Complications of diabetes
If you have type 1 diabetes or type 2 diabetes, you might develop complications. These include problems with your eyes, feet, kidneys and heart. Keeping your diabetes under good control will reduce your chances of having problems.
Eyes and diabetes
If you have diabetes, you will need regular eye checks because you have an increased risk of several eye problems. Diabetes eye damage needs to be picked up as early as possible for it to be successfully stopped or treated. If it is not picked up early it can lead to the loss of part or all of your sight.
Types of eye disease that affect people with diabetes
Over time, high blood sugar levels damage the blood vessels at the back of your eye (retina). This is known as diabetic retinopathy. Changes can range from mild to severe affecting your sight and possibly leading to blindness. You can have early diabetic retinopathy without knowing it. There are treatments that can slow the disease and save your sight if they are done early enough.
Glaucoma is an increase in pressure inside your eye that can make you lose your vision. People with diabetes are almost twice as likely to develop it than people without diabetes. You can get your eyes checked for signs of glaucoma when you have your diabetes eye check.
A cataract is when the eye's clear lens gets cloudy, blocking light. People with diabetes are twice as likely to develop this eye condition. This develops faster with tamariki and teens with diabetes.
Diabetes eye checks (retinal screening)
It is very important you have your eyes regularly checked to preserve your sight. A diabetes eye check will pick up any damage to your eyes so it can be treated early. This is different to a normal eye check for your glasses.
Do not wait until you notice changes to your sight before you have your eyes checked.
- If you have type 1 diabetes, you should have a diabetes eye check 5 years after being diagnosed with diabetes. Then have one at least every 2 years.
- If you have type 2 diabetes, you should have a diabetes eye check when you are first diagnosed with diabetes. Then have one at least every 2 years.
Your eye‑care professional may recommend you have a diabetes eye check more often. You do not have to pay for a diabetes eye check.
Your healthcare provider or diabetes clinic team will refer you to have the eye check.
Nerves and diabetes
Diabetes can damage the nerves that travel between your spinal cord and your muscles, skin and other parts of your body. This is called neuropathy.
Feet and diabetes
Diabetes can damage the nerves (neuropathy) and blood vessels (vascular disease) to your feet. This can affect the feeling you have in your feet and the circulation around your feet.
These changes can lead to problems with your feet such as infections and ulcers. Severe foot disease can lead to you losing toes or even your whole foot (amputation).
It is important to pick up any signs of damage early. You should check your own feet every day and also get them checked by your healthcare provider or podiatrist once a year.
Kidneys and diabetes
Diabetes can damage the small blood vessels and delicate filtering system in your kidneys. This is called diabetic nephropathy and it is the main cause of chronic kidney disease (CKD).
Kidney damage caused by diabetes happens slowly, but it does not happen to everyone with diabetes. It is more likely in people who:
- have poorly controlled blood glucose levels
- have high blood pressure
- smoke.
Your healthcare provider may use several tests to diagnose diabetic nephropathy. These include:
- blood tests that look at your kidney function
- urine tests that measure the amount of protein in your wee
- renal ultrasound, which measures the size of your kidneys (kidneys can get smaller with diabetic nephropathy).
Any treatment for diabetic nephropathy aims to slow down damage to your kidneys. It includes:
- keeping your blood glucose well controlled
- keeping your blood pressure well controlled
- starting medicines to lower your cholesterol levels.
If your diabetic nephropathy becomes severe, you will need treatment for CKD.
Heart and diabetes
Diabetes increases your risk of getting cardiovascular disease (CVD). This means there is a higher risk that you will have a heart attack or a stroke.
Your healthcare provider can help you do a heart risk assessment or you can use the My Heart Check tool yourself. This gives an estimate of how likely you are to have a heart attack or stroke within the next 5 years.
It is important to have regular checks for the other things that increase your risk of cardiovascular disease such as:
- high blood pressure
- high cholesterol
- kidney disease.
Learn to recognise the signs of a heart attack and stroke so you can quickly get help for yourself or someone close to you.
Diabetic ketoacidosis (DKA)
If you have type 1 diabetes, you can be at risk of diabetic ketoacidisis. This happens when your blood sugar levels are low and your body has to burn fat for energy. This releases toxic acids called ketones into your blood and can be dangerous.