Complications of Diabetes

Diabetes has many complications, both short-term and long-term. The short-term complications include both deadly and some easily resolved complications. Long-term complications tend to be serious but may not appear for years or decades.

Short-Term Deadly Complications of Diabetes. The most serious complications of diabetes are those where it is undiagnosed, where a person has poor control, or where a person is non-compliant with treatment (e.g. stops taking insulin). These complications include:

Short-Term Complications of Diabetes Medications. Both insulin and diabetes pills can cause an important complication: low blood sugars. This is called “hypoglycemia” and has various other names: hypoglycemic attack, hypoglycemic event, insulin attack, or just a “hypo”. This can be severe leading to various symptoms (sweating, trembling, vision loss, etc.) and eventually to fainting or temporary unconsciousness. People usually recover from a hypo, even after fainting, but not always. A small number of people can suffer a fatality from a severe low blood sugar event. It is important to control your blood sugars to avoid low sugars, and to have an emergency glucagon kit to treat a major hypo.

Other Short-Term Milder Complications of Diabetes. In addition to these potentially deadly complications of diabetes (and the medications), there are a number of other complications or short-term effects of diabetes that people may suffer from. Most of these complications are due to high blood sugar levels, and often resolve once blood sugars are back under control.

Long-Term Serious Complications of Diabetes: There are many longer term effects on various body organs, which can eventually lead to severe problems or death. Some of the major concerns are:

And that’s just the short list. Diabetes can impact just about any nerve or blood vessel in the body.

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Back to: « Diabetes

Complications of Diabetes

DM

Source: Healthy People (DHHS)1

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The Interaction of Coronary Heart Disease, High Blood Pressure, and Diabetes

Each of these risk factors alone can damage the heart. CHD reduces the flow of oxygen-rich blood to your heart muscle. High blood pressure and diabetes may cause harmful changes in the structure and function of the heart.

Having CHD, high blood pressure, and diabetes is even more harmful to the heart. Together, these conditions can severely damage the heart muscle. As a result, the heart has to work harder than normal. Over time, the heart weakens and isn’t able to pump enough blood to meet the body’s needs. This condition is called heart failure.

As the heart weakens, the body may release proteins and other substances into the blood. These proteins and substances also can harm the heart and worsen heart failure.

Source: NHLBI (NIH)2

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Diabetes is the most common cause of blindness, kidney failure and amputations in adults. It’s also a leading cause of heart disease and stroke.

People with diabetes have unusually high levels of a sugar called glucose in the blood. When blood glucose gets too high, it can damage your tissues and organs.

Source: NIH News in Health (NIH)3

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If you have diabetes, controlling your blood glucose, blood pressure and cholesterol will prevent or delay the complications of diabetes. Be sure to talk to your health care professional about your risk.

Source: NIH News in Health (NIH)4

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If not managed, diabetes can cause serious damage to the kidneys and can lead to blindness, nerve damage, and hearing loss.4

Source: NICHD (NIH)5

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What other health problems can diabetes cause?

Diabetes can lead to quite a number of health problems, especially if it is not well controlled. Among the problems diabetes can cause:3

For more information on other health problems caused by diabetes, visit the National Diabetes Information Clearinghouse.

Source: NICHD (NIH)6

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Does having diabetes or gestational diabetes affect my infant?

Most women who have diabetes and become pregnant or who have gestational diabetes have healthy pregnancies and deliver healthy babies because they manage their diabetes.

However, diabetes and especially uncontrolled diabetes are associated with several complications, including (but not limited to):

  • Jaundice (pronounced JAWN-diss)—This yellowish tint to the infant’s skin is treatable and typically has no lasting effects.
  • Hypoglycemia (pronounced hahy-poh-glahy-SEE-mee-uh)—Infant’s blood sugar is too low. You many need to breastfeed quickly, or find other ways to get more sugar into his/her system.
  • Macrosomia (pronounced mak-row-SOHM-ee-uh)—Infant is large, which increases the likelihood of a cesarean or surgical delivery.
  • Respiratory distress syndrome—Infant has trouble breathing and may require oxygen or other treatments.
  • Low calcium and magnesium levels—Infant may need supplements to avoid other complications.

Working with your health care provider to control diabetes can help reduce the risk of these and other complications.

In addition, children whose mothers had gestational diabetes are at higher lifetime risk for type 2 diabetes, and for having it at a younger age than children whose mothers didn’t have the condition.5

Source: NICHD (NIH)7

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Complications associated with diabetes include diabetic retinopathy (a leading cause of blindness and visual disability), kidney failure, heart disease, neuropathy and diabetic foot disease.

Source: EC (EU)8

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The prognosis of T2D is characterised by the development of complications and, as such, T2D is a disease which gives rise to excessive rates of heart disease, stroke, peripheral vascular disease, renal disease, eye diseases, and many neurological and mental problems.

Source: EC (EU)9

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Diabetes complications require hospitalisation most of the time. 50% of people with diabetes suffer from at least one complication.

Source: EC (EU)10

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Diabetes is a common disease that is on the rise in America. Having diabetes raises your risk for developing other dangerous conditions, especially heart disease and stroke. November is National Diabetes Month, a time to raise awareness about preventing and managing diabetes and protecting yourself from its complications.

Source: CDC Features11

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Women with diabetes have a 40% greater risk of developing heart disease and a 25% greater risk of stroke than men with diabetes do.5 Experts aren't sure why the risk is so much greater in women with diabetes than in men with diabetes. Women's biology may play a role: Women usually have more body fat, which can put them at greater risk for heart disease and stroke. If you are a woman with diabetes, you can take steps to control your condition and improve your chances for avoiding heart disease and stroke (see below).

Source: CDC Features12

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Almost 7 in 10 people with diabetes over age 65 will die of some type of heart disease. About 1 in 6 will die of stroke.[6] People with diabetes have very high blood sugar, which causes damage to nerves and blood vessels. Over time, this can lead to heart disease, stroke, kidney disease, and even blindness. People with diabetes are more likely to develop and die from heart disease or stroke.[7]

Source: CDC Features13

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Diabetes can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. Diabetes is the seventh leading cause of death in the United States.

Source: CDC14

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What is the link between diabetes, heart disease, and stroke?

Over time, high blood glucose from diabetes can damage your blood vessels and the nerves that control your heart and blood vessels. The longer you have diabetes, the higher the chances that you will develop heart disease.1

People with diabetes tend to develop heart disease at a younger age than people without diabetes. In adults with diabetes, the most common causes of death are heart disease and stroke. Adults with diabetes are nearly twice as likely to die from heart disease or stroke as people without diabetes.2

The good news is that the steps you take to manage your diabetes also help to lower your chances of having heart disease or stroke.

Source: NIDDK (NIH)15

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What health problems can people with diabetes develop?

Over time, high blood glucose leads to problems such as

You can take steps to lower your chances of developing these diabetes-related health problems.

Source: NIDDK (NIH)16

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If undetected or poorly controlled, diabetes can lead to blindness, kidney failure, lower limb amputation, heart attack, stoke and impotence.

Source: Queensland Health17

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Diabetes can affect many parts of your body. It’s important to keep diabetes under control. Over time, it can cause serious health problems like heart disease, stroke, kidney disease, blindness, nerve damage, and circulation problems that may lead to amputation. People with type 2 diabetes also have a greater risk for Alzheimer’s disease.

Source: NIA (NIH)18

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How does diabetes affect women differently than men?

Diabetes affects women and men in almost equal numbers. However, diabetes affects women differently than men.

Compared with men with diabetes, women with diabetes have:[9]

Source: OWH (DHHS)19

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Does diabetes raise my risk for other health problems?

Yes. The longer you have type 2 diabetes, the higher your risk for developing serious medical problems from diabetes. Also, if you smoke and have diabetes, you are even more likely to develop serious medical problems from diabetes, compared with people who have diabetes and do not smoke.11

The extra glucose in the blood that leads to diabetes can damage your nerves and blood vessels. Nerve damage from diabetes can lead to pain or a permanent loss of feeling in your hands, feet, and other parts of your body.12

Blood vessel damage from diabetes can also lead to:

Women with diabetes are also at higher risk for:  

Source: OWH (DHHS)20

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Diabetes may result in a range of health complications, including heart disease, kidney disease, blindness and lower limb amputation. It is frequently associated with other chronic health conditions, such as cardiovascular disease and chronic kidney disease.

Source: Australian Institute of Health and Welfare21

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Diabetes is serious.

You may have heard people say they have "a touch of diabetes" or "your sugar is a little high." These words suggest that diabetes is not a serious disease. That is not correct. Diabetes is serious, but you can learn to manage it!

All people with diabetes need to make healthy food choices, stay at a healthy weight, and be physically active every day.

Taking good care of yourself and your diabetes can help you feel better. It may help you avoid health problems caused by diabetes, such as:

When your blood glucose (blood sugar) is close to normal, you are likely to:

  • have more energy.
  • be less tired and thirsty and urinate less often.
  • heal better and have fewer skin or bladder infections.
  • have fewer problems with your eyesight, feet, and gums.

Learn how caring for your diabetes helps you feel better today and in the future.

Source: MedLinePlus Magazine (NIH)22

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Preventing and Managing Diabetes Complications

Diabetes means your blood glucose, or blood sugar, is too high. With type 2 diabetes, the more common type, your body does not make or use insulin well. Insulin is a hormone that helps glucose get into your cells to provide energy. Without insulin, too much glucose stays in your blood. Over time, this can cause problems with your heart, kidneys, nerves, feet, and eyes.

Other long-term complications of diabetes include skin problems, digestive problems, sexual dysfunction, and problems with your teeth and gums. Very high or very low blood sugar levels can also lead to emergencies in people with diabetes. The cause can be an underlying infection, certain medicines, or even the medicines you take to control your diabetes. However, early diagnosis and strict management of diabetes have been proven to make a great impact in preventing or delaying complications of the disease.

Source: MedLinePlus Magazine (NIH)23

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Major Complications of Diabetes

Heart Attacks and Stroke: People with diabetes have a higher risk for heart attacks, strokes, and other cardiovascular diseases. High blood pressure and high cholesterol increase this risk even more. Controlling blood pressure and cholesterol can help prevent heart attacks and strokes. Thanks to improved medical treatment, better management of diabetes, and some healthy lifestyle changes, deaths from heart disease and stroke in people with diabetes dropped 40 percent between 1997 and 2004, according to a study published in the journal Diabetes Care.

Kidney Disease: Your kidneys filter the waste materials in your blood. Diabetes can damage your kidneys' ability to filter waste, which can lead to kidney failure or end-stage kidney disease. When the kidneys are unable to keep the body healthy—dialysis or a kidney transplant may be needed. Managing your diabetes and high blood pressure, and getting your blood and urine checked for kidney disease can help keep your kidneys healthy.

Eye Problems: Diabetes can damage the blood vessels in the retina (called retinopathy), which can lead to vision loss or even blindness. If caught early through regular eye exams treatment can prevent progression to blindness.

Foot Problems: Diabetes can damage the nerves in the feet and cause problems with blood flow to the feet. This can lead to loss of feeling in the feet (numbness) and sores and cuts on the feet that do not heal. If not treated right away, they can lead to more serious problems and even amputation of the feet and/or legs.

Nerves: Nerve problems don't just affect the feet. They can also cause problems with digestion and erectile dysfunction.

Source: MedLinePlus Magazine (NIH)24

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Insulin is a chemical produced in the pancreas. It helps your body process sugars.

If blood sugar levels aren’t kept under control, diabetes can be life-threatening.

Diabetes can lead to other health conditions, including kidney failure, eye disease, foot ulceration and a higher risk of heart disease.

Keeping your blood sugar at a safe level means you’re less likely to have other health problems.

Source: New Zealand Health25

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Diabetes-related conditions

Over time, diabetes can damage the heart, blood vessels, eyes, kidneys, and nerves.

Source: New Zealand Health26

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Left untreated, hyperglycaemia can lead to diabetic ketoacidosis. This is a serious condition where the body breaks down fat and muscle as an alternative source of energy. This leads to a build-up of acids in your blood, which can cause vomiting, dehydration, unconsciousness and even death.

Diabetes UK has more information about diabetes symptoms.

Source: NHS Choices UK27

Increased Risks from Diabetes

Compared with people who don't have diabetes, people who have diabetes:

Source: NHLBI (NIH)28

Increased Risks from Diabetes

Dementia: Diabetes. People with diabetes appear to have a higher risk for dementia, although the evidence for this association is modest. Poorly controlled diabetes, however, is a well-proven risk factor for stroke and cardiovascular disease-related events, which in turn increase the risk for vascular dementia.

Source: NIA (NIH)29

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Cataract: People with diabetes are also at risk for cataracts, which cause clouding of the eye lens, and glaucoma, which damages the optic nerve.

Source: NIH News in Health (NIH)30

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Osteoporosis, Osteopenia, Bone Loss: Other health problems that increase their risk for bone loss. If you have one of the following health problems, talk to your doctor about your bone health.

Source: NIAMS (NIH)31

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Cancer: Diabetes

Some studies show that having diabetes may slightly increase the risk of having the following types of cancer:

Diabetes and cancer share some of the same risk factors. These risk factors include the following:

Because diabetes and cancer share these risk factors, it is hard to know whether the risk of cancer is increased more by diabetes or by these risk factors.

Studies are being done to see how medicine that is used to treat diabetes affects cancer risk.

Source: NCI (NIH)32

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Dementia Disorders: Dementia & Diabetes

High blood glucose increases the chance of developing dementia . Tell your doctor if you are forgetful because dementia can make it hard to manage your diabetes.

Source: NIDDK (NIH)33

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Sleep Disorders: Sleep Apnea & Diabetes

People who have sleep apnea —when you stop breathing for short periods during sleep—are more likely to develop type 2 diabetes. Sleep apnea also can make diabetes worse. Treatment for sleep apnea can help.

Source: NIDDK (NIH)34

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Heart attack: Uncontrolled diabetes can damage your arteries and make you more likely to get high blood pressure and form blood clots that can cause a heart attack. About 28% of Americans with diabetes don't know that they have it.[6] The only way to know for sure whether you have diabetes is to get a blood test.

Learn more at our diabetes page and learn about the link between diabetes and the risk for heart disease.

Source: OWH (DHHS)35

Complication Statistics for Diabetes

Adults with diabetes are 2-5 times more likely than those without diabetes to develop cataract.

Source: NEI (NIH)36

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In adults, diabetes nearly doubles the risk of glaucoma.

Source: NEI (NIH)37

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Between 40 and 45 percent of Americans diagnosed with diabetes have some stage of diabetic retinopathy, although only about half are aware of it.

Source: NEI (NIH)38

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In 2014-15, there were 4,100 lower-limb amputations provided in hospital to patients with a diagnosis of diabetes. Lower-limb amputations were more common in males (75%) and for those aged 65 and over (57%).

Note that hospitalisation data presented here provides counts on the total number of in-hospital episodes for amputations, but cannot calculate the number of individuals undergoing amputation, the number of repeat amputations, nor establish the link between the amputation and diabetes.

Source: Australian Institute of Health and Welfare39

Complications for Diabetes

Gum disease: How Does Diabetes Affect the Mouth?

People who have diabetes know the disease can harm the eyes, nerves, kidneys, heart and other important systems in the body. Did you know diabetes can also cause problems in your mouth?

People with diabetes are at special risk for periodontal (gum) disease, an infection of the gum and bone that hold the teeth in place. Periodontal disease can lead to painful chewing difficulties and even tooth loss. Dry mouth, often a symptom of undetected diabetes, can cause soreness, ulcers, infections, and tooth decay. Smoking makes these problems worse.

Source: NIDCR (NIH)40

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Mouth Disorders: Diabetes can cause serious problems in your mouth. You can do something about it.

If you have diabetes, make sure you take care of your mouth. People with diabetes are at risk for mouth infections, especially periodontal (gum) disease. Periodontal disease can damage the gum and bone that hold your teeth in place and may lead to painful chewing problems. Some people with serious gum disease lose their teeth. Periodontal disease may also make it hard to control your blood glucose (blood sugar).

Other problems diabetes can cause are dry mouth and a fungal infection called thrush. Dry mouth happens when you do not have enough saliva—the fluid that keeps your mouth wet. Diabetes may also cause the glucose level in your saliva to increase. Together, these problems may lead to thrush, which causes painful white patches in your mouth.

If your diabetes is not under control, you are more likely to develop problems in your mouth. The good news is you can keep your teeth and gums healthy. By controlling your blood glucose, brushing and flossing every day, and visiting a dentist regularly, you can help prevent serious problems in your mouth.

Source: NIDCR (NIH)41

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Hearing Loss: In addition, hearing loss may be a largely unrecognized complication of diabetes, which suggests that people with diabetes should be screened for hearing loss.12

Source: Healthy People (DHHS)42

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Peripheral arterial disease: One in every three people over the age of 50 with diabetes is likely to have P.A.D.

Source: NHLBI (NIH)43

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Chronic kidney disease: Approximately 1 out of 3 adults with diabetes have CKD.

Also, the number of young people with type 2 diabetes is increasing; having diabetes for a longer time means more time to develop diabetes complications, including CKD.

Source: CDC Features44

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Kidney disorders: Kidney disease is one of several problems caused by elevated levels of blood glucose, the central feature of diabetes. In addition to scarring the kidney, elevated glucose levels appear to increase the speed of blood flow into the kidney, putting a strain on the filtering glomeruli and raising blood pressure.

Source: NIDDK (NIH)45

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Diabetic Foot Disease: How can diabetes affect my feet?

Over time, diabetes may cause nerve damage, also called diabetic neuropathy, that can cause tingling and pain, and can make you lose feeling in your feet. When you lose feeling in your feet, you may not feel a pebble inside your sock or a blister on your foot, which can lead to cuts and sores. Cuts and sores can become infected.

Diabetes also can lower the amount of blood flow in your feet. Not having enough blood flowing to your legs and feet can make it hard for a sore or an infection to heal. Sometimes, a bad infection never heals. The infection might lead to gangrene.

Gangrene and foot ulcers that do not get better with treatment can lead to an amputation of your toe, foot, or part of your leg. A surgeon may perform an amputation to prevent a bad infection from spreading to the rest of your body, and to save your life. Good foot care is very important to prevent serious infections and gangrene.

Although rare, nerve damage from diabetes can lead to changes in the shape of your feet, such as Charcot’s foot. Charcot’s foot may start with redness, warmth, and swelling. Later, bones in your feet and toes can shift or break, which can cause your feet to have an odd shape, such as a “rocker bottom.”

Charcot’s foot can cause your feet to have an odd shape, such as a “rocker bottom.”

Source: NIDDK (NIH)46

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Sexual and Urologic Problems: Troublesome bladder symptoms and changes in sexual function are common health problems as people age. Having diabetes can mean early onset and increased severity of these problems.

Sexual and urologic complications of diabetes occur because of the damage diabetes can cause to blood vessels and nerves.

Men may have difficulty with erections or ejaculation. Women may have problems with sexual response and vaginal lubrication.

Urinary tract infections and bladder problems occur more often in people with diabetes.

People who keep their diabetes under control can lower their risk of the early onset of these sexual and urologic problems.

Source: NIDDK (NIH)47

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Sexual Problems: Diabetes and Sexual Problems

Both men and women with diabetes can develop sexual problems because of damage to nerves and small blood vessels. When a person wants to lift an arm or take a step, the brain sends nerve signals to the appropriate muscles. Nerve signals also control internal organs like the heart and bladder, but people do not have the same kind of conscious control over them as they do over their arms and legs. The nerves that control internal organs are called autonomic nerves, which signal the body to digest food and circulate blood without a person having to think about it. The body's response to sexual stimuli is also involuntary, governed by autonomic nerve signals that increase blood flow to the genitals and cause smooth muscle tissue to relax. Damage to these autonomic nerves can hinder normal function. Reduced blood flow resulting from damage to blood vessels can also contribute to sexual dysfunction.

Source: NIDDK (NIH)48

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Sexual Problems: What sexual problems can occur in men with diabetes?

Erectile Dysfunction

Erectile dysfunction is a consistent inability to have an erection firm enough for sexual intercourse. The condition includes the total inability to have an erection and the inability to sustain an erection.

Estimates of the prevalence of erectile dysfunction in men with diabetes vary widely, ranging from 20 to 75 percent. Men who have diabetes are two to three times more likely to have erectile dysfunction than men who do not have diabetes. Among men with erectile dysfunction, those with diabetes may experience the problem as much as 10 to 15 years earlier than men without diabetes. Research suggests that erectile dysfunction may be an early marker of diabetes, particularly in men ages 45 and younger.

In addition to diabetes, other major causes of erectile dysfunction include high blood pressure, kidney disease, alcohol abuse, and blood vessel disease. Erectile dysfunction may also occur because of the side effects of medications, psychological factors, smoking, and hormonal deficiencies.

Men who experience erectile dysfunction should consider talking with a health care provider. The health care provider may ask about the patient's medical history, the type and frequency of sexual problems, medications, smoking and drinking habits, and other health conditions. A physical exam and laboratory tests may help pinpoint causes of sexual problems. The health care provider will check blood glucose control and hormone levels and may ask the patient to do a test at home that checks for erections that occur during sleep. The health care provider may also ask whether the patient is depressed or has recently experienced upsetting changes in his life.

Treatments for erectile dysfunction caused by nerve damage, also called neuropathy, vary widely and range from oral pills, a vacuum pump, pellets placed in the urethra, and shots directly into the penis, to surgery. All of these methods have advantages and disadvantages. Psychological counseling to reduce anxiety or address other issues may be necessary. Surgery to implant a device to aid in erection or to repair arteries is usually used as a treatment after all others fail.

Retrograde Ejaculation

Retrograde ejaculation is a condition in which part or all of a man's semen goes into the bladder instead of out the tip of the penis during ejaculation. Retrograde ejaculation occurs when internal muscles, called sphincters, do not function normally. A sphincter automatically opens or closes a passage in the body. With retrograde ejaculation, semen enters the bladder, mixes with urine, and leaves the body during urination without harming the bladder. A man experiencing retrograde ejaculation may notice that little semen is discharged during ejaculation or may become aware of the condition if fertility problems arise. Analysis of a urine sample after ejaculation will reveal the presence of semen.

Poor blood glucose control and the resulting nerve damage can cause retrograde ejaculation. Other causes include prostate surgery and some medications.

Retrograde ejaculation caused by diabetes or surgery may be helped with a medication that strengthens the muscle tone of the sphincter in the bladder. A urologist experienced in infertility treatments may assist with techniques to promote fertility, such as collecting sperm from the urine and then using the sperm for artificial insemination.

More information about erectile dysfunction is provided in the NIDDK health topic Erectile Dysfunction.

Source: NIDDK (NIH)49

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Sexual Problems: What sexual problems can occur in women with diabetes?

Many women with diabetes experience sexual problems. Although research about sexual problems in women with diabetes is limited, one study found 27 percent of women with type 1 diabetes experienced sexual dysfunction. Another study found 18 percent of women with type 1 diabetes and 42 percent of women with type 2 diabetes experienced sexual dysfunction.

Sexual problems may include

Decreased or absent sexual response can include the inability to become or remain aroused, reduced or no sensation in the genital area, and the constant or occasional inability to reach orgasm.

Causes of sexual problems in women with diabetes include nerve damage, reduced blood flow to genital and vaginal tissues, and hormonal changes. Other possible causes include some medications, alcohol abuse, smoking, psychological problems such as anxiety or depression, gynecologic infections, other diseases, and conditions relating to pregnancy or menopause.

Women who experience sexual problems or notice a change in sexual response should consider talking with a health care provider. The health care provider will ask about the patient's medical history, any gynecologic conditions or infections, the type and frequency of sexual problems, medications, smoking and drinking habits, and other health conditions. The health care provider may ask whether the patient might be pregnant or has reached menopause and whether she is depressed or has recently experienced upsetting changes in her life. A physical exam and laboratory tests may also help pinpoint causes of sexual problems. The health care provider will also talk with the patient about blood glucose control.

Prescription or over-the-counter vaginal lubricants may be useful for women experiencing vaginal dryness. Techniques to treat decreased sexual response include changes in position and stimulation during sexual relations. Psychological counseling may be helpful. Kegel exercises that help strengthen the pelvic muscles may improve sexual response. Studies of drug treatments are under way.

Source: NIDDK (NIH)50

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Urologic Problems: Diabetes and Urologic Problems

Urologic problems that affect men and women with diabetes include bladder problems and urinary tract infections.

Bladder Problems

Many events or conditions can damage nerves that control bladder function, including diabetes and other diseases, injuries, and infections. More than half of men and women with diabetes have bladder dysfunction because of damage to nerves that control bladder function. Bladder dysfunction can have a profound effect on a person's quality of life.

Common bladder problems in men and women with diabetes include the following:

  • Overactive bladder. Damaged nerves may send signals to the bladder at the wrong time, causing its muscles to squeeze without warning. The symptoms of overactive bladder include ?urinary frequency-urination eight or more times a day or two or more times a night
  • urinary urgency-the sudden, strong need to urinate immediately
  • urge incontinence-leakage of urine that follows a sudden, strong urge to urinate
  • Poor control of sphincter muscles. Sphincter muscles surround the urethra-the tube that carries urine from the bladder to the outside of the body-and keep it closed to hold urine in the bladder. If the nerves to the sphincter muscles are damaged, the muscles may become loose and allow leakage or stay tight when a person is trying to release urine.
  • Urine retention. For some people, nerve damage keeps their bladder muscles from getting the message that it is time to urinate or makes the muscles too weak to completely empty the bladder. If the bladder becomes too full, urine may back up and the increasing pressure may damage the kidneys. If urine remains in the body too long, an infection can develop in the kidneys or bladder. Urine retention may also lead to overflow incontinence-leakage of urine when the bladder is full and does not empty properly.

Diagnosis of bladder problems may involve checking both bladder function and the appearance of the bladder's interior. Tests may include x-rays, urodynamic testing to evaluate bladder function, and cystoscopy, a test that uses a device called a cystoscope to view the inside of the bladder.

Treatment of bladder problems due to nerve damage depends on the specific problem. If the main problem is urine retention, treatment may involve medication to promote better bladder emptying and a practice called timed voiding-urinating on a schedule-to promote more efficient urination. Sometimes people need to periodically insert a thin tube called a catheter through the urethra into the bladder to drain the urine. Learning how to tell when the bladder is full and how to massage the lower abdomen to fully empty the bladder can help as well. If urinary leakage is the main problem, medications, strengthening muscles with Kegel exercises, or surgery can help. Treatment for the urinary urgency and frequency of overactive bladder may involve medications, timed voiding, Kegel exercises, and surgery in some cases.

Urinary Tract Infections

Infections can occur when bacteria, usually from the digestive system, reach the urinary tract. If bacteria are growing in the urethra, the infection is called urethritis. The bacteria may travel up the urinary tract and cause a bladder infection, called cystitis. An untreated infection may go farther into the body and cause pyelonephritis, a kidney infection. Some people have chronic or recurrent urinary tract infections. Symptoms of urinary tract infections can include

If the infection is in the kidneys, a person may have nausea, feel pain in the back or side, and have a fever. Frequent urination can be a sign of high blood glucose, so results from recent blood glucose monitoring should be evaluated.

The health care provider will ask for a urine sample, which will be analyzed for bacteria and pus. Additional tests may be done if the patient has frequent urinary tract infections. An ultrasound exam provides images from the echo patterns of sound waves bounced back from internal organs. An intravenous pyelogram uses a special dye to enhance x-ray images of the urinary tract. Cystoscopy might be performed.

Early diagnosis and treatment are important to prevent more serious infections. To clear up a urinary tract infection, the health care provider will probably prescribe antibiotic treatment based on the type of bacteria in the urine. Kidney infections are more serious and may require several weeks of antibiotic treatment. Drinking plenty of fluids will help prevent another infection.

Source: NIDDK (NIH)51

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Oral Disorders: How can diabetes affect my mouth?

Too much glucose, also called sugar, in your blood from diabetes can cause pain, infection, and other problems in your mouth. Your mouth includes

  • your teeth
  • your gums
  • your jaw
  • tissues such as your tongue, the roof and bottom of your mouth, and the inside of your cheeks

Glucose is present in your saliva—the fluid in your mouth that makes it wet. When diabetes is not controlled, high glucose levels in your saliva help harmful bacteria grow. These bacteria combine with food to form a soft, sticky film called plaque. Plaque also comes from eating foods that contain sugars or starches. Some types of plaque cause tooth decay or cavities. Other types of plaque cause gum disease and bad breath.

Gum disease can be more severe and take longer to heal if you have diabetes. In turn, having gum disease can make your blood glucose hard to control.

Source: NIDDK (NIH)52

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Oral Disorders: What are the most common mouth problems from diabetes?

The following chart shows the most common mouth problems from diabetes.

Source: NIDDK (NIH)53

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Low Blood Sugars: What happens if my blood glucose level becomes too low?

Sometimes blood glucose levels drop below where they should be, which is called hypoglycemia. For most people with diabetes, the blood glucose level is too low when it is below 70 mg/dL.

Hypoglycemia can be life threatening and needs to be treated right away. Learn more about how to recognize and treat hypoglycemia.

Source: NIDDK (NIH)54

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High Blood Sugars: What happens if my blood glucose level becomes too high?

Doctors call high blood glucose hyperglycemia.

Source: NIDDK (NIH)55

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Sleep apnea: Sleep apnea is common in people who have diabetes. Talk with your health care team if you think you have a sleep problem.

Source: NIDDK (NIH)56

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Diabetic neuropathy: What are diabetic neuropathies?

Diabetic neuropathies are a family of nerve disorders caused by diabetes. People with diabetes can, over time, develop nerve damage throughout the body. Some people with nerve damage have no symptoms. Others may have symptoms such as pain, tingling, or numbness—loss of feeling—in the hands, arms, feet, and legs. Nerve problems can occur in every organ system, including the digestive tract, heart, and sex organs.

Source: NIDDK (NIH)57

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Mouth disordes: Diabetes. People with diabetes are at special risk for gum disease. Gum disease can lead to painful chewing and even tooth loss. Dry mouth, often a symptom of undetected diabetes, can cause soreness, ulcers, infections, and tooth decay. People with diabetes can also get thrush. Smoking makes these problems worse. By controlling your blood glucose, brushing and flossing every day, and visiting a dentist regularly, you can help prevent gum disease. If your diabetes is not under control, you are more likely to develop problems in your mouth.

Source: OWH (DHHS)58

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Diabetic Heart Disease: Diabetes and Heart Health

If you have diabetes, it is important to take care of your heart. Learn about how diabetes affects your heart and tips for lowering your risk for heart disease and other heart problems.

People with diabetes should be aware of their heart health. Having diabetes makes heart attack and stroke more likely—but it doesn't have to. Research has shown that people with diabetes can lower their risk for heart disease and other heart problems by managing the ABCs of diabetes— A1C, Blood Pressure, Cholesterol—and stopping smoking. The NDEP provides educational resources for people with diabetes and health care professionals to raise awareness of the effect of diabetes on heart health.

Source: MedLinePlus Magazine (NIH)59

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Diabetic coma: People with diabetes could fall into a coma if their blood glucose levels suddenly became very low (hypoglycaemia) or very high (hyperglycaemia). 

Source: NHS Choices UK60

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Congenital heart disease: Maternal diabetes

Women with diabetes are five times more likely to give birth to a baby with congenital heart disease than women who don't have diabetes. It's estimated that 3-6% of women with diabetes who become pregnant will give birth to a baby with a heart defect - most commonly, transposition of the great arteries.

This increased risk only applies to type 1 diabetes and type 2 diabetes. It doesn't apply to gestational diabetes, which can develop during pregnancy and usually disappears once the baby is born.

The increased risk is thought to be caused by high levels of the hormone insulin in the blood, which may interfere with the normal development of a foetus.

Source: NHS Choices UK61

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Diabetic ketoacidosis: DKA mainly affects people with type 1 diabetes, but can sometimes occur in people with type 2 diabetes. If you have diabetes, it's important to be aware of the risk and know what to do if DKA occurs.

Source: NHS Choices UK62

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Diabetic retinopathy: Diabetic retinopathy is a complication of diabetes, caused by high blood sugar levels damaging the back of the eye (retina). It can cause blindness if left undiagnosed and untreated.

However, it usually takes several years for diabetic retinopathy to reach a stage where it could threaten your sight.

Source: NHS Choices UK63

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Diabetic retinopathy: How diabetes can affect the eyes

The retina is the light-sensitive layer of cells at the back of the eye that converts light into electrical signals. The signals are sent to the brain and the brain turns them into the images you see.

The retina needs a constant supply of blood, which it receives through a network of tiny blood vessels. Over time, a persistently high blood sugar level can damage these blood vessels in three main stages:

  • tiny bulges develop in the blood vessels, which may bleed slightly but don’t usually affect your vision - this is known as background retinopathy
  • more severe and widespread changes affect the blood vessels, including more significant bleeding into the eye - this is known as pre-proliferative retinopathy
  • scar tissue and new blood vessels, which are weak and bleed easily, develop on the retina - this is known as proliferative retinopathy and it can result in some loss of vision

However, if a problem with your eyes is picked up early, lifestyle changes and/or treatment can stop it getting worse.

Read about the stages of diabetic retinopathy.

Source: NHS Choices UK64

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Gangrene: Diabetes

People with diabetes have an increased risk of developing gangrene. This is because the high blood sugar levels associated with the condition can damage your nerves, particularly those in your feet, which can make it easy to injure yourself without realising.

High blood sugar can also damage your blood vessels, restricting the blood supply to your feet. Less blood means your feet will also receive fewer infection-fighting cells, so wounds will take longer to heal and are more likely to become infected.

It's therefore important that you take extra care of your feet if you have diabetes. Read more about foot care in preventing gangrene.

Source: NHS Choices UK65

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Diabetic peripheral neuropathy: Peripheral neuropathy becomes more likely the longer you've had diabetes. Up to one in every four people with the condition experience some pain caused by nerve damage.

Source: NHS Choices UK66

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References

  1. Source: Healthy People (DHHS): healthypeople.gov/ 2020/ topics-objectives/ topic/ diabetes
  2. Source: NHLBI (NIH): nhlbi.nih.gov/ health/ health-topics/ topics/ dhd/ causes
  3. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ 2009/ March/ capsules.htm
  4. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ 2006/ July/ docs/ 01features_02.htm
  5. Source: NICHD (NIH): nichd.nih.gov/ health/ topics/ PCOS/ conditioninfo/ Pages/ conditions-associated.aspx
  6. Source: NICHD (NIH): nichd.nih.gov/ health/ topics/ diabetes/ conditioninfo/ Pages/ faqs.aspx
  7. ibid.
  8. Source: EC (EU): ec.europa.eu/ health/ major_chronic_diseases/ diseases/ diabetes_en
  9. ibid.
  10. ibid.
  11. Source: CDC Features: cdc.gov/ features/ diabetes-heart-disease/ index.html
  12. ibid.
  13. ibid.
  14. Source: CDC: cdc.gov/ diabetes/ basics/ diabetes.html
  15. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ preventing-problems/ heart-disease-stroke
  16. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ what-is-diabetes
  17. Source: Queensland Health: conditions.health.qld.gov.au/ HealthCondition/ condition/ 8/ 77/ 286/ diabetes
  18. Source: NIA (NIH): nia.nih.gov/ health/ diabetes-older-people
  19. Source: OWH (DHHS): womenshealth.gov/ a-z-topics/ diabetes
  20. ibid.
  21. Source: Australian Institute of Health and Welfare: aihw.gov.au/ reports-statistics/ health-conditions-disability-deaths/ diabetes/ about
  22. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ fall14/ articles/ fall14pg14.html
  23. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ fall12/ articles/ fall12pg12.html
  24. ibid.
  25. Source: New Zealand Health: health.govt.nz/ your-health/ conditions-and-treatments/ diseases-and-illnesses/ diabetes
  26. Source: New Zealand Health: health.govt.nz/ our-work/ diseases-and-conditions/ diabetes/ about-diabetes/ diabetes-related-conditions
  27. Source: NHS Choices UK: nhs.uk/ conditions/ type-1-diabetes/ symptoms/ 
  28. Source: NHLBI (NIH): nhlbi.nih.gov/ health/ health-topics/ topics/ dhd
  29. Source: NIA (NIH): nia.nih.gov/ alzheimers/ publication/ dementias/ risk-factors-dementia
  30. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ issue/ nov2011/ capsule2
  31. Source: NIAMS (NIH): niams.nih.gov/ Health_Info/ Bone_Health/ default.asp
  32. Source: NCI (NIH): cancer.gov/ about-cancer/ causes-prevention/ patient-prevention-overview-pdq
  33. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ preventing-problems
  34. ibid.
  35. Source: OWH (DHHS): womenshealth.gov/ heart-disease-and-stroke/ heart-disease/ heart-disease-risk-factors/ health-conditions
  36. Source: NEI (NIH): nei.nih.gov/ health/ diabetic/ retinopathy
  37. ibid.
  38. ibid.
  39. Source: Australian Institute of Health and Welfare: aihw.gov.au/ reports/ diabetes/ diabetes-compendium/ contents/ hospital-care-for-diabetes
  40. Source: NIDCR (NIH): nidcr.nih.gov/ OralHealth/ Topics/ Diabetes/ 
  41. Source: NIDCR (NIH): nidcr.nih.gov/ oralhealth/ Topics/ Diabetes/ DiabetesDentalTips.htm
  42. Source: Healthy People (DHHS): healthypeople.gov/ 2020/ topics-objectives/ topic/ hearing-and-other-sensory-or-communication-disorders
  43. Source: NHLBI (NIH): nhlbi.nih.gov/ health/ educational/ pad/ about/ risk_factors_2.html
  44. Source: CDC Features: cdc.gov/ features/ worldkidneyday/ index.html
  45. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ kidney-disease/ glomerular-diseases
  46. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ preventing-problems/ foot-problems
  47. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ preventing-problems/ sexual-urologic-problems
  48. ibid.
  49. ibid.
  50. ibid.
  51. ibid.
  52. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ preventing-problems/ gum-disease-dental-problems
  53. ibid.
  54. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ managing-diabetes
  55. ibid.
  56. ibid.
  57. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ preventing-problems/ nerve-damage-diabetic-neuropathies
  58. Source: OWH (DHHS): womenshealth.gov/ a-z-topics/ oral-health
  59. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ fall14/ articles/ fall14pg17.html
  60. Source: NHS Choices UK: nhs.uk/ conditions/ coma/ 
  61. Source: NHS Choices UK: nhs.uk/ conditions/ congenital-heart-disease/ causes/ 
  62. Source: NHS Choices UK: nhs.uk/ conditions/ diabetic-ketoacidosis/ 
  63. Source: NHS Choices UK: nhs.uk/ conditions/ Diabetic-retinopathy/ 
  64. ibid.
  65. Source: NHS Choices UK: nhs.uk/ conditions/ gangrene/ causes/ 
  66. Source: NHS Choices UK: nhs.uk/ conditions/ peripheral-neuropathy/ causes/ 

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Note: This site is for informational purposes only and is not medical advice. See your doctor or other qualified medical professional for all your medical needs.