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Diabetes complications


Senior with diabetes using blood glucose analyser

What complications can develop from diabetes?

Health complications can occur when diabetes is not kept under control. These can range from mild to very serious so it’s very important to routinely test glucose levels and attend regular check ups. Please use the list below to familiarise yourself with common complications, symptoms and ways to prevent and treat each condition.

Common diabetes complications include:


Eye Problems- Retinopathy

Diabetic Kidney disease

Diabetic Neuropathy

Diabetic ketoacidosis

Foot Problems

What is atherosclerosis?

Atherosclerosis is a hardening of the arteries caused by a build up of fatty deposits, which cause the arteries to become blocked. This can lead to potentially life threatening conditions such as a heart attack or stroke. People with both type 1 and 2 diabetes are both at risk. Symptoms include chest pain, difficulty breathing, fatigue, confusion and weak muscles but in many cases there may be no obvious symptoms.

What causes atherosclerosis in people with diabetes?

High levels of glucose in the blood can damage the wall of the arteries which means that fatty deposits are more likely to form and block the arteries. This is why it is so important to manage and test your glucose levels.

How can I avoid atherosclerosis?

You can reduce your risk of atherosclerosis if you keep your diabetes under control and stick to a healthy balanced diet with plenty of exercise.

How is atherosclerosis diagnosed?

If your doctor or diabetes team think you might be at risk of atherosclerosis, they will recommend regular monitoring of your cholesterol and blood pressure levels. Your doctor may also recommend a ECG heart scan, CT scan or MRI scan before diagnosis.

How is atherosclerosis treated?

Treatment for atherosclerosis includes lifestyle changes like quitting smoking, healthy diet and regular exercise. You may also be prescribed medication such as statins to help lower cholesterol. If your arteries are blocked, angioplasty or surgery may be required.

For more detailed information on heart disease and strokes click here.

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Eye Problems – Diabetic Retinopathy

If you have diabetes, it’s very important that you have regular eye examinations at least once a year. A common complication of diabetes is damage to the retina at the back of the eye. If left untreated, vision can be affected and, in severe cases, can cause complete vision loss.  The retina needs a constant supply of blood, which it receives through tiny blood vessels. With diabetes, constant high glucose levels causes damage to the tiny vessels in the retina. Like most diabetes complications you are therefore more likely to develop eye problems if glucose levels are not kept under control.

Symptoms of diabetic eye problems

Not everyone will have any obvious symptoms but early symptoms you might experience are floaters or flashes, eye pain, sudden vision loss or worsening vision. If you experience any of these then you should visit your doctor or diabetes team immediately.

How are diabetic eye problems diagnosed?

If you have regular eye examinations, any changes to the eye should be picked up. Further tests may then be carried out to examine your eyes properly. The fluorescein angiogram eye test involves a fluorescent dye which is injected into a vein that travels to the eye. A special camera is then used to examine the eye for any swollen or abnormal blood vessels.

How is diabetic retinopathy treated?

If your condition is mild you may not require any treatment other than to keep your glucose levels under control and monitor blood pressure. If the eye problems are more serious, you may require laser treatment to seal leaks from blood vessels and stop new ones growing. Laser treatment won’t work if vision is already lost. Various eye operations may be required if you have a bleed or detached retina.

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Diabetic kidney disease

Diabetic kidney disease, commonly called diabetic nephropathy, is a complication of diabetes. It usually develops over many years but if left untreated it can cause kidney failure. Around 40% of people with diabetes will develop it.

What causes diabetic kidney disease?

Diabetic kidney disease is caused by raised glucose levels that result in the small blood vessels in the kidney becoming blocked. This causes the kidneys to leak proteins from the blood into the urine. The main protein that is leaked into the urine is called albumin.

Symptoms of diabetic kidney disease

Unfortunately, symptoms of diabetic kidney disease are not usually apparent until the disease is in its later stages, however symptoms may include:

  • Dry skin that may be itchy
  • Puffy eyes and swollen ankles, hands or lower legs caused by water retention.
  • Weight loss
  • Poor appetite
  • High blood pressure
  • Nausea
  • Darker urine
  • Anaemia
  • Difficulty thinking clearly

To prevent kidney disease reaching later stages, it is important to regularly test urine for the presence of the albumin protein.

How is diabetic kidney disease diagnosed?

A routine urine test usually detects the disease if it finds raised levels of albumin. If you have diabetes, you should therefore do regular urine tests. We sell a range of diabetic urine tests that can be carried out at home. A blood test may also be carried out to see how well the kidneys are working.

Risk factors for diabetic kidney disease

You are more at risk of developing any complication if your blood glucose levels are not kept under control. You are also more likely to develop the disease if you are overweight, have high blood pressure and if you are male.

Treatment for diabetic kidney disease

Your aim at treating kidney disease is to manage your blood glucose levels and blood pressure. There are several types of medication available which can help to lower blood pressure and reduce the loss of protein. However, if kidney damage becomes severe, you may require dialysis or a kidney transplant.

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What is Diabetic Neuropathy?

Diabetic neuropathy is nerve damage that can affect as many as 50% of people with diabetes. It develops over time as increased levels of glucose in the blood cause damage to the nerves. When the nerves become damaged they can no longer effectively carry messages around the body. It commonly affects the nerves in legs and feet.

Types of neuropathy

There are three main types of neuropathy:

  • Sensory neuropathy : as the name suggests this affects the nerves that detect touch, pain and temperature.
  • Motor neuropathy : this affects the nerves that control muscle movement.
  • Autonomic neuropathy : this affects the nerves that control your bodily functions such as heart rate, digestion, blood pressure or bladder and sexual function.

Symptoms of neuropathy

The type of symptoms you experience will depend on the type of neuropathy you have and what nerves are affected.  The most common symptom is a tingling or burning pain that spreads from your fingers or toes up through your limbs.  Other symptoms can include:

  • Nausea and vomiting
  • Diarrhoea or constipation.
  • Muscle weakness
  • Impotence
  • Dizziness or loss of co-ordination
  • Burning or stabbing pain in the affected area.

How neuropathy is diagnosed

Neuropathy is usually diagnosed based on your symptoms and a physical exam. Your  doctor will check your glucose levels, blood pressure, heart rate, muscle strength, reflex and your ability to move. Your doctor will ask if you have any sores that are not healing, which may require referral to a specialist.

Treatment for neuropathy

Treatment will depend on the severity and which nerves are affected. Often, the best treatment is to reduce high glucose levels and manage your diabetes with better lifestyle choices. Medication for nerve pain might be prescribed. Untreated neuropathy can put you at risk of infections due to cuts or sores that don’t heal. It’s therefore important you regularly check your body for sores.

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What is Diabetic Ketoacidosis?

Diabetic ketoacidosis, or DKA for short, is a potentially life threatening condition that occurs when the body runs out of insulin. It mainly affects people with Type 1 diabetes but can sometimes affect Type 2 sufferers.

What causes diabetic ketoacidosis?

Diabetic ketoacidosis is caused when your body doesn’t have enough insulin and is therefore unable to use glucose for energy. As a result, the body starts to burn fat for energy instead. When that fat is broken down,  harmful ketones are released into the blood.

Common causes of diabetic Ketoacidosis include:

  • Missing doses of insulin
  • Suffering from a urine infection or virus like flu
  • Pregnancy
  • Menstruation
  • Surgery
  • Steroids
  • Binge drinking and/or illegal drug taking

Symptoms of diabetic ketoacidosis

Symptoms of diabetic ketoacidosis can include any of the following:

  • Sickness and a pain in the stomach
  • Feeling very thirsty
  • Needing to pass urine more frequently.
  • Fatigue
  • Rapid heart rate
  • Fruity smelling breath

If you suspect you have DKA you should seek medical attention immediately.

How is diabetic ketoacidosis diagnosed?

You should be able to diagnose DKA yourself with a home test to detect ketones in the urine. If you have high levels then you should seek urgent medical attention immediately. The NHS website says:

If your blood sugar level is 11mmol/L or above, and you have a blood or urine ketone testing kit, check your ketone level.

If you do a blood ketone test:

  • lower than 0.6mmol/L is a normal reading
  • 0.6 to 1.5mmol/L means you’re at a slightly increased risk of DKA and you should test again in 2 hours
  • 1.6 to 2.9mmol/L means you’re at an increased risk of DKA and should contact your diabetes team or GP as soon as possible
  • 3mmol/L or above means you have a very high risk of DKA and should get medical help immediately

If you do a urine ketone test, a result of more than 2+ means there’s a high chance you have DKA and you should get medical help immediately. You can find out more by reading the instructions on these ketone tests: Ketone Tests

A doctor will diagnose ketoacidosis with either a urine or blood test.

When you have diabetes you should always do glucose checks and a urine test to check your levels whenever you feel unwell.

How is diabetic ketoacidosis treated?

Treatment usually involves giving insulin straight into the vein. You will also be given salts and fluids to re-hydrate the body. The doctors will closely monitor you to ensure no life threatening conditions develop.

How to prevent DKA

Managing your diabetes and regularly checking glucose levels can reduce your chances of developing DKA.

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Foot problems

What causes foot problems with diabetes?

When you have diabetes it’s important to take care of your feet. The arteries in the legs can become narrowed, resulting in poor circulation of blood to the feet.  If the blood supply is reduced then skin does not heal as well and foot ulcers can develop. If ulcers become infected this can lead to amputation of the foot if left untreated.

How to avoid foot problems

Firstly, you must control your blood glucose levels to avoid foot problems. You should also wash your feet regularly and dry them carefully before using a moisturiser to prevent cracked skin. Examine your feet daily, including in-between your toes, to check for any problems early one. If you notice anything new like cuts, bruises or blisters then you should see a podiatrist. Avoid walking barefoot to minimise the risk of treading on something and cutting the skin. Ensure your shoes and socks fit properly so that blisters, corns or calluses don’t develop.

How to treat foot problems

Though foot ulcers can be painful they are usually easily treated. If you have a problem with your feet you should see your doctor or podiatrist for help. The doctor will usually apply a dressing that will need to be cleaned and re-dressed regularly. If nearby tissue looks infected then antibiotics may be prescribed. If the arteries in the leg have become very narrowed an operation to widen them may be required.

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Please refer to each of our diabetes urine and blood tests for specific instructions. If in doubt, always consult your GP.