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Complications

By Mayo Clinic staff

Type 1 diabetes can affect many major organs in your body, including your 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. In fact, about 65 percent of people who have diabetes die of some type of heart or blood vessel disease, according to the American Heart Association.
  • 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 control digestion 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, requiring 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.
Preparing for your appointment Risk factors
References
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  2. Standards of medical care in diabetes — 2009. Alexandria, Va.: American Diabetes Association. http://care.diabetesjournals.org/cgi/reprint/32/Supplement_1/S13. Accessed April 1, 2009.
  3. Eisenbarth GS, et al. Pathogenesis of type 1 diabetes mellitus. http://www.uptodate.com/home.index.html. Accessed Jan. 5, 2009.
  4. Gillespie KM. Type 1 diabetes: Pathogenesis and prevention. Canadian Medical Association Journal. 2006;175. http://www.mdconsult.com/das/article/body/115743848-3/jorg=journal&source=MI&sp=163/jorg=journal&source=MI&sp=16. Accessed Jan. 6, 2009.
  5. Heart disease and stroke statistics — 2009 update. American Heart Association. http://www.americanheart.org/downloadable/heart/123565990943909Heart%20and%20Stroke%20Update.pdf. Accessed April 1, 2009.
  6. 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 April 1, 2009.
  7. What people with diabetes need to know about osteoporosis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Accessed Jan. 9, 2009.
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  10. Estimated average glucose, eAG. American Diabetes Association. http://professional.diabetes.org/GlucoseCalculator.aspx. Accessed Jan. 6, 2009.
  11. Pfizer statement on Exubera labeling update in the United States. Pfizer.com. Accessed April 3, 2009.
  12. About omnipod. Omnipod.com. http://www.myomnipod.com/products/. Accessed April 3, 2009.
  13. Symlin (prescribing information). San Diego, Calif.: Amylin Pharmaceuticals; 2008.
  14. Diabetes and women's sexual health. American Diabetes Association. http://www.diabetes.org/type-1-diabetes/women-sexual-health.jsp. Accessed April 3, 2009.
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  21. High blood sugar: Definition, symptoms. Juvenile Diabetes Research Foundation. http://www.jdrf.org/index.cfm?fuseaction=home.viewpage&page_id=EC92D98E-1321-C844-13EB771367A49526. Accessed April 3, 2009.
  22. Smoking. American Diabetes Association. http://www.diabetes.org/type-1-diabetes/smoking.jsp. Accessed April 3, 2009.
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June 13, 2009

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