If diabetes is not reversed then the excessive levels of glucose can have devastating health consequences. And there are a number of conditions, complications and dangerous side effects that can develop from diabetes.
The likelihood of developing these complications depends on duration and the severity of high blood glucose (1). Having high blood sugar levels causes oxidative stress which damages the blood vessels and leads to many of the complications associated with diabetes (2).
The complications include, but is not limited to: damage to the eyes kidneys, legs and feet and also heart-related problems (1).
In the United States, diabetes is the leading cause of preventable amputations, blindness and kidney failure. Untreated or poorly managed diabetes can be fatal, either killing you suddenly or drastically shortening your lifespan. Reversing your diabetes is the best way to reduce the likelihood of suffering any of the following diabetes-related health conditions(3).
Retinopathy (Damage to the retina in the eye)
Diabetic retinopathy refers to vascular disease that damages the retina, which is located in the eye. High blood glucose damages the nerves and this prevents the blood flow of nutrients to the retina. Over time the damage can become so severe that the retina detaches from the eye (4).
Diabetic retinopathy is the most common complication of diabetes. It is the leading cause of blindness among adults aged 20-74 years (5). In the United States alone, there are 10,000 new cases of blindness every year due to diabetic retinopathy (1). Along with poor glucose control, the duration of living with diabetes, hypertension and high levels of cholesterol all increase the risk of retinopathy (6).
Nephropathy (Damage to the kidneys)
Diabetic nephropathy is kidney disease caused by high blood glucose. High blood glucose levels damages the vessels in the kidney that filter out waste from our body. Damage to these vessels reduces the kidneys efficiency meaning that they are less able to filter out that waste. This toxic build-up can eventually lead to kidney failure (7).
Diabetic nephropathy is the leading cause of renal failure in the United States. Kidney disease also increases the likelihood of developing heart complications such as stroke and coronary heart disease (8).
Neuropathy (Damage to the nerve fibres)
Prolonged levels of high blood glucose damage nerve fibers. This prevents the nerves from sending signals properly and is most easily noticed by the patient as they often feel tingling feeling in their limbs as a first sign of this damage. The damage also prevents oxygen and nutrients from being delivered to the extremities (9).
Individuals with diabetes are 15 times more likely to have amputation of the lower-extremities (10). By the time people are diagnosed, approximately 8% of them are already suffering from diabetic neuropathy. In the long term, more than 50% of type 2 diabetics who do not reverse their condition go on to develop neuropathy, which can lead to the amputation of lower extremities (6). Neuropathy is also thought to play a role in impaired wound healing and erectile dysfunction (6).
Diabetes is a major risk factor for cardiovascular disease and it is the most common cause of death in adults with diabetes (11), with 80% of diabetics dying from a heart-related issue (12). Diabetic are 2-4 times more likely to suffer from cardiovascular disease (3).
There is a strong relationship between glucose levels and the development of atherosclerotic plaque, which is an important factor for heart disease (13). An autopsy study revealed that people with higher HbA1c had greater atherosclerotic plaque development (14). High blood glucose levels induce oxidative stress and this accelerates the development of atherosclerosis (15). Insulin resistance also speeds up the development of atherosclerosis by increasing inflammation and blood cholesterol (16).
Another complication that is associated with diabetes is strokes. Studies have found that people with diabetes were 5 times more likely to suffer from a stroke than people without diabetes. What was even more worrying about this finding was that the people were under the age of 65 (17). Every year the risk of a stroke increases by 3% in comparison to people without diabetes and after 10 years the risk of a stroke triples every year (18).
As previously mentioned, higher blood glucose levels speed up the development of an atherosclerotic plaque. Also, atherosclerotic plaque development occurs more rapidly through insulin resistance. Atherosclerotic plaque can block our blood vessels and result in a stroke (16).
Erectile dysfunction is another disorder associated with diabetes. If you are unable to control your diabetes then you have a higher risk of developing erectile dysfunction. A study found that people with a HbA1c level above 7.5% were nearly 8 times more likely to suffer from erectile dysfunction compared to people with a normal HbA1c level (19).
Obesity increases the risk of erectile dysfunction. Physical activity has shown to reduce the risk of developing erectile dysfunction, even in type II diabetics (20). Damaged nerves can restrict penile blood flow, which is required for erections. Also, obesity which is strongly associated with type II diabetes reduces levels of testosterone and this also contributes to erectile dysfunction (21).
The prevalence of depression is also greater in people with diabetes. Diabetic have been shown to be over 20% more likely to have depression compared to people without diabetes (22). One study also found that diabetics suffering from depression are more likely to die earlier than diabetes without depression (23).
There are a number of factors that may link diabetes and depression. Many social issues such as childhood adversity, deprived neighborhood, environment, and financial barriers are associated with both diabetes and depression (24). Chronic inflammation, which is elevated in diabetes, is also increased in many cases of depression (25).
With the large number of complications associated with type II diabetes, it is not surprising that type II diabetes increases the risk early death. A large study in the UK examined the risk that type II diabetes poses on early mortality in middle-aged adults (26). The study included 87098 people between 40-65 years of age. The study found that people with type II diabetes had double the risk of death from any cause and triple the risk of death from cardiovascular disease compared to people of the same age without type II diabetes (26).
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- Pitocco D, Tesauro M, Alessandro R, Ghirlanda G, Cardillo C. Oxidative stress in diabetes: implications for vascular and other complications. International journal of molecular sciences. 2013 Oct 30;14(11):21525-50.
- Reusch JE. Diabetes, microvascular complications, and cardiovascular complications: what is it about glucose?. Journal of Clinical Investigation. 2003 Oct 1;112(7):986.
- Cardoso CR, Leite NC, Dib E, Salles GF. Predictors of Development and Progression of Retinopathy in Patients with Type 2 Diabetes: Importance of Blood Pressure Parameters. Scientific Reports. 2017;7.
- Forbes JM, Cooper ME. Mechanisms of diabetic complications. Physiological reviews. 2013 Jan 1;93(1):137-88.
- Pálsson R, Patel UD. Cardiovascular complications of diabetic kidney disease. Advances in chronic kidney disease. 2014 May 31;21(3):273-80.
- Most RS, Sinnock P. The epidemiology of lower extremity amputations in diabetic individuals. Diabetes care. 1983 Jan 1;6(1):87-91.
- MEMBERS WG, Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, Dai S, Ford ES, Fox CS, Franco S. Heart disease and stroke statistics—2014 update: a report from the American Heart Association. circulation. 2014 Jan 21;129(3):e28.
- Martín-Timón I, Sevillano-Collantes C, Segura-Galindo A, del Cañizo-Gómez FJ. Type 2 diabetes and cardiovascular disease: have all risk factors the same strength?. World journal of diabetes. 2014 Aug 15;5(4):444.
- Ledru F, Ducimetière P, Battaglia S, Courbon D, Beverelli F, Guize L, Guermonprez JL, Diébold B. New diagnostic criteria for diabetes and coronary artery disease: insights from an angiographic study. Journal of the American College of Cardiology. 2001 May 31;37(6):1543-50.
- Burchfiel CM, Reed DM, Marcus EB, Strong JP, Hayashi T. Association of diabetes mellitus with coronary atherosclerosis and myocardial lesions: an autopsy study from the Honolulu Heart Program. American journal of epidemiology. 1993 Jun 15;137(12):1328-40.
- Kayama Y, Raaz U, Jagger A, Adam M, Schellinger IN, Sakamoto M, Suzuki H, Toyama K, Spin JM, Tsao PS. Diabetic cardiovascular disease induced by oxidative stress. International journal of molecular sciences. 2015 Oct 23;16(10):25234-63.
- Lee M, Saver JL, Hong KS, Song S, Chang KH, Ovbiagele B. Effect of pre-diabetes on future risk of stroke: meta-analysis. BMJ. 2012 Jun 7;344:e3564.
- Khoury, Jane C. et al. “Diabetes: A Risk Factor for Ischemic Stroke in a Large Bi-Racial Population.” Stroke; a journal of cerebral circulation 44.6 (2013): 1500–1504. PMC. Web. 24 Oct. 2017.
- Banerjee C, Moon YP, Paik MC, Rundek T, Mora-McLaughlin C, Vieira JR, Sacco RL, Elkind MS. Duration of diabetes and risk of ischemic stroke. Stroke. 2012 May 1;43(5):1212-7.
- Weinberg AE, Eisenberg M, Patel CJ, Chertow GM, Leppert JT. Diabetes severity, metabolic syndrome, and the risk of erectile dysfunction. The journal of sexual medicine. 2013 Dec 1;10(12):3102-9.
- Binmoammar TA, Hassounah S, Alsaad S, Rawaf S, Majeed A. The impact of poor glycaemic control on the prevalence of erectile dysfunction in men with type 2 diabetes mellitus: a systematic review. JRSM open. 2016 Feb 12;7(3):2054270415622602.
- Traish AM, Feeley RJ, Guay A. Mechanisms of obesity and related pathologies: androgen deficiency and endothelial dysfunction may be the link between obesity and erectile dysfunction. The FEBS journal. 2009 Oct 1;276(20):5755-67.
- Nouwen A, Winkley K, Twisk J, Lloyd CE, Peyrot M, Ismail K, Pouwer F, European Depression in Diabetes (EDID) Research Consortium. Type 2 diabetes mellitus as a risk factor for the onset of depression: a systematic review and meta-analysis.
- van Dooren FE, Nefs G, Schram MT, Verhey FR, Denollet J, Pouwer F. Depression and risk of mortality in people with diabetes mellitus: a systematic review and meta-analysis. PloS one. 2013 Mar 5;8(3):e57058.
- Holt RIG, de Groot M, Golden SH. Diabetes and Depression. Current diabetes reports. 2014;14(6):491. doi:10.1007/s11892-014-0491-3.
- Penckofer S, Doyle T, Byrn M, Lustman PJ. State of the science: depression and type 2 diabetes. Western journal of nursing research. 2014 Oct;36(9):1158-82.
- Taylor KS, Heneghan CJ, Farmer AJ, Fuller AM, Adler AI, Aronson JK, Stevens RJ. All-cause and cardiovascular mortality in middle-aged people with type 2 diabetes compared with people without diabetes in a large UK primary care database. Diabetes Care. 2013 Aug 1;36(8):2366-