Coronary artery (heart) disease is caused by a narrowing or blocking of the blood vessels to your heart. Its the most common form of heart disease.
These blood vessels to the heart are important because the blood flowing through them carries oxygen and other necessary materials to your. Unfortunately these blood vessels can become partially or totally blocked by fatty deposits.
A heart attack occurs when the blood supply to your heart is reduced or cut off.
4 Heart Disease and Diabetes
Having diabetes means that you are more likely to have coronary artery disease a heart attack or stroke.
Luckily there are steps that can be taken to prevent heart disease or reduce the chances of having another heart attack.
You can lower your risk by keeping ABCs of diabetes on target with wise food choices physical activity and medication.
5 The ABCs 6 Kidney Function
The job of kidneys in the body is to remove waste products from the blood.
Inside of the kidneys are millions of tiny blood vessels (capillaries) that act as filters.
When our bodies digest the protein we eat this process creates waste products.
Normally as blood flows through the small capillaries tiny molecules (waste products) squeeze through the holes and become incorporated in urine for removal from the body.
Useful substances such as protein and red blood cells are too big to pass through the filter and remain in the blood.
7 Kidney Disease
High levels of blood sugar can make the kidneys filter too much blood putting extra stress on the kidneys.
After years of damage the kidneys start to leak.
Useful protein becomes lost in the urine.
Having small amounts of protein in the urine is a condition known as microalbuminuria.
When kidney disease is diagnosed early (during microalbuminuria) there are several treatments that may keep the kidney disease from getting worse.
However when kidney disease is caught later (during macroalbuminuria) end-stage renal disease or ESRD usually follows.
8 Kidney Disease
With time the stress of overwork causes the kidneys to lose their filtering ability.
Waste products begin to build up in the blood.
Finally the kidneys fail.
ESRD is a very serious condition requiring either a kidney transplant or regular visits to a dialysis clinic in which their blood is filtered by a machine which contains an artificial kidney.
9 Who Gets Kidney Disease
Not everyone with diabetes will develop kidney disease.
Factors that influence kidney disease development include
Blood sugar control
Of course genetics are beyond our control.
On the other hand one can work on getting blood sugar and blood pressure in check.
The better a person controls diabetes and keeps blood pressure in control the lower their chance of developing kidney disease.
10 Facts About Diabetes and Kidney Disease
10-21 of all people with diabetes have nephropathy.
Approximately 43 of new cases of ESRD are attributed to diabetes.
The risk of ESRD is 12 times higher in people with type 1 diabetes than in those with type 2.
In the US the incidence of reported ESRD in people with diabetes is more than 4 times as high in African Americans 4 to 6 times as high in Mexican Americans and 6 times as high in Native Americans than in the general population of diabetes patients.
11 ---Eye Complications---
People with diabetes do have a higher risk of blindness than people without diabetes.
But most people with diabetes have nothing more than minor eye disorders.
Luckily there are ways to keep minor problems minor and to treat major problems if they do arise if you begin treatments right away.
Glaucoma occurs when pressure builds up in the eye.
The pressure pinches the blood vessels that carry blood to the retina and optic nerve.
Vision is gradually lost because the retina and nerve are damaged.
People with diabetes are 40 more likely to suffer from glaucoma than people without diabetes.
Risk increases with age and duration the individual has had diabetes for.
Luckily there are several effective treatments for glaucoma. For some drugs are used to reduce the pressure in the eye and for others surgery is an option.
With cataracts the eyes clear lens clouds blocking light.
For mild cataracts one may need to wear sunglasses more often and use glare-control lenses in eyeglasses.
For cataracts that interfere greatly with vision doctors generally remove the lens of the eye.
In which case a new transplanted lens is an option.
Individuals with diabetes are
60 more likely to develop cataracts
Likely to get cataracts at a younger age
Likely to have a faster progression of cataracts
Likely to have problems if removal of the lens is necessary due to the beginning stages of glaucoma
Diabetic retinopathy is a general term for all disorders of the retina caused by diabetes.
There are 2 major types of retinopathy
Nonproliferative This is the common mild form. It usually has no effect on vision and needs no treatment. Yearly monitoring is important however to make sure the condition isnt worsening.
Proliferative This form is much more serious. With proliferative retinopathy blood vessels are so damaged that they close off. In response new vessels begin growing in the retina. These vessels are weak and can leak blood blocking ones vision a condition known as vitreous hemorrhage. A more serious condition that can occur in this form is retinal detachment.
There are several factors that influence whether you get retinopathy
Blood sugar control
Blood pressure levels
How long you have had diabetes
Almost everyone with type 1 diabetes will eventually develop nonproliferative retinopathy. But luckily the retinopathy that destroys vision proliferative retinopathy is far less common.
17 Diabetic Neuropathy Nerve Damage
About half of all people with diabetes have some form of nerve damage.
Nerve damage from diabetes is referred to as diabetic neuropathy.
Its more common in those who have had the disease for many years.
The upside of things is that if you keep your blood glucose levels on target you can help prevent or delay nerve damage.
18 2 Common Types of Nerve Damage
Also known as peripheral neuropathy
Can cause tingling pain numbness or weakness in hands and feet.
Autonomic neuropathy Can lead to
Digestive problems such as feeling full nausea
Vomiting diarrhea or constipation
Problems with how well the bladder works
Problems having sex
Dizziness or faintness
Loss of the typical warning signs of a heart attack
Loss of warning signs of low blood glucose
Increased or decreased sweating
Changes in how your eyes react to light and dark
19 Keep Your Blood Glucose Levels in Your Target Range
It is important to
Report all possible signs of diabetic neuropathy
Get treatment right away if you have problems. Early treatment can help prevent more problems later on.
Take good care of your feet checking them every day. If you no longer feel pain in your feet then you might not notice a foot injury. Therefore rely on your eyes to find any potential problems.
Protect your feet. Wear shoes and socks that fit well and wear them all the time. Use warm water to wash your feet and dry them carefully afterwards.
Purchase special shoes if they are needed. Medicare may even cover the cost of these.
Be careful with exercising. Some activities are not safe for individuals with neuropathy.
20 Foot complications
21 Skin Changes and Calluses
Diabetes can cause feet to be very dry at times.
This is because the nerves that control the oil and moisture in your foot are no longer working.
After bathing dry feet and seal remaining moisture in with plain petroleum jelly unscented hand cream or a similar product.
It is important not to put oils or creams between toes extra moisture can lead to infection.
Occur more often and build up faster on the feet of people with diabetes.
Too much callus may mean that you need therapeutic shoes and inserts.
Calluses if not trimmed get very thick can break down and turn into ulcers (open sores).
Never try to cut calluses yourself this can lead to infection.
Let your healthcare provider cut them.
22 Foot Ulcers and Poor Circulation
Even though some ulcers do not hurt every ulcer should be seen by your health care provider right away.
Neglecting ulcers can result in infections potentially leading to loss of a limb.
Also keeping off of your feet is very important. Walking on the ulcer can make it get larger and force the infection deeper into your foot.
Poor blood flow can make your foot less able to fight infection and heal.
You can control some of the things that cause poor blood flow such as
Stop smoking and keep blood pressure and cholesterol in check
Also exercise is good for poor circulation. It stimulates blood flow in the legs and feet. Exercise is a good idea for individuals who currently do not have any open sores on the foot. Proper shoes are essential.
People with diabetes are far more likely to have a foot or leg amputated than other people.
The problem is that many people with diabetes have artery disease which reduces blood flow to the feet.
Also individuals with diabetes often have nerve damage which reduces sensation.
These two problems together make it much more likely to get ulcers and infections that may lead to amputation.
Luckily most amputations are preventable with regular care and proper footware.
Taking good care of your feet is essential to prevent this event.
Always follow your health care providers advice when caring for foot problems.
One of the biggest threats to your feet is smoking!
Smoking affects small blood vessels by decreasing their blood flow to the feet making wounds heal slower.
Cessation of smoking is a good way to decrease the likelihood serious problems such as amputation.
25 Skin Complications
Disseminated Granuloma Annulare
Necrobiosis Lipoidica Diabeticorum
26 Bacterial and Fungal Infections
Several kinds of bacterial infections occur in individuals with diabetes.
Styes are infections of the glands of the eyelid.
Boils are infections of the hair follicles.
Carbuncles are deep infections in the skin and the tissue underneath.
Inflamed tissues are usually hot swollen red and painful.
Today antibiotics are the response to such infections.
Candida albicans is a yeast-like fungus which is often responsible for fungal infections in individuals with diabetes.
Common fungal infections include jock itch athletes foot ringworm and vaginal infections.
If you suspect having a yeast or fungal infection contact your doctor. He can prescribe medication to treat it.
Stye Ringworm Athletes foot 27 Itching and Diabetic Dermopathy
Localized itching is often caused by diabetes.
Itching can be caused by a yeast infection dry skin or poor circulation.
When poor circulation is the cause the itchiest regions are often the lower parts of the legs.
Limiting how often you bathe particularly when humidity is low using mild soap with moisturizer and applying skin cream after bathing may help resolve the issue.
Refers to changes in the small blood vessels caused by diabetes
Dermopathy looks like light brown scaly patches often mistaken for age spots.
The disorder most often occurs on the front of both legs.
The patches do not hurt open up or itch.
Dermopathy is harmless and does not require treatment.
28 Atherosclerosis and Allergic Reactions
Refers to thickening of the arteries
People with diabetes tend to get atherosclerosis at younger ages.
As atherosclerosis narrows blood vessels skin changes occur.
It becomes hairless thin cool and shiny.
Because blood carries the infection-fighting white cells affected legs heal slowly when the skin is injured.
Skin reactions can occur in response to medications such as insulin or diabetes pills.
If you think you are having a reaction to a medication contact your doctor immediately.
Be on the lookout for rashes depressions or bumps around the sites where you inject insulin.
29 Diabetic Blisters and Eruptive Xanthomatosis
Occurs rarely in individuals with diabetes
They can occur on the backs of fingers hands toes feet and on legs or forearms.
They are sometimes large and resemble burn blisters.
Painless and with no redness around them they often heal themselves within 3 weeks.
The only treatment is to bring blood sugar levels under control.
This is a condition caused by diabetes that is out of control.
Consists of firm yellow pea-like enlargements in the skin.
The disorder usually occurs in young men with type 1 diabetes.
Like diabetic blisters these bumps disappear when diabetes control is restored.
30 Digital Sclerosis and Disseminated Granuloma Annulare
Consists of tight thick waxy skin on the back of the hands.
The finger joints become stiff and can no longer move the way they should.
Rarely knees ankles or elbows also get stiff.
Happens to about 1/3 of people with type 1 diabetes
The only treatment is to bring blood sugar levels under control.
Disseminated Granuloma Annulare
Consists of sharply defined ring-shaped or arc-shaped raised areas on the skin.
Rashes most often occur on parts of the body far from the trunk (i.e. ears or fingers) but sometimes the raised areas occur on the trunk.
Contact your doctor if you see rashes like this.
Certain drugs can help clear up the condition.
31 Acanthosis Nigricans
This is a condition in which tan or brown raised areas appear on the sides of the neck armpits and groin.
Usually strikes people who are overweight.
The best treatment is to lose weight.
Some creams can help the spots look better.
32 Gastroparesis and Diabetes
Occurs when the nerves to the stomach are damaged or stop working
The muscles of the stomach and intestines do not work normally and the movement of food is slowed or stopped.
Signs and symptoms
Vomiting of undigested food
An early feeling of fullness when eating
Erratic blood glucose (sugar) levels
Lack of appetite
Spasms of the stomach wall
These symptoms may be mild or severe depending on the person. 33 Complications of Gastroparesis
Gastroparesis can worsen diabetes by making it harder to manage blood glucose.
Food staying in the stomach too long can
Cause problems like bacterial overgrowth due to fermentation
Harden into solid masses called bezoars that may cause nausea vomiting and obstruction of the stomach
Bezoars can be dangerous if they block the passage of food into the small intestine.
34 Treatment of Gastroparesis
The most important treatment goal for diabetes-related gastroparesis is to manage your blood glucose levels as well through the usage of
If you are feeling symptoms of depression dont keep them bottled up. Talk to your doctor. There may be a physical cause for your depression.
Diabetes that is in poor control can cause symptoms that look like depression
High or low blood sugar during the day can make you feel tired or anxious
Low blood sugar levels can also lead to hunger and eating too much
Low blood sugar n the night could disturb sleep
High blood sugar in the night can lead to frequent urinating and then feeling tired throughout the next day
There are many potential complications of diabetes.
When diabetes is diagnosed early in the course of the disease and glucose and insulin levels are controlled well complications can be minimized.
It is important to discuss any of the above mentioned conditions with the physician immediately upon occurrence to minimize the side effects.
37 Division of Education
Heli J. Roy PhD RD
Shanna Lundy BS
Phillip Brantley PhD
Reviewed by 38 References
All information used was obtained from
American Diabetes Association
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