1. 1 Complications of Diabetes

2. Heart Disease Kidney Disease/Kidney Transplantation Eye Complications Diabetic Neuropathy and Nerve Damage Foot Complications Skin Complications Depression Common Potential Complications of Diabetes

3. Heart Disease Caused by a narrowing or blocking of the blood vessels to your heart. The vessels carry oxygen and nutrients to your heart. Vessels can become partially or totally blocked by fatty deposits. A heart attack - when the blood supply to your heart is reduced or cut off.

4. Diabetes increases the risk for coronary artery disease, a heart attack or stroke. Heart Disease and Diabetes

5. “A” is for A1C A1C is the blood glucose level “B” is for blood pressure Recommended blood pressure below 130/80. “C” is for cholesterol HDL protects your heart. LDL can clog your blood vessels, leading to heart disease. Triglycerides can increase your risk for heart disease. “The ABC’s of Diabetes”

6. Kidney Function Kidneys act as filters. Kidneys remove waste products from the blood. We create waste products from digestion. Normally, waste products are eliminated in urine from the body. Protein and red blood cells are too big to pass through the filter and remain in the blood.

7. Kidney Disease High levels of blood sugar can put extra stress on the kidneys. After years of damage, the kidneys start to leak. Useful proteins are lost in the urine. Get a condition known as microalbuminuria. There are several treatments at this point that may keep the kidney disease from getting worse. When kidney disease is diagnosed later, during macroalbuminuria, end-stage renal disease (ESRD) usually follows.

8. Kidney Disease Kidneys lose their filtering ability. Waste products begin to build up in the blood. Finally, the kidneys fail. ESRD kidney transplant or regular visits to a dialysis clinic.

9. Who Gets Kidney Disease? Factors that influence kidney disease development include: Genetics Blood pressure Blood sugar control Controlling blood sugar and blood pressure are very important in reducing the chances of developing kidney disease.

10. Facts About Diabetes and Kidney Disease Nephropathy - 10-21% of diabetes cases. ~ 43% of new cases of ESRD are attributed to diabetes. 12 times higher in people with type 1 diabetes 4 times higher in African Americans, 4 to 6 times higher in Mexican Americans 6 times higher in Native Americans than in the general population of diabetes patients.

11. ---Eye Complications--- Higher risk of blindness. Many have minor eye disorders. Early treatments critical.

12. Glaucoma Pressure build-up in the eye. Pinches the blood vessels. Damages nerves. Vision is gradually lost. 40% more likely to suffer from glaucoma. Risk increases with age and duration of diabetes.

13. Cataracts The eye’s clear lens clouds, blocking light. Wear sunglasses Use glare-control lenses in eyeglasses. Damaged lens – remove. transplant.

14. Individuals with diabetes are: 60% more likely to develop cataracts at a younger age faster progression have problems if removal of the lens is necessary due to the beginning stages of glaucoma Cataracts

15. Retinopathy Diabetic retinopathy is a general term for all disorders of the retina caused by diabetes. There are 2 major types of retinopathy: Nonproliferative: This is the common, mild form. Proliferative: This form is much more serious.

16. There are several factors that influence whether you get retinopathy: Blood sugar control Blood pressure levels How long you have had diabetes Genetics Almost everyone with type 1 diabetes will eventually develop nonproliferative retinopathy. Retinopathy

17. Diabetic Neuropathy & Nerve Damage ~50% have some form of nerve damage. It’s more common in those who have had the disease for many years. Blood glucose control can help prevent or delay nerve damage.

18. 2 Common Types of Nerve Damage Sensorimotor neuropathy: Also known as “peripheral neuropathy” Can cause tingling, pain, numbness, or weakness in hands and feet. Autonomic neuropathy: Can lead to Digestive problems such as feeling full, nausea Vomiting, diarrhea, or constipation Problems with how well the bladder works Dizziness or faintness Loss of the typical warning signs of a heart attack Loss of warning signs of low blood glucose Increased or decreased sweating Changes in how your eyes react to light and dark

19. Foot complications Skin Changes Calluses Foot Ulcers Poor Circulation Amputation

20. Highly likely in diabetes. Due to artery disease, which reduces blood flow to the feet and nerve damage, which reduces sensation. These can lead to ulcers and infections that may lead to amputation. Amputations are preventable.

21. Skin Complications Bacterial infections Fungal infections Itching Diabetic Dermopathy Necrobiosis Lipoidica Diabeticorum Atherosclerosis Allergic Reactions Eruptive Xanthomatosis Digital Sclerosis Disseminated Granuloma Annulare Acanthosis Nigricans

22. Bacterial and Fungal Infections Bacterial infections Styes, Boils, Carbuncles. Inflamed tissues are usually hot, swollen, red, and painful. Treated by antibiotics. Fungal infections Candida albicans is a yeast-like fungus. Leads to common fungal infections. Can be treated by medication. Stye Athlete’s foot

23. Itching and Diabetic Dermopathy Diabetic Dermopathy Changes in the small blood vessels. Looks like light brown, scaly patches. The disorder most often occurs on the front of both legs. The patches do not hurt, open up, or itch. Dermopathy is harmless and does not require treatment.

24. Atherosclerosis and Allergic Reactions Atherosclerosis Thickening of the arteries Occurs at younger ages. Can lead to skin changes. Skin becomes hairless, thin, cool, and shiny. Affected legs heal slowly when the skin is injured. Allergic Reactions In response to medications, such as insulin or diabetes pills. If you think you are having a reaction to a medication, contact your doctor immediately. Report any rashes, depressions, or bumps around the insulin injection sites immediately.

25. PBRC 200925 of 39 Eruptive Xanthomatosis This is a condition caused by diabetes that is out of control. Consists of firm, yellow, pea-like enlargements in the skin. The disorder usually occurs in young men with type 1 diabetes. Like diabetic blisters, these bumps disappear when diabetes control is restored.

26. Digital Sclerosis and Disseminated Granuloma Annulare Digital Sclerosis Consists of tight, thick, waxy skin on the back of the hands. The finger joints become stiff and can no longer move the way they should. Happens to about 1/3 of people with type 1 diabetes The only treatment is to bring blood sugar levels under control. Disseminated Granuloma Annulare Consists of sharply defined ring-shaped or arc-shaped raised areas on the skin. Rashes most often occur on parts of the body far from the trunk (i.e., ears or fingers), but sometimes the raised areas occur on the trunk. Certain drugs can help clear up the condition.

27. Acanthosis Nigricans This is a condition in which tan or brown raised areas appear on the sides of the neck, armpits, and groin. Usually strikes people who are overweight.

28. Gastroparesis and Diabetes damage to nerves that control the stomach. Leads to poor muscle control of the stomach and intestines. Movement of food is slowed or stopped. Signs and symptoms: Heartburn, Nausea Vomiting of undigested food An early feeling of fullness when eating Weight loss Abdominal bloating Erratic blood glucose (sugar) levels Lack of appetite Gastroesophageal reflux Spasms of the stomach wall

29. Complications of Gastroparesis Gastroparesis makes it harder to manage blood glucose. Slower digestion can result in: Bacterial overgrowth due to fermentation Food can harden into solid masses called bezoars that may cause nausea, vomiting, and obstruction of the stomach Bezoars can be dangerous if they block the passage of food into the small intestine.

30. Depression Poorly controlled diabetes can cause depression like symptoms: High or low blood sugar during the day can make you feel tired or anxious Low blood sugar levels can also lead to hunger and eating too much Low blood sugar in the night could disturb sleep High blood sugar in the night can lead to frequent urinating and then feeling tired throughout the next day