Complications

People with diabetes, whether type 1 or Type II, have an increased risk of severe complications if the disease goes undiagnosed and untreated -- or if it is poorly managed. High blood glucose levels make it easier for blockages to form in the blood vessels that supply the heart, brain, and legs as well as the rest of the body. High blood glucose can also damage nerves, causing numbness and tingling -- especially in the legs and feet.

Diabetes-related damage to a person's circulatory and nervous systems increases the risk of heart attacks, strokes, blindness, kidney failure, and foot and leg amputations. The good news is that early diagnosis and aggressive treatment of diabetes can help keep these complications from developing.

Other Complications.

People with diabetes are at higher risk for influenza and its complications, including pneumonia, possibly because the disorder neutralises the effects of protective proteins on the surface of the lungs. Scaly and hardened skin may develop after a patient has had diabetes for many years. Such skin changes may be indicators of other complications, including retinopathy. There has been some concern that Type I diabetics are at risk for bone-density loss, although a recent two-year study found little basis for alarm. Longer studies are needed. Type I Diabetes also appears to increase the risk for celiac disease, an allergy to gluten, found in corn and wheat. Both women and men with diabetes appear to have a higher risk for colon and rectal cancers.

Specific Complications for Adolescents.

Blood sugar control is a major problem in adolescents with Type I Diabetes, who are at high risk for permanent damage in small vessels, such as those in the eyes. Up to one third of young women with Type I Diabetes have eating disorders resulting in under use of insulin to lose weight. Anorexia and bulimia pose significant health dangers, particularly in people with diabetes. One study found that young people with diabetes have a higher than average rate of suicidal fantasies. Although the actual rate of suicide was no higher than that of their non-diabetic peers, such thoughts are strongly associated with self-destructive behavior, including low treatment compliance. Adolescents with diabetes are at higher risk than adults for ketoacidosis resulting from non-compliance.

Specific Complications in Women.

Both temporary diabetes that occurs during pregnancy (gestational diabetes) and pregnancy in a patient with existing diabetes can increase the risk for birth defects. Because glucose crosses the placenta, hyperglycemia can be passed on to the foetus. In response to abnormally high blood glucose levels, the foetus secretes large amounts of insulin. This combination of high foetal blood levels of both insulin and glucose leads to excessive foetal growth. It may also delay maturation of the lungs or cause the death of the foetus. Diabetes also presents risks to the pregnant woman, particularly preeclampsia, a potentially dangerous condition involving very high blood pressure. Studies indicate that hyperglycemia may effect the developing foetus as soon as it is conceived. Diabetic women who want to become pregnant should be diligent about controlling blood glucose levels before and during pregnancy.

Diabetes appears to affect female hormones. It seems to blunt the beneficial effects of oestrogen, increasing the risk for heart disease. Women with Type I Diabetes often have lumps in the breast that are benign but which make mammograms difficult to interpret. It is not clear whether these lumps are risk factors for breast cancer. One study indicated that women with diabetes have a higher risk for endometrial cancer and possibly for breast cancer. They also have a higher risk for early menopause, which, in one study, occurred at an average age of about 41 years.