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Harvard Commentaries
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Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Health Problems That Diabetes Can Cause


October 28, 2013

Diabetes Type 2
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Learn The Basics
Health Problems That Diabetes Can Cause
Health Problems That Diabetes Can Cause
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Diabetes can lead to health problems in many systems of your body, primarily by damaging blood vessels and nerves.
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InteliHealth
2010-07-16
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InteliHealth Medical Content
2013-07-16

Reviewed by the Faculty of Harvard Medical School

Health Problems That Diabetes Can Cause
 
The most important health impacts of type 2 diabetes are the long-term complications it can cause. Most of these health problems are related to the effects of type 2 diabetes on arteries or nerves.
 
Arteries
 
Type 2 diabetes causes damage to both large and small arteries. This artery damage results in medical problems that are both common and serious:
  • Heart attack — Type 2 diabetics have two to four times the risk of dying from heart disease as non-diabetics. Middle-aged type 2 diabetics have the same high heart-attack risk as people without diabetes who already have had a heart attack. They are more likely than non-diabetics to die if they have a heart attack. They are also more likely to have repeat heart attacks.
  • Stroke — Type 2 diabetics have two to four times the risk of stroke as people without diabetes.

  • Amputations — More than half of the amputations done in the United States are related to diabetes. When an amputation is needed, it is most commonly needed because of damage to the peripheral arteries (arteries to the legs). Poor circulation from artery damage also causes open skin sores and infections.

  • Kidney failure — About 40% of all people who need dialysis have kidney failure from diabetes. (Only 4% to 6% of all type 2 diabetes patients end up requiring dialysis. However, about 20% to 30% of people with type 2 diabetes will develop at least some kidney damage.)
  • BlindnessDiabetes damages the eye by injuring small blood vessels in the retina. It is the most common cause of blindness that starts between ages 20 and 74.
These artery problems are the most serious consequences of type 2 diabetes. Why does diabetes lead to artery damage? Part of the answer is that diabetes usually occurs along with other diseases that place the heart and arteries at risk. People with diabetes are more likely than other people to develop high blood pressure, obesity and high cholesterol.
 
When several risks to the heart or arteries occur together, they present a powerful health threat. This is known as the metabolic syndrome. If you are aggressive in treating each of these risk factors, you can greatly reduce your risk of heart attack and other problems caused by artery injury.
 
Nerves
 
Type 2 diabetes also injures nerves. About 60% to 70% of diabetics develop nerve damage. Many health problems can result:
  • Peripheral neuropathy — The feet and legs can develop tingling, pain, or a loss of feeling. This problem makes foot ulcers and foot infections more common. Foot problems increase your risk of needing an amputation.
  • Stomach and bowel problems — The nerves that trigger normal movements of the stomach and intestines can become less active or less predictable. This can result in nausea, constipation or diarrhea. A stomach that is slow to empty has a diabetes condition called gastroparesis.

  • Dizziness when standing — Your body has to make some adjustments to move blood from your toes to your torso when you are standing up. That's because the heart is pumping against gravity. When your body is working correctly, blood vessels get tighter to prevent pooling of blood in your lower body. The circulation relies on nerve signals to know when to do this. These signals can fail in diabetes. If this happens, standing up can leave you with low blood pressure. You may feel lightheaded.

  • Sexual-function problemsImpotence is especially common in people with nerve damage from diabetes. Artery damage also contributes to impotence.
  • Localized nerve failures — A nerve that controls a single muscle can lose its function. This could cause a variety of problems. Possible examples include eye movement problems with double vision, or drooping of the cheek on one side of the head (commonly known as Bell's palsy).
Many of these potential problems can significantly shorten the life of a person with type 2 diabetes. All of them can diminish the quality of life. But prevention is possible in many cases through diet and exercise, use of medicines, careful control of your blood sugar and other protective measures.
 
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