10 health issues that can come from having diabetes

When diabetes is not well-controlled, it can lead to additional health problems (known as complications) over time. Some people develop heart disease, for example. Others experience vision loss. Still others develop kidney disease. The good news is that there are things that can help prevent these issues.

"Preventing complications is pretty straightforward," says Steve Edelman, MD, founder of the organization Taking Control of Your Diabetes (TCOYD). "Keep your blood sugar levels as close to normal as possible to prevent and delay the progression of eye, kidney, and nerve disease."

Here are 10 diabetes complications you can learn to prevent or delay.

People with diabetes are at least twice as likely to have a heart attack or stroke. They're also more likely to have a heart attack or stroke at an earlier age. To reduce your risk, work on lowering your blood pressure and levels of cholesterol (a fat-like substance in the blood). You can do this with lifestyle changes that include getting regular exercise as you are able and eating a diet that's low in salt and saturated fat (which is solid at room temperature, like butter), and that includes fruits, vegetables, lean protein and whole grains. If lifestyle changes alone do not work, talk to a healthcare provider (HCP) about medication for high blood pressure and/or high cholesterol. It's also important to quit smoking (if you smoke) and to try to maintain a weight that's healthy for you.

Blurry vision. Floating spots. Distorted images. Having consistent high blood sugar (or glucose) levels can damage the blood vessels that feed your retina. This is the sensitive part of your eye that detects light and images. Damage to the retina can cause an eye problem called diabetic retinopathy.

Diabetic retinopathy often starts with no symptoms, but over time, it can destroy your eyesight and cause vision loss. In fact, diabetes is the leading cause of blindness in adults between the ages of 20 and 74. To prevent retinopathy, watch your blood sugar levels closely and see an eye specialist once a year for a complete eye exam.

Think of your kidneys as your body's filtration system. When blood vessels in the kidneys are damaged by excess blood sugar, your kidneys can't filter toxins. You end up with high levels of protein in your urine and waste products in your blood. Over time, your kidney function gets worse. And this can lead to kidney failure, dialysis, or a kidney transplant.

"Diabetes with hypertension [high blood pressure] is now the number one cause of end-stage kidney disease," says Betul Hatipoglu, MD, an endocrinologist in Cleveland, Ohio. Ask your HCP about routine tests to detect proteins in your urine. To keep your kidney disease from getting worse, your HCP may also prescribe medication to lower your blood pressure.

Up to 70 percent of people with diabetes have some degree of damage to their nervous system, known as neuropathy. The damage can result in loss of feeling or pain in the hands or feet, slow digestion of food in the stomach, carpal tunnel syndrome in the wrists (a condition that affects a nerve in your wrist and causes hand pain or tingling), or other nerve problems. Mild neuropathy may go completely unnoticed. Severe neuropathy—most likely involving the feet and lower limbs—may lead to loss of feeling that increases your risk for injury and infections that require amputation. To help prevent neuropathy, get a diabetes foot exam that tests your sensation every year.

Gastroparesis, a form of neuropathy, interferes with the emptying of the stomach and leads to poor digestion. In people with diabetes, it's often caused by chronic periods of high blood sugar levels.

"Food can get stuck in stomach because the nerves aren't working right, so the food isn't passing into the intestines," says Melinda Maryniuk, RD, CDE, a diabetes nutrition consultant and former director of clinical education programs for the Joslin Diabetes Center in Boston. The result may be digestive problems, such as heartburn, stomach pain, constipation, and weight loss. If you have diabetes and problems with digestion, talk to your HCP about getting tested for gastroparesis.

Daibetes thatis not well-controled can lead to sexual dysfunction. Men and people assigned male at birth who have diabetes are two to three times more likely to have erectile dysfunction (difficulty achieving erection) than those who do not. Women and people assigned female at birth may experience vaginal dryness, pain during intercourse, or loss of libido (low sex drive). If you're having problems with your sex life due to diabetes, talk to your HCP about treatment options.

Managing diabetes can be stressful and exhausting. Demands such as paying attention to what you eat, the cost of care, and frequent blood sugar testing, may contribute to feelings of depression. Depression can get in the way of appropriate diabetes care. If you feel sad or hopeless due to diabetes, talk to your HCP. They may refer you to a mental health professional, recommend medications, or a combination of both.

Most people experience a little hearing loss with age. But people with diabetes often have worse hearing loss, especially if the disease isn't well-controlled. In fact, according to the American Diabetes Association, the rate of hearing loss is 30 percent higher in people with diabetes than it is in people without diabetes. That's because hearing relies on small blood vessels and nerves in the inner ear. High blood sugar levels can damage those vessels and nerves, which affects hearing. Ask your HCP for a hearing test if you or people around you notice that you're having trouble hearing.

High blood sugar levels can cause poor blood flow to your brain, increasing the risk for dementia or Alzheimer's. Research has shown that people with diabetes have more deterioration in the parts of their brain where problem-solving, decision-making, and memory take place. Due to the effects of diabetes on the brain, they also had more depression, walked slower, and had more problems with balance. The best prevention is to keep your blood sugar levels as close to your target range as possible.

Having diabetes puts you at risk for periodontal disease (gum disease). Over time, gum disease breaks down the bone and tissue that hold your teeth in place, which can lead to infection and tooth loss. If you have diabetes, your risk of gum disease is higher due to your body's lower resistance to infection. The high-sugar environment (brought on by high blood sugar levels) also gives bacteria in your mouth a chance to thrive. The more bacteria in your mouth, the higher your chances of having gum disease or tooth decay.

Diabetes can also cause dry mouth, mouth infections, and cavities, too. If you have diabetes, it's important to see a dentist at least twice a year, maybe more. And be sure to practice good oral hygiene, including regular brushing, flossing, and rinsing every day.