What are the complications from diabetes?
You may have one or more complications from type 1 diabetes.

Macrovascular complications
Heart or large blood vessel disease can damage vessels that supply blood to the heart and brain. It can also block or decrease blood flow in the large blood vessels of your legs (peripheral arterial disease). Without proper blood flow, you could have a heart attack or stroke.

Microvascular complications
Eye disease (diabetic retinopathy) can cause poor eyesight or blindness.

Kidney disease (diabetic nephropathy) may require dialysis or a transplant.

Nerve disease (diabetic neuropathy) can change how you feel sensations, particularly in your legs and feet. Nerve damage can also harm your internal body functions. This could lead to trouble with digestion and sexual functioning.

What causes complications?
Complications from type 1 diabetes are caused by damage to either your blood vessels or nerves, or both. Excess sugar (glucose) in your body causes cellular and hormonal changes that damage these tissues.

Diabetes damages the lining of the blood vessels throughout the body, causing blockages with hard, fatty deposits called plaques. This process is called atherosclerosis.

Diabetes also damages the nerves so that the movement of impulses through the organs, legs, arms, and other parts of the body is decreased or completely blocked.

What are the symptoms?
Your symptoms will vary depending on the complication.

Heart and large blood vessel disease symptoms may not be noticeable until you have a heart attack or stroke. You may have chest pain (angina). You may also have leg pain when you exercise. However, a heart attack can be painless or silent because of nerve damage.

Eye disease symptoms may include blurred or distorted vision or difficulty reading that does not go away when high blood sugar is corrected. You might see floaters or flashes of light. And you could experience partial or total loss of vision or pain in your eye.

Kidney disease symptoms are not present in the early stages of the disease. As the disease goes on, you may notice swelling (edema) in your feet and legs and later throughout your body. Your blood pressure may go up. Late-developing symptoms can include fatigue, poor appetite and decreased mental sharpness.

Nerve disease symptoms occur when nerves that transmit sensation are damaged. These symptoms include tingling, numbness, tightness, burning, or shooting or stabbing pain in the feet, hands, or other parts of your body. When the nerves that control your internal organs are damaged, you may have digestive problems; profuse or reduced sweating; difficulty sensing when your bladder is full; sexual problems; dizziness, weakness, or fainting when you stand up; or difficulty knowing when your blood sugar is low (hypoglycemia unawareness).

What can happen?
Complications from type 1 diabetes can lead to kidney failure or blindness, or death from a severe heart attack or stroke. If the small blood vessels around your joints and connective tissue are affected, you can develop bone and joint deformities, such as Charcot foot. If you have nerve damage, you may not notice a minor injury, especially one on your foot, until it turns into a severe infection. These infections can spread up your leg and infect the bones, possibly leading to amputation.

Am I at risk for more complications?
Having one complication increases your risk for others. For example, damage to the small blood vessels in your body can cause eye and kidney disease. As a result, these complications are likely to occur together. Also, the longer you have diabetes, the greater your risk for having complications.

Another risk for most complications is if your blood sugar levels remain high over months or years. Smoking, high blood pressure, high cholesterol, and a family history of heart disease or peripheral arterial disease can also increase your risk.

What is the treatment for diabetic complications?
Treatment for diabetic complications focuses on stopping or at least slowing damage. Your treatment may involve medication, surgery, or other therapies.

The best way to slow or stop the progression is to keep your blood sugar levels as near normal as possible. The near-normal target may be a lower blood sugar level than you tried to achieve before you had complications. Tight control of blood sugar is especially likely to help people who have early, rather than advanced, complications. See your health professional every 3 to 4 months, or more often if you're having problems. Have exams and tests that monitor your complication(s), and screen for other complications regularly.

If you have high blood pressure or high cholesterol, get regular treatment for those conditions.Do not smoke. These actions can also help prevent other diabetic complications.

What can I do?
Keep your blood sugar levels within a normal to near-normal range. This is the key to slowing or reversing complications, and it helps prevent new complications.You can spread carbohydrate intake throughout the day, get regular physical exercise, and take insulin as prescribed. All these activities help keep your blood sugar under control.