Complications

The possible long term complications of diabetes include:

• Cardiovascular disease: This is damage to the heart and blood circulation caused by fatty deposits on the linings of  blood vessels around the body.
• Retinopathy: This is the most common cause of blindness among people aged 16 and 64 in the UK as it affects the blood vessels supplying the retina – the seeing part of the eye.
• Neuropathy: This is also known as nerve damage. There are many different types of neuropathy depending ion which nerve has been damaged. Sensory neuropathy is the most common type of neuropathy and mainly affects the nerves in the feet and the legs.
• Nephropathy: This is also known as kidney or renal disease.

The good news is that by keeping your blood glucose, blood cholesterol and blood pressure levels to as near normal as possible the risks of the long term complications can be significantly reduced. It is also important to have your eyes screened and feet checked at least once a year so that any problems can be picked up early and treated appropriately.

Foot problems can affect anyone who has diabetes.  Diabetes, particularly if it is poorly controlled, can damage your nerves, muscles, sweat glands and circulation in the feet and legs. By keeping your blood glucose, blood fats and blood pressure under control you can help to prevent some of the complications associated with the feet of people with diabetes and if you already have complications, this can reduce the risk of them getting worse.

If you have been told that there are problems with your feet, make sure that you leave the surgery or clinic knowing exactly what the problem is, what any treatment you have been prescribed is for, how to use/take it, what it does, what the expected outcome of using/taking it will be and what the next steps are if it does/doesn’t achieve the desired outcome.

Kidney disease can happen to anyone but it is much more common in people with diabetes and people with high blood pressure. Kidney disease in diabetes develops very slowly, over many years. It is most common in people who have had the condition for over 20 years.

Keeping blood pressure under control is extremely important and tablets for lowering blood pressure are often used. Increasingly common forms of treatment for people with diabetes are 'ACE inhibitor' drugs or Angiotensin II receptor antagonists (AIIRAs). These are particularly successful as they not only lower blood pressure but also help protect the kidneys from further damage. These drugs are also sometimes used therefore in people who have normal blood pressure, due to their protective effect on the kidneys.

Your doctor should discuss any treatment with you before starting you on it, explaining what it does and how it will help. If you are at all unclear, don’t be afraid to ask for clarification.

By keeping your blood glucose, blood fats and blood pressure under control you can help to prevent kidney problems and if you have them, help to stop them from getting worse.

People with diabetes are at risk of developing a complication called retinopathy.  Retinopathy affects the blood vessels supplying the retina – the seeing part of the eye.  Blood vessels in the retina of the eye can become blocked, leaky or grow haphazardly.  This damage gets in the way of the light passing through to the retina and if left untreated can damage vision.

Retinopathy can be treated by laser which is very successful if the condition is caught early and is generally pain free.  In 80 percent of cases it can prevent any further loss of sight.

Keeping blood glucose and blood pressure under control will help to reduce the risk of developing retinopathy and if you have been diagnosed with retinopathy, will help to stop this from getting worse. If any treatment has been suggested for you, make sure you are clear about what it is for, how it may help, what it involves and what the next steps are.

If you have retinopathy you must notify the DVLA.

If you are anxious, embarrassed or don’t know which words to use, you may wish to write down what you want to say and take it with you. This can help both the healthcare professional and you to open the consultation. Your doctor will be able to refer you, if necessary, to someone trained in this speciality.

You may also wish to speak to someone about your sexual difficulties before you discuss them with your doctor or nurse. People often find that the thought of talking about such matters is worse than the actual reality of doing so and once they have overcome the first hurdle of talking to someone, it gets easier each time.

The Diabetes UK Careline is a helpline run by trained counsellors ready to listen. The Careline can provide confidential support and information on diabetes and related issues. All team members have extensive counselling skills and experience in giving advice.

You can also contact the Sexual Dysfunction Association