What Are the Side Effects of Diabetes?
When I meet with a patient who has diabetes, inevitably they ask me, “What are the side effects of diabetes?"
This involves explaining to them that yes, there are can be side effects or complications of diabetes, but they can be greatly reduced by taking certain steps.
Below, we’ll discuss several of the side effects of diabetes, and strategies for reducing these side effects.
Hypoglycemia
Hypoglycemia, or low blood glucose, is a short-term complication of diabetes. This complication can occur for a variety of reasons:
- Incorrect dosing of insulin (for example, too much basal insulin or an aggressive carbohydrate ratio)
- A sulfonylurea drug, which causes the pancreas to produce insulin throughout the day
- Certain prescription medications
- Alcohol
Symptoms of hypoglycemia include:
- Sweating
- Dizziness
- Shakiness
- Pallor
- Rapid heartbeat
- Anxiety
- A headache
When hypoglycemia is left untreated, symptoms can worsen:
- Confusion
- Numbness in the extremities
- Sleepiness
- Slurred speech
- Seizures
Treatment of hypoglycemia includes consuming a quick-acting carbohydrate to bring the blood glucose level back to a normal level. An example includes juice, hard candy, glucose tablets, or milk.
If you take insulin, you should carry glucagon with you – glucagon is an emergency medication that can be administered by in the event that you become unresponsive and are unable to treat a low glucose level yourself.
Diabetic Ketoacidosis
Diabetic ketoacidosis, or DKA, is most common in people with type 1 diabetes but it can also occur in people with type 2 diabetes.
DKA occurs when your body does not have any insulin available. Generally, when you are an insulin-requiring diabetic, your body utilizes the insulin to metabolize glucose by allowing the glucose to enter the cells, where it can be transported for energy.
When your develop DKA, there is a lack of insulin available – the body is unable to metabolize the glucose, so it is unable to utilize it for energy. Instead, it begins to break down fat for energy, and the byproduct of this is ketones.
DKA is an emergency situation because it signifies that there is a complete lack of insulin in the body.
Neuropathy
Although hypoglycemia and DKA are both life-threatening, they are short-term complications. This means that if detected early, they are unlikely to cause lasting damage.
However, there are multiple complications that are long-term, and neuropathy is one of the most common.
Diabetic neuropathy occurs when damage occurs to the tiny blood vessels that “feed" the nerves; according to Endocrine Web, “if the blood vessels are damaged, then the nerves will eventually be damaged as well."
There are various forms of diabetic neuropathy – peripheral neuropathy, autonomic neuropathy, proximal neuropathy, and focal neuropathy. Peripheral neuropathy is the most common, and it affects the tiny nerves of the extremities, causing weakness, pain, and tingling.
Peripheral neuropathy can lead to further complications; due to this complication, you may not be able to feel your extremity fully. This can cause you not to realize when you have a sore on your foot. If you are not examining your feet regularly, sores can become infected, which can cause further problems.
Retinopathy
Just as elevated glucose levels can affect the tiny vessels of the extremities, it can also affect the tiny vessels of the eyes. When this happens, diabetic retinopathy occurs – which is damage to the eyes.
Elevated glucose levels can also increase your likelihood of developing cataracts and other eye issues.
Should you develop diabetic retinopathy, cataracts, or other diabetes-related eye diseases, you should regularly follow-up with an eye doctor. It is likely that they will perform a dilated eye exam yearly to monitor your condition(s).
Nephropathy
Diabetic nephropathy, also called diabetic kidney disease, is another side effect of diabetes. Poorly controlled glucose levels typically cause this complication.
Untreated diabetic nephropathy may lead to impaired kidney function, dialysis, and the eventual need for a kidney transplant. This happens because when the kidneys are unable to function properly, they are unable to filter the blood effectively.
Your physician should monitor your kidney function by ordering urine microalbuminuria levels at regular intervals. This test detects diabetic nephropathy in its early stages. Once protein is detected in the urine, medications can be ordered to slow the progression of nephropathy.
Preventing Complications of Diabetes
As you’re reading through these side effects of diabetes, likely you’re thinking, “These sound awful."
They do.
To some extent, complications may be unavoidable. Sometimes, a complication may occur despite your best intentions and hard work. However, there are things that you can do to attempt to prevent them from happening.
Take Insulin as Prescribed
Your best bet in avoiding hypoglycemia and DKA is to take your insulin as prescribed and keep track of your insulin and glucose levels.
If hypoglycemia occurs as a result of too much insulin, knowing how much you took is vital – this is valuable information when you discuss the event with your physician. Without this information, it will be difficult for your provider to adjust your insulin dose.
DKA can be prevented, most of the time, by taking your insulin as it is prescribed and by troubleshooting issues with your insulin pump if you are using one.
Take Your Prescribed Medications
As far as preventing long-term complications, your best bet is also taking medications as prescribed and checking glucose levels.
The likelihood of developing long-term complications increases when glucose levels have been elevated for long periods of time, so it stands to reason that if you take your insulin or medication as prescribed, you can reduce your chances of developing the complications.
Follow Up With Your Health Care Team
You should keep follow up regularly with your providers – your primary care provider, your eye doctor, dentist, and your diabetes educator and registered dietitian, if you work with them.
Your health care team can monitor your glucose levels, your lab work, your medication regimen, your weight, your blood pressure, and other variables that may increase your risk of developing complications.
The Bottom Line…
You may have diabetes, but that doesn’t mean that you are destined to develop the side effects (or complications) of diabetes!