The long term complications of diabetes are health conditions caused by gradual damage to blood vessels feeding one or more organs in the body.

There are many different complications that can occur and it is common for people to develop more than one diabetic complication, particularly if they had diabetes for a long time or have not kept their condition controlled well enough.

How do complications occur?

Long term complications develop if blood glucose levels are too high for extended periods of time.

The higher sugar levels are and the longer they remain high can each increase the likelihood of diabetic complications.

People with type 2 diabetes should note that blood glucose levels may have been running higher than normal for a number of months or years before they were diagnosed ,which is a major reason for why early diagnosis of diabetes is important.

Treating long term complications

The treatment for different conditions varies. However a number of basic but important treatment measures are common to the complications listed. These treatment measures include:

Neuropathy (nerve damage)

Neuropathy is the name for nerve damage. Nerves can become damaged anywhere in the body, with the nerves in extremities such as the feet and hands being the most common. If neuropathy develops, nerves that feed the muscles and internal organs can also become damaged.

Neuropathy is commonly the first complication that people with diabetes notice symptoms of and, in people with type 2 diabetes, may sometimes be recognised before diabetes is diagnosed.

If neuropathy causes excessive or regular pain, specific painkillers that are able to reduce nerve pain may be prescribed.

Retinopathy (eye disease)

Retinopathy is damage that occurs to the retina, the layer of cells at the back of the eye that receives light and converts it into electrical signals, allowing us to see.

Retinopathy occurs if blood vessels feeding the retina are not able to deliver oxygen and nutrients.

This causes new but weaker blood vessels to form which are susceptible to damage and leak which can pose a risk to our ability to see.

People can usually live with the earlier stages of retinopathy but it’s very important to keep diabetes well controlled and to attend all retinopathy screenings so any worsening of symptoms can be treated.

Treatments for developed forms of retinopathy include:

  • Laser photocoagulation therapy
  • Anti-VEGF injections

Nephropathy (kidney disease)

Diabetic nephropathy is a form of kidney disease which can lead to difficulties in living daily life, such as tiredness and shortage of breath, if it develops to a later stage of damage.

Nephropathy is a general term for the deterioration of proper kidney function. This deterioration occurs when high blood lgucose levels over time – usually a number of years – affect the arteries of the body, which are used by the kidneys to filter blood.

Left undiagnosed or untreated, kidney disease can progress to a stage known as end stage renal disease (ESRD), which requires one of the following treatments:

  • Kidney transplantation
  • Kidney dialysis

Heart disease and stroke

Coronary heart disease and stroke are known as macrovascular complications because they are caused by damage to one or more of the body’s larger blood vessels that supply blood to the heart or brain.

Heart disease is the biggest known killer in people with diabetes, responsible for 4 out of every 5 diabetes-related deaths, while stroke is also a major cause of mortality amongst diabetic patients.

Both heart disease and, stroke can have immediately devastating consequences, but leading a healthy lifestyle and meeting your diabetes health targets can help to prevent these complications from occurring.

In most cases, people at high risk of stroke or heart disease will be offered medications to further assist in preventing them. The medications you may be offered include:

  • Statins – if you have high cholesterol levels
  • Blood pressure medication – if you have high blood pressure levels
  • Blood thinning medication to help prevent blood clots

Diabetic foot problems

Foot problems can be dangerous for people with diabetes as factors such as high blood sugar levels, reduced circulation and neuropathy can each contribute to a higher risk of developing serious foot complications.

Foot care, which includes checking your own feet each day for any signs of damage is important as even small damage, such as blisters, can become problematic if they heal slowly or infection sets in.

A type of non-healing wound, known as a foot ulcer, is quite common in people with diabetes, particularly where adequate diabetes control is not achieved.

If diabetic foot problems are not spotted or treated early, amputation may sometimes be the only option.