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Common health complicationsCardiovascular diseaseCardiovascular disease (CVD) is a broad term and includes heart disease, stroke and other diseases of the heart and circulation – for example hardening and narrowing of the arteries supplying blood to the legs (peripheral vascular disease). CVD is more common in people with diabetes because high glucose levels in the blood enable fatty deposits to build up more easily on the inner walls of arteries. CVD is also the leading cause of death and disability in people with diabetes. Because of prolonged periods of poorly controlled blood glucose levels, patients with diabetes also tend to have raised cholesterol and triglyceride levels and higher blood pressure. High blood glucose levels actually cause an increase in the blood lipids (fats) and make cholesterol more likely to stick to the walls of blood vessels. All these complications contribute to Kidney diseaseHigh blood glucose levels and high blood pressure can cause damage to small blood vessels, particularly in the kidneys. Kidneys clean blood by filtering out waste products and excess compounds but are extremely sensitive to damage. Once the damage reaches a certain point, they start to fail. The sign of kidney damage is when protein albumin begins to appear in the urine. The level of damage is measured by the amount of this protein present in the urine. Almost one in three people with type 2 diabetes develops kidney disease (Department of Health, 2006) and one in five with type 1 diabetes dies of kidney failure (Morrish et al., 2001). RetinopathyBlood vessels in the eye are just as sensitive to high blood glucose and cholesterol levels and high blood pressure as those in the kidneys. Blood vessels supplying the retina – the seeing part of the eye – can become blocked, damaged, leaky or grow unpredictably. Any such damage or abnormal growth affects the vision and can ultimately lead to blindness. The condition where the retina is damaged is called retinopathy and it is estimated that 4,200 people in England are blind due to diabetic retinopathy (Scanlon, 2008). Almost all people with type 1 diabetes develop some degree of retinopathy within 20 years of diagnosis and almost two thirds of people with type 2 diabetes have retinopathy (Scanlon, 2008). AmputationAny type of diabetes, especially when poorly controlled, can lead to nerve, muscle and sweat gland damage, which can seriously affect circulation and sensitivity in feet and legs and can result in injuries or infections. It can progress to a point where amputation is necessary. DepressionDiabetes and the complications that can spring from it, the side effects of medication or daily diabetes management itself can affect the emotional well being of anyone. As a result, depression, eating disorders, anxiety and various phobias can develop. NeuropathyChanging levels of blood glucose can damage nerves which transmit impulses to and from the brain and spinal cord, to muscles, blood vessels, skin and other organs. The nerve damage can cause pain and may also lead to other problems, such as poor sensitivity in the feet making any minor injuries more likely to go unnoticed, which makes the damage more serious. Neuropathy can also lead to erectile dysfunction or impotence. Neuropathy affects up to 50 per cent of people with diabetes (Boulton, 2005) whilst chronic painful neuropathy affects about one in six – compared to one in 20 non-diabetic people of the same age (Daousi et al., 2004). |