Health Head to Toe: Protect Your Body
How you can prevent and fight diabetes-related complications
Keep track of the regular tests and screenings that protect you head to toe.
Arm yourself with knowledge about the effect of diabetes-related damage on the following parts of the body and some treatment options.
Problems: Strokes occur when blood flow to the brain is interrupted—either by a blocked artery or a broken blood vessel. When this happens, brain cells begin to die and permanent brain damage may occur. Signs of stroke include sudden weakness on one side of the body, difficulty speaking, drooping of one side of the face, vision problems, loss of balance, and severe headache. Strokes are more common in people with diabetes, who are more likely to have high blood pressure and high cholesterol, two of the most common risk factors for strokes.
Treatments: Strokes are medical emergencies; call 911 immediately. Depending on the type of stroke, your doctor may prescribe medication or have a specialist perform procedures to relieve symptoms and prevent a future stroke.
Problems: Damage to the blood vessels in the eyes, retinopathy, is linked to long-term high blood glucose and high blood pressure, and to living with diabetes for many years. Retinopathy occurs when retinal blood vessels become blocked or leaky. When new blood vessels grow in an attempt at healing, they can leak and block vision or cause scar tissue that can lead to a detached retina. You may not notice any symptoms until retinopathy has become severe. Fast-spreading proliferative retinopathy may lead to blindness. Glaucoma, cataracts, and macular edema (resulting in loss of clear central vision) are other common eye problems in diabetes.
Treatments: Regular eye exams can detect retinopathy early before vision loss occurs. Laser surgery is the gold standard for treating retinopathy. It helps reduce the risk of more vision loss. Injections of certain medications into the eye may also help.
Problems: Diabetes control plays a role in oral health: Uncontrolled diabetes can lead to the gum infection known as periodontal disease. The condition can cause red, swollen, and bleeding gums, loose teeth, and bad breath, and may ultimately destroy tissues and bones in the mouth. Gum disease may also make blood glucose harder to control.
Treatments: Your dentist may do a deep cleaning, prescribe medication, or perform surgery, depending on the extent of periodontal disease.
Problems: Coronary artery disease (blockages in the arteries that supply blood to the heart muscle) occurs more frequently in people who have diabetes, especially those with high blood pressure, high cholesterol, and uncontrolled blood glucose. Coronary artery disease can lead to heart attacks, heart failure, and sudden cardiac death.
Treatments: Talk to your doctor about medications for controlling blood pressure, cholesterol, and blood glucose as well as a heart-healthy eating, exercise, and weight management plan.
Problems: Nerve damage due to long-term and poorly controlled diabetes can cause slowed emptying of the stomach, a condition called gastroparesis. It can lead to frequent pain, nausea, and vomiting and may cause hard-to-control blood sugar highs and lows. Constipation and/or diarrhea are other signs of nerve damage in the digestive tract. People with diabetes are also more likely to have celiac disease, an autoimmune disorder that affects the absorption of food.
Treatments: Work with a dietitian—eating smaller meals, limiting or avoiding high-fiber foods, or using meal-replacement drinks or smoothies can help. Medications and gastric pacing devices may also be prescribed. People with celiac disease need to avoid eating gluten, found in wheat, barley, and rye.
Problems: Long-standing diabetes and long-term high blood glucose and/or blood pressure can damage blood vessels in the kidneys. When this occurs, the kidneys may start to leak protein into the urine—a sign of nephropathy (kidney disease).
Treatments: In the early stages of kidney disease, treatment includes blood pressure medication and efforts to better control blood glucose. In late-stage kidney disease, dialysis (using a machine that performs the blood-cleaning function of the kidney) or kidney transplantation may be necessary
Problems: A buildup of fat in the liver can lead to fatty liver disease, which is commonly seen in people with obesity and/or diabetes. There are no symptoms of this dangerous disease, but left untreated, it can cause inflammation, liver scarring (cirrhosis), and even liver failure. Your doctor may screen for the disease with a blood test, ultrasound, CT scan, or MRI. A liver biopsy may be needed in some cases.
Treatments: There’s no specific treatment for fatty liver, but weight loss through diet and exercise can decrease the amount of fat in the liver. Liver transplantation may be required to treat liver failure due to fatty liver disease.
Problems: Long-standing diabetes and chronic high blood glucose can lead to a number of sexual problems. Blood vessel damage in the penis can weaken blood flow, making it difficult for men to get an erection. Nerve damage may also be behind erectile dysfunction. Women with nerve damage may have vaginal dryness and problems reaching orgasm.
Treatments: Erectile dysfunction medications are available. Men may also want to try penile injections, penile rings, vacuum pumps, sleeves, or penile implants. When female sexual problems aren’t a result of low estrogen (which can be treated with prescription estrogen pills, a patch, or a cream), the main treatment option is over-the-counter lubricants.
Peripheral Arteries in Legs
Problems: When fat builds up in the arteries of the legs, it can impede blood flow, resulting in a condition called peripheral arterial disease (PAD). The poor circulation can cause leg cramps when exercising (sometimes at rest, too) and can slow wound healing, raising the risk for foot ulcers, infection, and amputation. PAD is also a sign that arteries around the heart may be clogged, putting you at risk for heart attack and stroke.
Treatments: Your health care provider may advise you to lower your A1C, blood pressure, and LDL (“bad”) cholesterol; quit smoking; exercise more; and start a medication that improves blood flow, such as aspirin. Weight loss is beneficial for overweight and obese people with PAD.
Problems: Long-term diabetes and persistent high blood glucose can damage nerves throughout the body. One form of neuropathy, known as peripheral neuropathy, affects the legs and feet in particular, causing tingling, burning, pain, and/or numbness. Numbness can make it hard to feel blisters, scrapes, or cuts. These injuries may result in wounds that are slow to heal, or infections.
Treatments: Some people find pain relief with antidepressants, such as duloxetine (Cymbalta), and antiseizure medications, such as gabapentin (Neurontin). Maintain blood glucose control to prevent progression, and protect your feet by wearing shoes that fit well and never going barefoot—even around the house.