent for men older than 75. But ED is not an inevitable part of aging. ED is treatable at any age.
ED usually has a physical cause, such as disease, injury, or side effects of drugs. Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED. Diseases—such as diabetes, high blood pressure, nerve disease or nerve damage, multiple sclerosis, atherosclerosis, and heart disease—account for the majority of ED cases.