Long-Term Effects of Diabetes

Diabetes mellitus is a metabolic disease that can affect many systems in the body. Type 1 diabetes occurs when the pancreas does not produce insulin, which is necessary for the metabolism of glucose (sugar) in the body. Type 2 diabetes (also known as adult-onset diabetes) occurs when production of insulin is inadequate or the body is unable to properly utilize insulin. Long-term complications are most common in those with poorly-controlled diabetes.

Cardiovascular Disease

• Diabetes can cause cholesterol levels to increase, leading to cardiovascular (heart and vessel) disease. According to the National Diabetes Information Clearinghouse, fatty deposits (atherosclerosis) narrow the opening in the vessels throughout the body, so the heart has to pump harder to circulate the blood, causing the blood pressure to rise.

  The coronary arteries that feed the heart muscle may become clogged, depriving the heart muscle of adequate oxygen and causing angina (heart pain). Clots may form in the narrow vessels, break loose and travel to the heart (causing a heart attack), to the brain (causing a stroke) or to the lungs (causing a pulmonary embolism).

Peripheral Vascular Disease

• As the blood vessels narrow in the legs, peripheral circulation to the lower legs and feet becomes increasingly impaired, and the blood isn't able to carry enough oxygen to nourish the tissues, so the tissues damage easily and heal slowly. The lack of circulation may cause pain in the legs, especially when walking. In some cases, ulcers (open wounds) develop and may become gangrenous, leading to amputation of the toes and/or foot and sometimes part of the leg.

Eye Disease

• The National Eye Institute outlines the damage that diabetes causes in the eyes. Retinopathy, the most common disorder, occurs when the vessels in the eye do not adequately provide nourishment to the retina. Sometimes new vessels form on the retina to compensate, but these can interfere with vision. Diabetics are also at increased risk for cataracts and also for glaucoma, in which eye pressure increases as the eye fails to drain properly. The increased pressure damages the optic nerve and can cause blindness. Additionally, nerve damage associated with diabetes may prevent the pupil from reacting properly to light, interfering with vision, especially at night.

Neuropathy

• According to the NDIC, up to 70 percent of people with diabetes develop some degree of neuropathy (nerve damage) because of excess glucose levels. Neuropathy may range from slight numbness or tingling in the hands or feet to severe lack of sensation and pain and weakness. Neuropathy can affect various systems, such as the autonomic nervous system, resulting in impaired digestion with nausea, vomiting, constipation and/or diarrhea. It can impair urination so that the bladder fails to empty completely or the person doesn't feel the urge to urinate.

Erectile Dysfunction

• Diabetes is one of the primary causes of erectile dysfunction. An erection occurs when nerves send a message to the muscles of the corpus cavernosa in the penis to relax so that the spongy tissue can fill with blood. With diabetes, the nerve impulses are impaired, so the muscles don't relax adequately, and the circulation to the corpus cavernosa may be impaired as well so that the tissue can't fill with blood.

Kidney Disease

• High blood pressure and high glucose levels resulting from diabetes may damage the filtering parts of the kidney, the glomeruli. As blood is filtered through the kidneys, normal kidneys retain the proteins, returning them to the blood, and filter out waste products, sending them to the urine. According to the NDIC, when the glomeruli are damaged so that they can't filter properly, protein begins to leak into the urine, and waste products build up in the blood. Over time, the kidneys may fail to function completely as more damage occurs, and the person may need dialysis to remove waste from the blood.

Periodontal Disease

• Circulatory impairment of the vessels that provide oxygen and nourishment to the gums can lead to periodontal disease and tooth loss in those with diabetes.