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Diabetes makes your blood sugar higher than normal. After many years, too much sugar in the blood can cause problems in your body. It can harm your eyes, kidneys, nerves, skin, heart, and blood vessels.

• You could have eye problems. You could have trouble seeing, particularly at night. Light could bother your eyes. You could become blind.
• Your feet and skin can develop sores and infections. If it goes on too long, your toes, foot, or leg may need to be amputated. Infection can also cause pain, itching, or oozing in your feet, legs, and other areas.
• Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to heart attack, stroke, and other blood vessel problems. It can become harder for blood to flow to the legs and feet.
• Nerves in the body can become damaged, causing pain, burning, tingling, and loss of feeling. Nerve damage can also make it harder for men to have an erection.
• You could have problems digesting the food you eat. You could have trouble having a bowel movement (constipation) or have looser or watery bowel movements.
• High blood sugar and other problems can lead to kidney damage. Your kidneys might not work as well and may even stop working. As a result, you might need dialysis or a kidney transplant.
• Diabetes can weaken your immune system. This can make you more likely to have serious complications from common infections.
• People with diabetes often have depression and the two diseases may be linked.
• Some women with diabetes may have irregular menstrual periods and may have problems getting pregnant.
• Diabetes increases the risk for dementia.
• Diabetes increases the risk for bone diseases, including osteoporosis.
• Low blood sugar (hypoglycemia) from treatment of diabetes can also increase the risk for heart disease.

Take Control of Your Diabetes

Keeping your blood sugar in a healthy range reduces all of the complications from diabetes.

It is important to keep your blood pressure and cholesterol in a healthy range.

You should learn these basic steps for managing diabetes and staying as healthy as possible. Steps may include:

• A healthy diet
• Physical activity
• Medicines

You may need to check your blood sugar daily or more often. Your health care provider will also help you by ordering blood tests and other tests. All these may help you keep complications of diabetes away.

If you need to check your blood sugar level at home.

• You may use a device called a glucose meter to test your blood sugar. Your provider will let you know if you need to check it every day and how many times each day.
• You may use a device called a glucose sensor that attaches to your body. Your provider will tell you if this is a better choice for you.
  
• Your provider will also tell you what blood sugar numbers you are trying to achieve. This is called managing your blood sugar. These goals will be set for different times during the day.

To prevent heart disease and stroke, you may be asked to take medicine and change your diet and activity:

• Your provider may ask you to take a medicine called an ACE inhibitor or a different medicine called an ARB, for high blood pressure or kidney problems.
• Your provider may ask you to take a medicine called a statin to keep your cholesterol down.
• Your provider may ask you to take aspirin to prevent heart attacks. Ask your provider if aspirin is right for you.
• Regular exercise is good for people with diabetes. Talk to your provider first about what exercises are best for you and how much exercise you should do every day.
• Do not smoke. Smoking makes diabetes complications worse. If you do smoke, work with your provider to find a way to quit.

To keep your feet healthy, you should:

• Check and care for your feet every day. Keep your skin well moisturized.
• Get a foot exam by your provider at least every 6 to 12 months and learn whether you have nerve damage.
• Make sure you are wearing the right kinds of socks and shoes.

A nurse or dietitian will teach you about good food choices to lower your blood sugar and stay healthy. Make sure you know how to put together a balanced meal with protein and fiber.

See Your Doctor Often

If you have diabetes, you should see your provider every 3 months. At these visits your provider may:

• Ask about your blood sugar level (always bring your blood glucose meter to every visit if you are checking your blood sugar at home)
• Check your blood pressure
• Check the feeling in your feet
• Check the skin and bones of your feet and legs
• Examine the back part of your eyes

The provider may also send you to the lab for blood and urine tests to:

• Make sure your kidneys are working well (every year)
• Make sure your cholesterol and triglyceride levels are healthy (every year)
• Check your A1C level to see how well your blood sugar is controlled (every 3 to 6 months)

Visit your dentist every 6 months. You should see your eye doctor once a year. Your provider may ask you to see your eye doctor more often.

References

American Diabetes Association website. 5. Facilitating behavior change and well-being to improve health outcomes: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(Suppl 1):S60-S82. PMID: 34964866 pubmed.ncbi.nlm.nih.gov/34964866/.

Brownlee M, Aiello LP, Sun JK, et al. Complications of diabetes mellitus. In: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 37.

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