Type 2 Diabetes: Living With Complications

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Topic Overview

Is this topic for you?

This topic provides information for people who have complications from diabetes, such as eye, heart, blood vessel, nerve, or kidney` disease. If this topic does not answer your questions, see:

• Type 2 Diabetes, if you want to learn about type 2 diabetes but do not have the disease.
• Type 2 Diabetes: Recently Diagnosed, if you have been told recently that you have type 2 diabetes.
• Type 2 Diabetes in Children, if your child has been diagnosed with type 2 diabetes.
• Type 2 Diabetes: Living With the Disease, if you have type 2 diabetes. If you have not read the topic Type 2 Diabetes: Recently Diagnosed, you may want to read it first.
• Diabetic Retinopathy, Diabetic Neuropathy, or Diabetic Nephropathy, if you want more information on these complications of diabetes.

If you are looking for information about type 1 diabetes, see the topic Type 1 Diabetes.

What is type 2 diabetes?

Type 2 diabetes is a lifelong disease that affects the way your body uses food for energy. The disease develops when the cells of the body become resistant to insulin or when the pancreas cannot make enough insulin. Insulin is a hormone that helps your body's cells get the energy they need from sugar. When insulin is not able to do its job, too much sugar builds up in your blood. Over time, this extra sugar in your blood can lead to problems with your eyes, heart, blood vessels, nerves, and kidneys. It also makes you more likely to get severe illnesses or infections. When diabetes causes other problems, they are called complications.

What is it like to live with the complications?

Diabetes and its complications can change your life. Living with health problems caused by diabetes can be an ongoing struggle. It is a lot of work to monitor your health, keep up with your doctor appointments, and control your blood sugar. You may not always do everything exactly right, and it is normal to feel frustrated and sad at times. But don't give up. People with health problems from diabetes can still live full lives. If you are having trouble coping, talk to your doctor. Counseling or a diabetes support group may also help.

What are the complications from diabetes?

The complications from diabetes are:

• Hardening of the arteries (atherosclerosis). It can cause coronary artery disease, peripheral arterial disease, a stroke, or a heart attack.
• Diabetic retinopathy. This is a type of eye disease that has no early symptoms but can lead to vision loss.
• Diabetic nephropathy. This is kidney disease that has no early symptoms but can lead to kidney failure.
• Diabetic neuropathy. This is a nerve disease that can affect your internal organs as well as your ability to feel touch and pain, especially in your feet.

What are the symptoms?

Your symptoms will vary depending on which complications you have.

• Eye disease can cause vision problems, blindness, or (rarely) pain in your eyes.
• Heart disease can cause chest pain (also called angina) or shortness of breath when you exercise. You may have other symptoms, such as dizziness or lightheadedness, shoulder or stomach pain, or a racing heartbeat. Some people don't have any symptoms until they have a heart attack or a stroke.
• Circulation problems in your legs and feet (peripheral arterial disease) can cause changes in skin color, less feeling in your legs and feet, and leg cramps during exercise.
• Nerve disease causes different symptoms depending on which nerves are affected.
  • If the nerves related to feeling and touch are affected, it can cause tingling, numbness, tightness, burning, or shooting or stabbing pain in your feet, hands, or other parts of your body, especially at night. It is possible that you may not notice an injury, especially on your foot, until a severe infection develops. A bad foot infection can spread up your leg and into your bones. If this happens, the affected limb may need to be removed (amputated).
  • If the nerves that control internal organs are damaged, you may have digestion, bladder, or sexual problems. You may also sweat a lot or too little, feel dizzy or weak, or faint when you stand up. It may become hard to tell when your blood sugar is low.
• Kidney disease may not cause any symptoms at first. As time goes on, you may have swelling in your feet and legs and, later, throughout your body. It can also cause high blood pressure over time.

How are they treated?

The treatment for complications focuses on stopping or at least slowing down the damage. Depending on the problem, treatment may include medicine, surgery, or other therapies. Early treatment for a complication can help slow the damage and may prevent other problems.

Here are eight steps that people with diabetes can take to help keep health problems from getting worse.

1. Keep your blood sugar as close to normal as possible. Part of your daily routine includes checking your blood sugar levels regularly as advised by your doctor.
2. Eat a balanced diet and, if you are overweight, reduce your calorie intake so that you can lose some weight. Losing as little as 10 to 20 pounds can improve your blood sugar levels. There are many ways to manage how much and when you eat. Your doctor, a diabetes educator, or a dietitian can help you find a plan that works for you. Making these lifestyle changes may make you feel better and help control your blood sugar.
3. Exercise regularly. Get at least 30 minutes of exercise on most, preferably all, days of the week. Exercise helps control your blood sugar by using glucose for energy during and after activity. It also helps you to stay at a healthy weight, lower your total cholesterol, raise your HDL (good) cholesterol, and lower high blood pressure.
4. If you are age 30 or older, talk to your doctor about taking a low-dose aspirin each day. This may help prevent heart attack, stroke, or other large blood vessel disease.
5. Don't smoke. Smoking increases your risk for heart attack, stroke, and many other serious problems.
6. Control your cholesterol and keep your blood pressure lower than 130/80 by exercising regularly, eating a balanced diet, and taking medicine if necessary.
7. Take care of your feet. Wash and dry them carefully every day, and look for any sores or injuries that you may not feel because of nerve damage.
8. Have regular checkups every 3 to 4 months (or more if needed), and watch for signs of other problems. During these visits, your doctor will review your treatment and look for other problems. Also be sure to see your eye doctor and dentist regularly.

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Last updated:	August 09, 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