Diabetes Side Effects and Comorbidities

When an individual has diabetes, it requires a lifestyle change. If changes aren’t made, diabetes can lead to other health conditions.

As a person with diabetes, it is important to fully follow the plan that is given by a healthcare provider to help your condition and possibly prevent long-term complications.

This article outlines comorbidities that can occur alongside diabetes.

Cardiovascular Disease

Research shows it is common that people with diabetes also have cardiovascular disease and other heart-related issues. These conditions are intertwined and can create complications.

It is possible for people who have longstanding diabetes and heart-related conditions to develop other complications such as:

• Stroke
• Congestive heart failure
• Coronary artery disease
• Peripheral vascular disease

When a person has type 2 diabetes, their risk for cardiovascular mortality and morbidity is higher than those who do not have diabetes. This is due to the lack of glycemic control.

Other risk factors include:

• Obesity
• Smoking
• Lack of physical activity

All of these are factors of both conditions.

Research shows that when a person has type 1 diabetes, cardiovascular disease is a major cause of mortality. It is important to work with a healthcare professional to understand your conditions and follow the specified treatment plan related to both.

Dry Mouth

Diabetes can cause too much glucose in the blood. As a result, this can cause infection, pain, and dryness in the mouth.

High amounts of glucose will reduce the ability of saliva to produce effectively. When there are high glucose levels in the saliva, this increases the growth of bacteria. This can also increase the risk of:

• Gum disease
• Plaque
• Tooth decay

Some of the symptoms along with dry mouth include:

• Pain
• Cracked lips
• Mouth infection
• Problems eating
• Problems swallowing
• Problems talking

Along with taking your medicine prescribed by a healthcare provider, other treatments that can help include:

• Consuming frequent sips of water
• Rinsing the mouth with fluoride to prevent cavities
• Avoiding caffeine, tobacco, and alcohol
• Consuming sugarless gum or mints to increase the flow of saliva
• Avoiding foods with high amounts of sodium and foods that are spicy
• Using a humidifier at night
• Having a good oral hygiene regimen

It is important to develop a treatment plan with your healthcare professionals. Both a healthcare provider and dentist can help with a plan that is effective.

Erectile Dysfunction

Research has shown that erectile dysfunction is known to be a complication of diabetes. It is also an under-reported and under-diagnosed condition. Therefore, treatment and the age of diagnosis are delayed.

People who are older and have poor glycemic control are known to have a higher risk of getting severe erectile dysfunction

Fatigue

Fatigue is known as mental or physical exhaustion. It can be triggered by:

• Overwork
• Physical illness
• Medication
• Stress
• Disease
• Mental illness

When a person is fatigued, it can impair the mental and physical function for both short-term and long-term activities. Studies recommend that if an individual presents with complaints of fatigue, a healthcare professional should conduct a focused medical and endocrine checkup.

Fatigue is a common factor for both type 1 and type 2 diabetes. Along with diabetes medication, there are other risk factors of fatigue, including:

• Inflammation
• Depression
• Poor diet
• Lack of exercise and physical activity
• Poor sleep habits
• Excess weight

Some people with diabetes become depressed, which is another condition that is, at times, diagnosed as fatigue.

It is important to speak with a healthcare professional about your specific symptoms so they can accurately diagnose the condition. If the lifestyle, nutritional, and medical factors are ruled out, a targeted gluco-endocrine evaluation should be done to determine a diabetes fatigue syndrome diagnosis.

Foot Ulcers

Diabetic foot ulcers occur in approximately 15% of people with diabetes. The length of time a person has had diabetes is a factor as to whether or not a patient will get a foot ulcer.

The condition can result from:

• Numbness in the foot
• Poor circulation
• Foot deformities

About 6% of people with diabetes could be hospitalized due to complications or infections of a foot ulcer.

If a person has type 1 or type 2 diabetes, they can get a foot ulcer. Certain individuals are at higher risk, including those who:

• Have peripheral vascular disease
• Have neuropathy
• Have poor glycemic control
• Smoke cigarettes
• Have diabetic nephropathy
• Have had previous foot ulcerations/amputations
• Use insulin
• Are overweight
• Consume alcohol

People who have diabetes-related eye disease, heart disease, and kidney disease are also at a higher risk.

Treatment for diabetic foot ulcers includes:

• Applying medication or dressings to the ulcer
• Managing blood glucose
• Taking the pressure off the area
• Removing dead skin and tissue

Ulcers are not always infected. If one does become infected, see a healthcare professional regarding proper medication and care.

Gum Disease

Gingivitis or gum disease occurs when plaque builds up around your teeth and inflammation in the gums occurs. For people who have diabetes, the inflammatory response to the plaque is greater.

Some of the symptoms of gum disease include:

• Loose teeth
• Sensitive teeth
• Gums that are swollen, red, or bleeding
• Bad breath

If a person does have gum disease and it goes untreated, it can turn into periodontitis. This is an infection that damages the soft tissue of the gum, and it can damage the bones that support your teeth.

Some of these suggestions can help prevent gum disease:

• Avoid acidic drinks—they are known to erode the enamel on the teeth
• Floss regularly
• Regularly brush your teeth and gum line gently
• Brush your tongue to help get rid of bacteria

It is important to go to regularly scheduled dental and healthcare provider appointments. Healthcare professionals can help you create a plan and possibly prevent complications.

Hearing Loss

A large number of people have both hearing loss and diabetes. It is estimated that 34.5 million people have hearing loss and more than 34 million people in the United States have diabetes.

A recent study reported that hearing loss is twice as common with people who have diabetes. It is speculated that high blood glucose levels in diabetic patients may cause damage to the small blood vessels in the inner ear. However, more research needs to be conducted to confirm this theory.

Although hearing loss is gradual over time, it is important to look for symptoms. Some of the signs of hearing loss are the following:

• Turning up the television to a volume that is too loud
• Asking people to repeat themselves
• Trouble following conversations that have more than two people

If you feel you are experiencing hearing loss, contact a healthcare provider so they can assist you in getting the help that you need.

Hypoglycemia

Hypoglycemia happens when the blood sugar falls below a certain range. If the blood sugar falls below 70 mg/dL, that is considered too low. It is important to check with a healthcare professional about your specific numbers.

If you are diabetic and hypoglycemic, this may cause an insulin shock.

Some ways to stay current with your blood sugar numbers is to:

• Regularly check your blood sugar
• Use a monitor
• Keep an eye out for symptoms

Hypoglycemia symptoms include:

• Being nervous or anxious
• Sweating or chills
• Irritability or impatience
• Confusion
• Tiredness
• Feeling weak or having no energy
• Blurred/impaired vision
• Tingling or numbness in the lips, tongue, or cheeks
• Headaches
• Clumsiness
• Nightmares or crying out during sleep
• Seizures

If you have any of these symptoms, contact a healthcare provider right away.

Kidney Failure

The kidneys are an important function of the body. Diabetes is the leading cause of kidney disease. In fact, about one out of three adults with diabetes have kidney disease

A healthy kidney filters waste out of the bloodstream and controls blood pressure. If a kidney is not healthy, it can’t filter properly and the waste will build up.

An unhealthy kidney can also lead to other health problems. If a person has diabetes over a period of years, the kidney will become damaged, disease can occur, and eventually kidney failure can occur. This is due to the blood pressure and glucose being too high.

It is important to talk to a healthcare provider and check your kidneys to make sure they are healthy. It is recommended that you get tested every year if you have type 2 diabetes and if you’ve had type 1 diabetes for more than five years.

If a person has diabetes and is not active, eats foods high in sodium, doesn’t follow the eating plan, smokes, has heart disease, or is obese, they are at an increased risk of developing kidney disease and/or failure.

Memory Loss

When a person has diabetes, it may increase the risk of memory loss and other cognitive problems.

When the blood glucose is higher than normal, it is known to damage nerve cells and blood vessels in the body and brain. Diabetes is also known to damage the capillaries which could also cause a slow progression of memory loss.

Research has shown that people with type 2 diabetes could have a higher risk of developing dementia. Overall, if the diabetes is not properly controlled, the chances of having complications with memory are higher. It is important to manage your condition and follow the plan provided by a healthcare provider.

Neuropathy

Diabetic neuropathy happens when there is nerve damage due to diabetes. There are different types with different symptoms. Some of the symptoms affect the internal organs, heart, and bladder.

A person who has this condition may experience pain and numbness in the feet and issues with internal organs.

With diabetic neuropathy, nerve damage happens over time. This is due to the high blood sugar, and high levels of triglycerides in the blood due to diabetes. There are different types of diabetic neuropathy, and the symptoms for each vary. These include:

• Peripheral neuropathy: This is very common and is known to affect primarily the feet and legs. There are times that the arms and hands are affected too. Approximately one-half to one-third of patients with diabetes have peripheral neuropathy.
• Autonomic neuropathy: This affects the nerves that control the internal organs. It is also known to lead to hypoglycemic unawareness. This can create complications with the digestive system, bladder, sweat glands, eyes, heart rate, and blood pressure.
• Focal neuropathies: This causes damage to single nerves that are common in the head, leg, torso, or hand. Carpal tunnel syndrome is the most common type of this condition.
• Proximal neuropathy: This typically affects one side of the body. The areas that are impacted are the buttock, thigh, and hip. The symptoms are known to improve over a period of months or years.

Obstructive Sleep Apnea

Obstructive sleep apnea commonly affects people who have type 2 diabetes. Research shows that up to 83% of people with type 2 diabetes have this condition.

There is an association between this condition, insulin resistance, and glucose intolerance. More research needs to be done to conclude that treatment of obstructive sleep apnea can prevent the compilations and development of type 2 diabetes.

Skin Infections

Diabetes affects the skin in different ways. Sometimes, certain problems with the skin such as itching, fungal infections, and bacterial infections are a sign that a person has the condition. If an individual has diabetes, they are known to get these types of skin conditions easier.

Other skin conditions that people specifically with diabetes could develop include:

• Acanthosis nigricans: This appears on the side of the armpits, neck, and groin as tan or brown raised areas. They can occasionally appear on the hands, knees, and elbows.
• Diabetic dermopathy: These are patches that are circular or oval. The texture and color are scaly and light brown. They primarily appear on the front of the legs. The patches are not known to hurt or itch.
• Necrobiosis lipoidica diabeticorum: This is a rare condition that is commonly known to affect adults assigned female at birth. Necrobiosis lipoidica diabeticorum begins as a raised area that is red and dull. Over time it develops into a shiny scar with a violet border. This skin condition is known to be painful and itchy, and the spots may crack open. If this happens, contact a healthcare provider to get treatment.

Vision Impairment

When an individual has diabetes, they can develop problems with their eyes. Diabetic retinopathy can cause complete blindness and vision loss in people with diabetes.

This condition affects the blood vessels in the retina. Diabetic retinopathy can lead to:

• Neovascular glaucoma: This happens when fluid is blocked from draining out of the eye due to abnormal blood vessels growing out of the retina.
• Diabetic macular edema: When this condition occurs, the vision becomes blurry because there is extra fluid in the macula. The extra fluid is due to the blood vessels in the retina that leak fluid and cause swelling in the macula area of the eye.

Although there are no direct symptoms, it is important to notice any changes in the eyes. As a person with diabetes, it is important to get an eye exam once a year, including a comprehensive dilated exam. This can help with prevention and vision protection.

A Word From Verywell

If you are an individual who is living with diabetes, it is important to follow the plan that a healthcare provider has created for you. It is also important to educate yourself on your condition so you can have a healthy quality of life and prevent any complications. If you have questions or concerns about your condition, a healthcare provider can help.