Complications associated with Type I Diabetes 

There are several, both short term and long term, complications associated with Type I diabetes. Examples of short term complications include hypoglycaemia and Ketoacidosis whereas more long term effects may be related to issues with the heart, kidneys, nerves, feet and eyes. Below discusses these complications in more detail.

CVD (Cardiovascular Disease)

Cardiovascular Disease (CVD) is a generalised term referring to diseases that cause damage to the heart and include Heart disease, stroke and other circulation problems such as hardening and narrowing of blood vessels such as arteries. CVD also includes PVD or Peripheral Vascular diseases associated with circulation of peripheral limbs such as legs.

People with Type I diabetes can have up to five times greater risk of suffering from a type of CVD mainly due to poorly controlled blood glucose levels over a prolonged period of time. In addition to this, alterations in blood cholesterol levels as well as risk factors such as smoking, obesity, hypertension and decreased physical activity can also contribute to the triggering of heart complications.

The major cause of CVD for diabetic patients is the increased risk of fatty material building up in the arteries, known as Atherosclerosis. Build-up of fatty material causes blockages in the blood vessels and can reduce the flow of blood through the circulation system. This inadvertently increases the blood pressure in the system and can result in areas of the blood being starved of the oxygen supply required for survival. This may therefore lead to heart attacks or Myocardial Infarctions (MI) and in more severe cases a Stroke, where the blood supply is blocked to an area of the brain. In blockages to the peripheral areas of the body in PVD, pain in the limbs and complications such as gangrene can lead to drastic results such as amputation.

It is therefore important that diabetic patients control their blood glucose levels and health very well to ensure no sure problems arise. Below is a list of factors that need to be considered by diabetes patients as given on the Diabetes UK website to ensure prevention of CVD.

Reducing your risk of CVD

• Be more physically active.
• Lose weight if you are overweight.
• Stop smoking if you smoke.
• Eat a healthy balanced diet.
• Take your medication as prescribed by your doctor.
• Try to keep your blood glucose levels well controlled – between 4 – 6mmol/l before meals and less than 10mmol/ll 2 hours after. 
• Try to keep your blood pressure well controlled – it should be treated if it is above 130/80 mmHg.
• Try to control your blood fats to – total cholesterol below 4mmol/l, low-density lipoprotein cholesterol (LDL – often known as “bad cholesterol”) below 2mmol/l, high density lipoprotein cholesterol (HDL – often known as “good cholesterol”) 1.0mmol/l or above if you are a man and 1.2mmol/l or above if you are a woman, triglycerides 1.7mmol/l or below.
• It may also be beneficial to take a small amount of aspirin – check with your doctor.
• Have regular medical examinations at least once a year.

Retinopathy

As mentioned in the monitoring health section, the eyes are another target of the body that is regularly assessed in routine check-ups for diabetic patients. This is due to the increased risk of retina damage associated with both Type I and Type II diabetes. Retinopathy is the most common cause for blindness currently in the UK (Diabetes UK) and therefore a key complication related to poor control of blood sugar levels as well as other influencing factors.

Below is a table from the Diabetes UK website showing the different types of retinopathy a diabetic patient may be diagnosed with including the signs and diagnosis, treatment as well as other side effect associated with the retinopathy. (N.B Underlined treatments open up a new page in browser and link to Diabetes UK website for more detailed information).

The main aspects of reducing the risk of developing retinopathy include controlling blood glucose levels, lipid levels and blood pressure. The ideal values for each of these are discuss in the monitoring health section. Smoking also increases the risk of developing retinopathy as well as being overweight and low physical activity levels. 

Neuropathy

Another long term complication associated with diabetes is Neuropathy which is more commonly referred to as damage to the nerves. Due to the fact that nerves are involved in transfer of information to all areas of the human body, neuropathy can have a wide range of side effects. Neuropathy can therefore be categorised into three different types; sensory, autonomic and motor. (For more detailed information, please follow the links which will open up a new web page (Diabetes UK)).

The relationship between the cause of nerve damage and diabetes is not yet fully understood and research is still on going to find the exact mechanisms involved. However we do know that an increased long term blood glucose level (shown in the HbA1c) can limit the nerves ability to transmit the action potentials as well as damage the blood vessels supply the oxygen and other nutrients required by the nerve cells.

The effects of neuropathy can be found in all areas of the body. Below is a table of examples and the symptoms that may occur as a result.