Diabetes complications

With regular screening, blood tests and effective diabetes management, the incidence of complications can be greatly reduced or prevented. Short term complications such us high blood glucose levels (hyperglycaemia) or low blood glucose levels (hypoglycaemia) are part of daily life with diabetes, and the risk of severe hypoglycemia and diabetes keto-acidosis (DKA), in particular in those with Type 1 diabetes, is always a side effect of insulin treatment (or the lack of it), and may occur rapidly.

Long-term complications such as retinopathy or neuropathy develop slowly and are a consequence of a long stretch of high glucose levels in your body. See below more information about diabetes long-term complications.

Blood pressure and diabetes

• High blood pressure is often common in people with diabetes and is called Hypertension
• Blood pressure is the pressure of the blood in the arteries as the heart pumps it around the body. High blood pressure can result in increased risks of stroke, heart disease, kidney disease, eye disease and nerve damage
• Diabetes changes the body chemistry, thus increases the risk of blood pressure
• People with diabetes should get their blood pressure checked regularly

When to check your blood pressure

Have your blood pressure checked at every doctor’s visit, at least:

• Every six months for people with normal blood pressure
• Three months for people with high blood pressure
• Every 4-8 weeks if your blood pressure medication is being changed
• Home blood pressure monitors are available to purchase at some pharmacies. However, it’s best to talk to your doctor first if you are thinking of buying one.

• HbA1c is what is known as glycated haemoglobin (A1C). This is something that is made when the glucose in your body sticks to your red blood cells, so the more of it that sticks to your blood cells the more it builds up in your blood.
• Red blood cells are active for around 2-3 months, which is why the reading should be done quarterly.
• Your GP or healthcare professional will request an HbA1c measurement for you. This is carried out by a blood test. This result determines how your diabetes is managed and how you can prevent complications.
• Most people will have a test every 3 to 6 months. But you may need it more often if you’re planning a pregnancy or have had your medications or treatment changed.
• A HbA1c test is also used to diagnose diabetes or determine if individuals have prediabetes Link to Prediabetes page **
• Your HbA1c can change for lots of reasons such as illness, taking medications such as steroids, changes in lifestyle or stress.

Target HbA1c for diabetes

The target level for diabetes is 48mmol/mol (6.5%).

Prediabetes level is 39mmol/mol-47mmol/mol. (6-6.5%)

Normal level is below 39mmol/mol. (<6%). Targets for older people may be individualised. Speak to your GP or healthcare professional about your HbA1c, know your numbers!

Peripheral Arterial Disease (PAD) and Peripheral Vascular Disease (PVD) are common and serious complications of diabetes. They involve narrowing or blockages of the arteries that supply blood to the legs and feet, usually due to atherosclerosis (plaque build up). Diabetes significantly increases the risk and severity of PAD/PVD.

How Diabetes Increases Risk of PVD/PAD

• Raised blood glucose levels can damage blood vessels and accelerate plaque buildup.
• Diabetes often leads to smaller, more diffuse blockages, especially in the lower legs and feet.
• Reduced circulation + nerve damage (neuropathy) = high risk of foot ulcers, infections, and amputations.

Symptoms of PAD/PVD in Diabetics

Symptoms may be silent in early stages, especially in people living with diabetes with neuropathy, but common signs include:

• Leg pain when walking (claudication), relieved by rest
• Numbness or weakness in the legs
• Cold feet or legs
• Sores or ulcers on feet/toes that don’t heal
• Shiny skin, hair loss, or discoloration of legs
• Weak or absent pulses in the feet

The treatment goals for peripheral artery disease (PAD) are:

• Manage symptoms, such as leg pain, so exercise is comfortable
• Improve artery health to reduce the risk of heart attack, stroke, and other complications
• Lifestyle changes
• Medication
• Surgery
• Don’t smoke or use tobacco
• Get regular exercise
• Eat a healthy diet

Gum disease also called periodontal gum disease, is the most common and serious mouth problem related to diabetes. Untreated, the disease advances in stages, from inflamed gums to tooth loss. High levels of blood glucose increase the risk that gum disease will progress from mild to severe.

See your dentist right away if you notice any signs or symptoms of mouth problems.

• tell your dentist about your diabetes, including how long you’ve had the disease, any diabetes-related problems you may have, and any medicines you take
• keep your dentist updated on any changes to your health or medications
• follow your dentist’s advice on how to prevent and treat mouth problems from diabetes

Diabetes & sexual health

A healthy sexual relationship can be an important part of your life. While most people with diabetes can lead a normal sex life, diabetes may contribute to sexual problems for both men and women.

Men and diabetes

The most common problem for men is erectile dysfunction. This is where men have difficulty getting aroused long enough for intercourse due to reduced blood flow and nerve damage. There are many causes, such as being tired, stressed, depressed, or drinking too much alcohol. Erectile dysfunction can also be caused by certain medications taken for high blood pressure, depression, or stomach ulcers.

There are many ways to treat erectile dysfunction:

• Tablets (Viagra)
• Prostaglandin injection into the side of the penis
• Devices such as the vacuum pump
• Surgery, such as penile implants.

Chat with your doctor about all the options to decide what is best for you.

Sexual & reproductive health in women

Much less is known about how diabetes affects women’s sexual health. What we do know are the main sexual problems that women, with or without diabetes, deal with:

• Vaginal dryness
• A decrease in sexual desire
• Pain during sex
• Trouble having an orgasm
• More vaginal thrush (yeast infection).

It’s still unclear whether diabetes has any impact at all. But if you’re having a hard time coming to terms with living with diabetes, you’re more likely to experience sexual problems.

In most cases, keeping blood glucose levels within your target range will reduce your risk of thrush and urinary tract infection.

During periods or menopause, your blood glucose levels may change. We recommend speaking with your GP or diabetes educator to adjust your treatment.

• Talk to your doctor or healthcare professional about your sexual problems in the same way you would any other medical problem.
• If you have a partner, talk through the problems you’re both experiencing.
• Learn about the condition and what treatments are available to improve your sense of wellbeing.

Mental Health: People with diabetes have higher risk of developing mental health related problems such as depression, anxiety, or diabetes distress.

Read our special section about wellbeing and mental health and learn about our mental health and wellbeing support programmes.