Problems related to diabetes complications

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Problems related to diabetes complications

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The biggest challenge for many people with diabetes is to come to terms not just with the diagnosis of diabetes but with the fact that their diabetes places them at risk for a number of serious complications.

There are four main categories of complications from diabetes, affecting:

Small blood vessels (microvascular), causing damage to the eyes and kidneys.
Large blood vessels (macrovascular), which damages the heart and large blood vessels.
Nerves (neuropathy), which damages the nerves in your body. Nerve damage can affect both the functioning of internal organs, such as the stomach (gastroparesis), and your ability to feel pain when injured.
Immune system functioning, which affects your ability to fight infections and heal properly.

The experts do not completely understand what causes some people to develop complications from diabetes while others do not. For unknown reasons, some people have tissue and unidentified factors that are more or less resistant to damage. But having other risk factors for a specific complication increases the likelihood that you may develop that complication. For example, people with diabetes who smoke are at higher risk for heart disease than people with diabetes who do not smoke.

In some cases, you may be able to prevent complications. In other cases, that may not be possible, but good management of your diabetes can delay the onset of these problems and minimize their intensity when they do occur.

This table presents the potential problems related to diabetes complications and the symptoms that indicate those problems.

**Potential problems related to diabetes complications**
Diabetes complication	Potential problem	Symptoms of potential problem
Heart disease (coronary artery disease)	Heart attacks	Chest pain Decreased tolerance for physical activity Chronic fatigue Shortness of breath Swelling of the legs and ankles Palpitations (feeling like the heart is racing or pounding)
Blood flow cut off to brain (cerebrovascular disease)	Strokes	Impaired speech Inability to see Inability to walk Paralysis on one side of the body Numbness or tingling in limbs
Problem with blood circulation (peripheral arterial disease)	Reduced blood flow to the limb	Pain in the calves when walking Coolness of the lower extremities Loss of hair on the legs Development of leg ulcers that do not heal promptly
Impaired immune system functioning	Developing infections that linger and wounds that do not heal quickly	Frequent infections, sometimes with unusual types of bacteria and fungus Symptoms are associated with a variety of infectious diseases
Impaired processing of cholesterol	Contributes to problems with coronary artery disease and strokes	Buildup of plaque in blood vessels, which contributes to increased frequency of heart disease, strokes, and circulation problems
Eyes (diabetic retinopathy)	Damage to the retina	Impaired vision Blindness, in severe cases
Kidneys (diabetic nephropathy)	Impaired functioning of the kidneys Kidney failure, in severe cases	Fatigue Muscle cramping Inability to think clearly Swelling from retention of body fluids
Nerves (peripheral neuropathy)	Decreased sensation, especially common in the feet and hands	Numbness, tingling, and/or weakness in the feet and hands, which is usually worse at night.
Autonomic nervous system (autonomic neuropathy)	Weakness Abnormal functioning of some organ systems: Blood pressure and heart rate Gastrointestinal tract Male sexual performance	Swings in heart rate and blood pressure Nausea and vomiting from failure of the stomach to contract and move food along the digestive tract (gastroparesis) Impotence in men and retrograde ejaculation Dizziness and drop in blood pressure when going from sitting to standing or when getting out of bed in the morning (orthostatic hypotension)

Credits

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Author	Caroline Rea, RN, BS, MS
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Michele Cronen
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	Caroline S. Rhoads, MD - Internal Medicine
Specialist Medical Reviewer	Matthew I. Kim, MD - Endocrinology & Metabolism
Last Updated	August 14, 2007

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Last updated:	August 14, 2007
Author:	Caroline Rea, RN, BS, MS
Reviewed By:	Caroline S. Rhoads, MD - Internal Medicine, Matthew I. Kim, MD - Endocrinology & Metabolism
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman, MATC

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