Diabetic Complications

What is Type 2 diabetes?

Type 2 diabetes is a disease where your body can’t use energy from food properly. Your pancreas produces insulin (a hormone) to help your cells use glucose (sugar). But over time your pancreas makes less insulin and the cells resist the insulin. This causes too much sugar to build up in your blood. High blood sugar levels from Type 2 diabetes can lead to serious health problems including heart disease, stroke or death.

What causes Type 2 diabetes?

Type 2 diabetes develops when the pancreas makes less insulin than the body needs, and the body cells stop responding to insulin. They don’t take in sugar as they should. Sugar builds up in your blood. When cells don’t respond to insulin, this is called insulin resistance. It's usually caused by:

• Lifestyle factors, including obesity and a lack of exercise.
• Genetics, or abnormal genes, that prevent cells from working as they should.

What are the symptoms of Type 2 diabetes?

Symptoms of Type 2 diabetes tend to develop slowly over time. They can include:

• Blurred vision.
• Fatigue.
• Feeling very hungry or thirsty.
• Increased need to urinate (usually at night).
• Slow healing of cuts or sores.
• Tingling or numbness in your hands or feet.
• Unexplained weight loss.

What are the complications of high blood sugar levels?

Potential complications of high blood sugar levels from Type 2 diabetes can include:

• Digestive problems, including gastroparesis.
• Eye problems, including diabetes-related retinopathy.
• Foot problems, including leg and foot ulcers.
• Gum disease and other mouth problems.
• Hearing loss.
• Heart disease.
• Kidney disease.
• Liver problems, including nonalcoholic fatty liver disease.
• Peripheral neuropathy (nerve damage).
• Sexual dysfunction.
• Skin conditions.
• Stroke.
• Urinary tract infections and bladder infections.

How is Type 2 diabetes managed?

There’s no cure for Type 2 diabetes. But you can manage the condition by maintaining a healthy lifestyle and taking medication if needed. Work with your healthcare provider to manage your:

• Blood sugar: A blood glucose meter or continuous glucose monitoring (CGM) can help you meet your blood sugar target. Your healthcare provider may also recommend regular A1c tests, oral medications (pills), insulin therapy or injectable non-insulin diabetes medications.
• Blood pressure: Lower your blood pressure by not smoking, exercising regularly and eating a healthy diet. Your healthcare provider may recommend blood pressure medication such as beta blockers or ACE inhibitors.
• Cholesterol: Follow a meal plan low in saturated fats, trans fat, salt and sugar. Your healthcare provider may recommend statins, which are a type of drug to lower cholesterol.

Type 1 diabetes is a chronic (life-long) autoimmune disease that prevents your pancreas from making insulin.

Insulin is an important hormone that regulates the amount of glucose (sugar) in your blood.

Who does Type 1 diabetes affect?

Anyone at any age can develop Type 1 diabetes (T1D), though the most common age at diagnosis is between the ages of 4 to 6 and in early puberty (10 to 14 years).

In the United States, people who are non-Hispanic white are most likely to get Type 1 diabetes, and it affects people assigned female at birth and people assigned male at birth almost equally.

While you don’t have to have a family member with Type 1 diabetes to develop the condition, having a first-degree family member (parent or sibling) with Type 1 diabetes increases your risk of developing it.

What are the symptoms of Type 1 diabetes?

Symptoms of Type 1 diabetes typically start mild and get progressively worse or more intense, which could happen over several days, weeks or months. This is because your pancreas makes less and less insulin.

Symptoms of Type 1 diabetes include:

• Excessive thirst.
• Frequent urination, including frequent full diapers in infants and bedwetting in children.
• Excessive hunger.
• Unexplained weight loss.
• Fatigue.
• Blurred vision.
• Slow healing of cuts and sores.
• Vaginal yeast infections.

How is Type 1 diabetes treated?

People with Type 1 diabetes need synthetic insulin every day, multiple times a day in order to live and be healthy. They also need to try to keep their blood sugar within a healthy range.

Since several factors affect your blood sugar level, Type 1 diabetes management is complex and highly individualized.

Three of the main components of Type 1 diabetes management include:

• Insulin.
• Blood glucose (sugar) monitoring.
• Carbohydrate counting.

What are the complications of Type 1 diabetes?

Since your blood touches virtually every part of your body, having poorly managed Type 1 diabetes that results in continuous high blood sugar (hyperglycemia) can damage several different areas of your body.

Potential complications of Type 1 diabetes include:

• Eye problems, such as diabetes-related retinopathy diabetes-related macular edema, cataracts and glaucoma.
• Foot problems, including ulcers and infections that can lead to gangrene.
• Heart disease.
• High blood pressure.
• Kidney disease.
• Oral health problems.
• Diabetes-related neuropathy (nerve damage).
• Skin conditions, such as dry skin, bacterial and fungal infections and diabetes-related dermopathy.
• Stroke.

Type 1 diabetes management

Type 1 diabetes is a complex condition that requires daily management, effort and planning. Some tips that can help you manage your Type 1 diabetes include:

• Check your blood sugar often: Checking your blood sugar with a glucometer and/or using a continuous glucose monitor (CGM) is crucial to managing diabetes and preventing complications. Try to at least check your blood sugar before and after meals and before you go to sleep. It’s important to treat high blood sugar as soon as possible.
• Take your insulin and other medication regularly: Follow your healthcare provider’s instructions for taking your insulin and other medications (if applicable).
• See your endocrinologist regularly: It’s important to see your endocrinologist regularly to be sure that your Type 1 diabetes management plan is working. Don’t be afraid to ask them specific questions.
• See your other providers regularly, especially your eye doctor: Type 1 diabetes can cause complications in various areas of your body, but especially your eyes. It’s important to see your eye doctor (ophthalmologist) at least yearly so that they can check the health of your eyes.
• Have a sick day plan: Talk with your endocrinologist about how to take care of yourself and manage your diabetes when you’re sick. Since illness can trigger diabetes-related ketoacidosis (DKA), it’s important to know what to do if you get sick before it happens so that you’re prepared.
• Stay educated: Don’t be afraid to ask your provider questions about Type 1 diabetes. The more you know about Type 1 diabetes your diabetes management, the more likely you’ll be able to live healthily and prevent complications.
• Find community: Connecting with other people who have Type 1 diabetes — whether in-person or online — can help you feel less alone in living with and managing diabetes.
• Take care of your mental health: People with diabetes are two to three times more likely to have depression and are 20% more likely to be diagnosed with anxiety than those without diabetes. Living with a chronic condition that requires constant care can be overwhelming. It’s important to talk to a mental health professional if you’re experiencing signs of depression and/or anxiety.

OVERVIEW

What is gestational diabetes?

Gestational diabetes (GD) is a type of diabetes that develops in pregnancy when blood sugar levels get too high. GD usually appears during the middle of pregnancy, between 24 and 28 weeks.

SYMPTOMS AND CAUSES

What causes gestational diabetes?

Gestational diabetes comes from hormonal changes and the way our bodies convert food into energy.

A hormone called insulin breaks down the glucose (sugar) from food and delivers it to our cells. Insulin keeps the level of glucose in our blood at a healthy level. But if insulin doesn’t work right or we don’t have enough of it, sugar builds up in the blood and leads to diabetes.

During pregnancy, hormones can interfere with the way insulin works. It may not regulate your blood sugar levels like it’s supposed to, which can lead to gestational diabetes. Genes and having overweight (a BMI greater than 25) may also play a role.

 factors that may increase your chances of GD include:

• Heart disease.
• High blood pressure.
• Inactivity.
• Obesity.
• Personal or family history of GD.
• Polycystic ovary syndrome (PCOS).
• Previous birth of a baby weighing nine pounds (lb) or more.
• Prediabetes (history of higher-than-normal blood glucose).

What are the symptoms of gestational diabetes?

Gestational diabetes doesn’t usually cause any symptoms. But some people experience:

• Frequent urination.
• Nausea.
• Thirst.
• Tiredness.

Why is it important to treat gestational diabetes?

If left untreated, gestational diabetes can lead to complications for both you and the fetus.

Gestational diabetes increases your risk of:

• Cesarean birth (C-section) if the fetus gets too big.
• Preeclampsia (high blood pressure during pregnancy).
• Type 2 diabetes.

MANAGEMENT AND TREATMENT

How does gestational diabetes affect my baby?

If you have gestational diabetes, your baby’s more at risk for:

• Increased birth weight (weighing nine pounds or more).
• Breathing problems at birth.
• Hypoglycemia. This can cause seizures in newborns.
• Obesity.
• Premature birth.
• Type 2 diabetes later in life.

What is stress?

Most people experience stress as an emotional or physical strain. It can result in worry, anxiety, and tension. Everyday events or changes in life may create stress. Stress affects everyone to some degree, but it may be more difficult to manage when people learn that they have diabetes.

Symptoms of stress can include:

• Nervousness
• A fast heartbeat
• Rapid breathing
• Stomach upset
• Depression

Stress can make it more difficult to manage your diabetes as it may throw off your daily routine and can result in wear and tear on your body. Hormones from stress increase your blood pressure, raise your heart rate, and can cause blood sugar to rise. High blood sugar can make you feel down or tired. Low blood sugar may result in your feeling upset or nervous.

How can I reduce stress in my life?

There are many things you can do to reduce stress. The following are some suggestions:

• Take your medications as directed and eat healthy meals.
• Use relaxation techniques such as deep breathing.
• Get some exercise. You can reduce stress though activities such as dancing, walking, or biking. Do something that you enjoy.
• Share what you are going through with friends and family. If you talk about your problems, you can help to relieve your stress and perhaps solve those problems.
• Remember to keep your sense of humor. Laughing helps to reduce stress.
• Join a support group. You can meet people with problems similar to yours and make new friends.
• Seek out professional help in order to talk about what's troubling you.

There are additional strategies that you can use to help reduce stress in your life. Talk to your diabetes educator or doctor for more ideas.

What are symptoms of depression?

Too much stress sometimes can lead to depression. People with diabetes are more likely to be depressed than the average person. You may be at risk for depression if you have any of the following symptoms for more than a week:

• Feeling sad or irritable
• Having lost interest in activities you enjoy
• Feeling worthless
• Having a change in sleeping patterns
• Feeling fatigued or like you have lost energy

Feelings of fatigue or feelings of worthlessness could make it harder to do self-care things that manage your diabetes. It is important to remember that doctors can help to treat depression. Call your doctor if any of these symptoms apply to you. Depression can be treated with lifestyle activities (like increased exercise and relaxation), medication and counseling.

What is a diabetes rash?

Diabetes affects various parts of your body, including your skin. An estimated 1 in 3 people with diabetes (Type 1 or Type 2) will develop a skin rash or other skin problem at some point.

When you have diabetes, your chances of having dry, itchy skin are higher than someone who doesn’t have the disease. You’re also more likely to get other diabetes-related skin conditions.

What causes a diabetes rash?

For people who don’t have diabetes, a skin rash may be the first sign of high blood sugar (hyperglycemia) or prediabetes. Your healthcare provider can help you take steps to prevent diabetes.

If you take medications for diabetes, a skin rash may indicate that you need to adjust treatments to lower your blood sugar (glucose) levels. Some other rashes result from reduced blood flow to your extremities (hands and feet).

How can I prevent diabetes-related skin problems?

The best thing you can do to prevent skin problems is to keep blood sugar levels within the range recommended by your healthcare provider. Proper skin care can lower your chances of getting a skin rash, infection or wound that’s difficult to heal.

Take these steps to prevent skin problems:

• Check your skin daily for signs of rashes, redness, infections or sores.
• Use warm (not hot) water and moisturizing soap in the shower. (Soaking in a tub dries out skin.)
• Pat skin dry with a towel (don’t rub), making sure to dry in between fingers, toes and skin folds.
• Apply fragrance-free moisturizers after showering while skin is still damp and soft. Look for creams and ointments (not lotions) with ceramide to help skin retain moisture.
• Apply creams containing 10% to 25% urea (an emollient) to cracked, dry heels at bedtime.
• Prevent dehydration and keep skin hydrated by drinking plenty of fluids.
• Treat cuts and wounds immediately with soap and water. Use antibiotic ointments only if your healthcare provider gives the OK. Bandage the wound daily. Call your provider if you notice signs of redness, pain, drainage or infection.
• Use a humidifier to add moisture to the air in your home.

What is diabetes-related neuropathy?

Diabetes-related neuropathy refers to nerve damage caused by high blood sugar due to diabetes.

Your nerves carry electrical signals from your brain to other parts of your body. These signals:

• Alert you of sensations.
• Help you move your body.
• Control specific bodily functions, such as digestion, sweating and bladder emptying.

When you have nerve damage, you may experience numbness or weakness. Nerve damage may also affect your internal organs or your ability to move.

SYMPTOMS AND CAUSES

What causes diabetes-related neuropathy?

Diabetes that's not well managed can lead to hyperglycemia (high blood sugar). Over time, elevated blood sugar can damage your nerves. Too much blood sugar can also lead to damage to your blood vessels, which bring oxygen and nutrients to your nerves.

What are the symptoms of diabetes-related neuropathy?

Your symptoms depend on which type of diabetes-related neuropathy you have. In general, diabetes-related neuropathy symptoms may include:

• Burning or shooting sensations.
• Increased pain sensitivity.
• Numbness or weakness.
• Slow-healing foot or leg sores (ulcers).
• Tingling.
• Total loss of sensation in your feet.

How is diabetes-related neuropathy treated?

Diabetes-related neuropathy treatment involves carefully managing your blood sugar. Managing diabetes is the most important step to prevent nerve damage from getting worse. You can manage your blood sugar through:

• Eating a nutritious diet.
• Exercising regularly.
• Taking all diabetes medications as prescribed.

You may manage diabetes-related neuropathy symptoms with:

• Pain medicines, including topical creams or patches.
• Other medications can reduce pain.

You should also check your feet daily for wounds or injuries. Foot wounds can contribute to foot and skin complications of diabetes.

Can diabetes-related neuropathy be reversed?

Maybe. You can keep diabetes-related neuropathy from worsening, and you may be able to reverse nerve damage with very good management of blood glucose, but the process is very slow.

What are diabetes-related foot conditions?

People with diabetes often have problems with their feet. They may develop foot develop sores, deformities and infections more easily.

If not treated quickly, a foot ulcer or blister on a person with diabetes can get infected. Sometimes a surgeon must amputate (remove) a toe, foot or part of the leg to prevent the spread of infection.

What causes diabetes-related foot conditions?

Long-term high blood sugar can cause a type of nerve damage called diabetes-related neuropathy. Diabetes-related neuropathy can occur throughout the body, but most often in the legs and feet.

The condition might make you lose feeling in your feet. If your feet are numb, you might not notice a blister, cut or sore. You might not even feel a pebble in your sock that is cutting your foot, for example. Wounds that go unnoticed and untreated can become infected.

Diabetes can also affect blood flow to your legs and feet. People with diabetes are more likely to develop peripheral artery disease (PAD). This condition causes arteries to become narrowed or blocked. Reduced blood flow (poor circulation) can make it difficult for a diabetes-related foot ulcer or infection to heal.

What are the symptoms of diabetes-related neuropathy?

The signs of diabetes-related neuropathy may include:

• Darkened skin on the affected area.
• Diminished ability to sense hot or cold.
• Loss of hair in the area.
• Numbness.
• Pain.
• Tingling.

If diabetes-related neuropathy leads to foot ulcers, symptoms to watch out for include:

• Any changes to the skin or toenails, including cuts, blisters, calluses or sores.
• Discharge of fluid or pus.
• Foul smell.
• Pain.
• Redness.
• Skin discoloration.
• Swelling.

How are diabetes-related foot ulcers treated?

Care for diabetes-related foot pain may involve a doctor who specializes in the feet, called a podiatrist. Treatment may include:

• Cleaning the wound.
• Draining any fluid or pus from the ulcer.
• Removing or cutting away dead or infected tissue (called debridement).
• Applying special bandages and ointments to absorb extra fluid, protect the wound and help it heal.
• Prescribing a wheelchair or crutches to take weight off the affected foot (called offloading).
• Prescribing oral or IV antibiotics to manage and eliminate infection.

Depending on how severe the infection is, your healthcare provider may recommend hospitalization. Sometimes amputation is necessary to prevent infection from spreading to other parts of the body.

How does smoking increase complications for people who have diabetes?

While smoking can increase your chances of getting diabetes, it can also make managing diabetes more difficult for those who already have it. Smoking can worsen all of the above complications of high blood sugar, including eye disease, heart disease, stroke, vascular (blood vessel) disease, kidney disease, nerve damage, foot problems, and many others.

Other ways smoking can harm you include:

• Cancer of the mouth, throat, lung, and bladder
• Stroke
• Heart attack
• Hardening of the arteries (atherosclerosis)
• High blood pressure
• Limited joint mobility
• Increased cholesterol and other fat levels in your blood
• Impotence
• Miscarriage
• Stillbirth

How can I reduce my risk of getting diabetes?

A person with some or all of the risk factors might never develop diabetes, but your chances increase as more risk factors are present. Certain risk factors like age, family history, and ethnicity cannot be changed, but a change in lifestyle that includes eating a modified diet, increasing physical activity, and quitting smoking might help reduce your risk. Ask your doctor for specific recommendations that are right for you.

What is diabetes-related dermopathy?

Diabetes-related dermopathy (often called “shin spots”) is a fairly common skin condition that affects people who are living with diabetes, including Type 1 diabetes and Type 2 diabetes.

Diabetes-related dermopathy looks like small, round pink, reddish or brown patches on your skin. They can look like scars and be indented. They’re generally 1 centimeter to 2.5 centimeters in size.

The patches are harmless and don’t itch, ooze liquid or cause pain. Diabetes-related dermopathy most often appears on the front of both of your lower legs (on your shins), but one leg may have more patches than the other. It can also appear on other parts of your body, such as your thighs and arms.

What are the signs and symptoms of diabetes-related dermopathy?

Diabetes-related dermopathy is usually asymptomatic, meaning it doesn’t cause symptoms like pain or itching.

Characteristics of the diabetes-related dermopathy spots that develop on your skin include spots that are:

• Pink, reddish or brown.
• Round or oval.
• Slightly indented into your skin and/or somewhat scaly.
• Bilateral, meaning they appear on the skin of both of your legs or both of your arms at the same time.

The spots last for many months. Over time, the clusters of spots may look like age spots.

What causes diabetes-related dermopathy?

Researchers don’t yet know the exact cause of diabetes-related dermopathy. Many researchers and healthcare providers think that diabetes-related dermopathy may be related to prior trauma to your skin from an injury or extreme heat or cold, especially if you have neuropathy, which is a type of nerve damage that’s caused by chronic high blood sugar (hyperglycemia).

Diabetes-related dermopathy is strongly associated with the following complications of diabetes:

• Diabetes-related nephropathy (damage to your kidneys).
• Diabetes-related retinopathy (damage to the retina in your eye).
• Diabetes-related neuropathy (damage to your nerves).

What is dry mouth?

Dry mouth, also called xerostomia (ZEER-oh-STOH-mee-ah), is a lack of moisture in your mouth. It happens when you don’t have enough saliva (spit).

Is dry mouth a symptom of diabetes?

Dry mouth is a common symptom of high blood sugar in people with diabetes. Sometimes dry mouth is the first noticeable symptom of diabetes. If you have dry mouth and think you could have diabetes, talk to your healthcare provider.

How is dry mouth with diabetes treated?

The best way to treat dry mouth is to treat whatever’s causing it.

If high blood sugar is the cause, you and your healthcare provider can find ways to monitor and manage your blood sugar. If a medication leads to dry mouth, you can ask your healthcare provider about stopping or changing the medication or taking lower doses.

Your healthcare provider also may recommend a saliva substitute such as sorbitol.

How can I prevent dry mouth with diabetes?

The best way to prevent dry mouth with high blood sugar is to work with your healthcare team to find a diabetes management plan that works for you. Here are some things that can help to keep your blood sugar in the target range:

• Eating a healthy, balanced diet that includes fruits and vegetables.
• Keeping all your medical appointments.
• Monitoring your blood glucose.
• Taking medications as prescribed.
• Staying active and maintaining a healthy weight.

Other lifestyle changes can also help prevent dry mouth:

• Avoid alcohol, smoking, caffeine and anything with a lot of sugar or sugar substitutes.
• Brush your teeth and gums twice a day, using toothpaste that contains fluoride.
• Drink lots of water every day.
• Floss between your teeth every day.
• Limit salty and spicy foods.
• Visit a dentist regularly (once or twice a year).

What is diabetes-related ketoacidosis (DKA)?

Diabetes-related ketoacidosis (DKA) is a serious and life-threatening, but treatable, complication that affects people with diabetes and those who have undiagnosed diabetes.

Diabetes-related ketoacidosis occurs when your body doesn't have enough insulin (a hormone that's either produced by your pancreas or injected). Your body needs insulin to turn glucose, your body’s go-to source of fuel, into energy. If there’s no insulin or not enough insulin, your body starts breaking down fat for energy instead. As fat is broken down, ketones are released into the bloodstream.

For a person with diabetes, a high amount of ketones causes their blood to become acidic (the blood pH is too low). This creates an emergency medical situation that requires immediate attention and treatment.

What are the symptoms and signs of DKA

It’s important to remember these signs of DKA, especially if you have diabetes or if you or your child are at risk for developing Type 1 diabetes.

Early symptoms of DKA can include:

• Peeing more often than usual (frequent urination).
• Extreme thirst.
• Dehydration.
• Headache.
• High amounts of ketones in your pee or blood (as shown by at-home urine ketone test strips or a blood meter test).
• High blood glucose (blood sugar) levels (over 250 mg/dL).

What causes diabetes-related ketoacidosis (DKA)?

The main cause of DKA is not enough insulin in your body. The following situations can cause a lack of insulin:

• New diagnosis of Type 1 diabetes
• Forgetting to take or not taking one or more insulin doses
• Insulin pump issues
• Using expired or spoiled insulin

What is diabetes-related nephropathy?

Diabetes-related nephropathy is a condition that affects your kidneys. Another name for diabetes-related nephropathy is diabetes-related kidney disease (DKD).

Your kidneys filter waste from your body. Common waste products include nitrogen waste products such as urea, muscle waste (creatinine) and many other toxins. Your kidneys also help balance your body’s fluids and electrolytes. Each kidney contains more than a million nephrons, which help filter your blood and keep all of this in balance.

Diabetes causes diabetes-related nephropathy. If you have diabetes, your body can’t properly process the blood sugar (glucose) from the foods and drinks you consume. Extra glucose in your bloodstream may damage the glomerular membranes as well as other parts of the nephron.

What are diabetes-related nephropathy symptoms?

Diabetes-related nephropathy symptoms usually don’t appear until it has affected at least 80% to 90% of your kidneys. These symptoms include:

• Swelling in your face, hands and feet (edema).
• Nausea and vomiting.
• Tiredness or fatigue.
• Dyspnea (shortness of breath).
• Loss of appetite.
• Foamy or bubbly pee.
• Difficulty focusing or confusion.
• Dry, itchy skin.
• Muscle cramps.
• Not needing to take as much insulin.

What causes diabetes-related nephropathy?

Type 1 or type 2 diabetes causes diabetes-related nephropathy.

How are diabetes and diarrhea related?

Diabetes can cause diarrhea, along with several other gastrointestinal (digestive) problems. Diarrhea is a common symptom of diabetes. It’s more common in people who have had diabetes for a long time.

Sometimes, people with diabetes-related diarrhea also experience fecal (bowel) incontinence, especially at night. That’s because nerve damage (neuropathy) due to diabetes affects the anal sphincter. The anal sphincter is the muscle that opens and closes to allow poop to exit your body.

What causes diabetes-related diarrhea?

People with diabetes may experience frequent diarrhea due to:

• Autonomic neuropathy: Over time, people with diabetes may develop neuropathy from high blood sugar levels. Neuropathy can lead to problems with how food and fluids travel through the colon. It also affects how your digestive system functions overall. You may have constipation alternating with diarrhea.
• Problems in the small or large intestine: Fluids may travel through the colon faster. As a result, you may need to have a bowel movement more often and more urgently. The stool may be watery because it doesn’t have a chance to solidify.
• Other gastrointestinal problems: People with diabetes may have other intestinal problems. Conditions such as irritable bowel syndrome cause diarrhea.
• Sweeteners: People with diabetes often consume a lot of artificial sweeteners. These sweeteners can sometimes cause diarrhea.
• Metformin: This diabetes medicine can cause stomach problems, including diarrhea.

Other possible causes of diabetes-related diarrhea:

• Products with sugar alcohols: Consuming high amounts of sugar alcohols can cause stomach cramping and diarrhea. Check product labels to check for added sugar alcohols in low-carb or sugar-free foods, baked goods and sauces. These ingredients usually end in “ol,” including xylitol and sorbitol. Many people find that sorbitol has a laxative effect.
• Celiac disease: Some people with diabetes may also have celiac disease or gluten intolerance. For them, consuming even a tiny amount of gluten (a protein in wheat and some other grains) can cause diarrhea or other digestive problems.
• Bacteria in the digestive tract: Sometimes, fluids and food move more slowly through the digestive system. Bacteria may grow, contributing to diarrhea.
• Yeast infection in the GI tract: If you have consistently high blood sugar, yeast infections may form in your gastrointestinal tract. These infections can also cause diarrhea. Fortunately, antifungal medication can easily treat infections.
• Exocrine pancreatic insufficiency: With this problem, your pancreas doesn’t produce enough enzymes, which affects digestion. It can cause diarrhea.

How is diabetes-related diarrhea treated?

The most important part of treating diabetes-related diarrhea is to control your blood sugar. Controlling blood sugar can prevent nerve damage and improve your symptoms. A nutritionist can help you develop the best meal plan to improve your symptoms. You may need to:

• Eat plenty of fiber, including whole grains. Be sure to monitor carbs’ effect on your blood sugar.
• Drink more water. You lose fluids through diarrhea.
• Change the vegetables (or amount of vegetables) you eat.

How can I live best with diabetes-related diarrhea?

Often, people who have diabetes have digestive problems. But you can take steps to keep these problems to a minimum:

• Improve your blood sugar levels by following the diabetes plan you and your provider develop.
• Take medications as necessary.
• Eat whole foods — including whole grains and fiber.
• Drink plenty of water.
• Get regular exercise.
• Quit smoking and using tobacco products.
• Limit alcohol.

What is a stroke?

A stroke occurs when a blood vessel in the brain is blocked or bursts. A stroke interrupts the flow of blood and oxygen to the brain, which can damage brain tissue and lead to:

• Difficulty speaking or understanding speech.
• Memory loss.
• Numbness or paralysis (inability to move).
• Pain.
• Problems managing or expressing emotions, or depression.
• Trouble thinking, paying attention, learning or making judgments.
• Sometimes death.

How does diabetes cause stroke?

Diabetes prevents your body from processing food properly. Your body can’t make insulin or can’t use insulin correctly, which causes glucose (sugar) to build up in your blood.

Over time, high glucose levels can damage the body’s blood vessels, increasing the chance of stroke.

Many adults with diabetes also have other health problems that can lead to stroke:

• Extra body weight (the optimum range for body mass index, or BMI, is from 18.5 to 24.9).
• Heart disease.
• High blood pressure.
• High cholesterol.

What are diabetes-related stroke symptoms?

The symptoms of diabetes-related stroke are the same as the symptoms of any stroke:

• Any trouble talking.
• Dizziness, problems with balance or trouble walking.
• Severe, sudden headache.
• Sudden confusion.
• Trouble seeing or double vision.
• Weakness or numbness on one side of the body (for example, one side of the face, one arm or one leg).

A stroke is a medical emergency. Get medical attention immediately if you experience any of the symptoms.

How can I reduce my diabetes stroke risk?

If you have diabetes, certain lifestyle changes can help you lower your chance of stroke:

• Check your blood glucose level often and take steps to keep it within a healthy range (less than 140 mg/dL).
• Check your blood pressure regularly and report problems to your healthcare team.
• Eat a nutritious, balanced diet to lower cholesterol and maintain a healthy weight.
• Exercise regularly.
• Get enough sleep to maintain health and energy.
• Keep all of your medical appointments.
• Limit salt in your diet to help regulate blood pressure.
• Maintain a weight that’s healthy for you and lose belly fat.
• Quit smoking and/or using tobacco products.
• Take all of your medications exactly as prescribed.

What is diabetes-related retinopathy?

Diabetes-related retinopathy is an eye condition that weakens the blood vessels in your retina.

How does diabetes-related retinopathy affect my body?

Without treatment, diabetes-related retinopathy may lead to vision loss, low vision or blindness.

What causes diabetes-related retinopathy?

Diabetes can cause multiple eye diseases including cataracts, glaucoma, and diabetes-related retinopathy which is defined as damage to the retinal vessels of the eye. These damage vessels can lead to poor blood flow (ischemia), inflammation, and ultimately legal blindness if not treated.

What are the symptoms of diabetes-related retinopathy?

In the early stages, most people experience no signs of diabetes-related retinopathy. You may not experience vision changes until the condition is severe. For some people, symptoms come and go.

Symptoms of diabetes-related retinopathy include:

• Blurred or distorted vision.
• New color blindness or seeing colors as faded.
• Poor night vision (night blindness).
• Small dark spots (eye floaters) or streaks in your vision.
• Trouble reading or seeing faraway objects.

How can I reduce my risk of diabetes-related retinopathy?

If you have diabetes, you can lower your risk of developing diabetes-related retinopathy by:

• Avoiding smoking.
• Controlling your blood sugar.
• Exercising regularly.
• Having annual eye exams.
• Keeping your blood pressure within a healthy range.
• Taking any medications exactly as prescribed.

What is Type 3c diabetes?

Type 3c diabetes develops when your pancreas experiences damage that affects its ability to produce insulin. Conditions like chronic pancreatitis and cystic fibrosis can lead to pancreas damage that causes diabetes. Having your pancreas removed (pancreatectomy) also results in Type 3c diabetes.

Diabetes is a condition that happens when your blood sugar (glucose) is too high. It develops when your pancreas doesn’t make any or enough insulin (a hormone), or your body isn’t responding to the effects of insulin properly.

What causes Type 3c diabetes?

Type 3c diabetes develops when your pancreas experiences enough damage to affect its ability to make insulin. The damage can result from the following underlying conditions or situations:

• Chronic pancreatitis.
• Acute pancreatitis.
• Pancreatic cancer.
• Hemochromatosis.
• Cystic fibrosis.
• Pancreatectomy.

What are the symptoms of Type 3c diabetes?

The symptoms of Type 3c diabetes are the same as other forms of diabetes. They include:

• Increased thirst (polydipsia) and dry mouth.
• Frequent urination.
• Fatigue.
• Blurred vision.
• Unexplained weight loss.
• Numbness or tingling in your hands or feet.
• Slow-healing sores or cuts.
• Frequent skin and/or vaginal yeast infections.

People with Type 3c diabetes typically also have symptoms of exocrine pancreatic insufficiency, which include:

• Abdominal pain, gas and bloating.
• Constipation.
• Diarrhea.
• Fatty stools (pale, oily, foul-smelling poop that floats).
• Unexplained weight loss.

It’s important to see a healthcare provider if you have these symptoms.

What are the complications of Type 3c diabetes?

Blood glucose levels that remain high for too long can damage your body’s tissues and organs. This is mainly due to damage to your blood vessels and nerves, which support your body’s tissues.

Cardiovascular (heart and blood vessel) issues are the most common type of long-term diabetes complication. They include:

• Coronary artery disease (CAD).
• Heart attack.
• Stroke.
• Atherosclerosis.

Other diabetes complications include:

• Nerve damage (neuropathy.
• Nephropath.
• Retinopathy.
• Diabetes-related foot conditions.