Reducing the Risk of Complications

Working with health care providers can reduce the occurrence of diabetes complications by controlling levels of blood glucose, blood pressure and blood lipids, and by ensuring that the person with diabetes receives other preventive care treatments and advice in a timely manner.

Reducing the risk of diabetes complications can be achieved by:

• not smoking;
• being physically active in accordance with Canada’s Physical Activity Guide to Healthy Active Living;
• eating a healthy, balanced diet in accordance with Canada’s Food Guide
• monitoring blood glucose levels with daily testing and an A1C blood test every three months;
• maintaining a healthy cholesterol level;
• controlling blood pressure;
• having a kidney function test every 12 months;
• having regular eye exams;
• taking care of your feet by regularly examining toes and skin; and,
• having regular dentist visits.

For general help and support about types 1, 2 and gestational diabetes in your province, please visit the Canadian Diabetes Association or Diabète Québec

For information specific to type 1 diabetes, please visit the Juvenile Diabetes Research Foundation

Some of the common complications of diabetes are listed below:

Cardiovascular Disease

• People living with diabetes have an increased risk of developing high blood pressure and other cardiovascular problems, as diabetes adversely affects the arteries, predisposing them to atherosclerosis (hardening of the arteries). Atherosclerosis can cause high blood pressure, which if not treated, can lead to blood vessel damage, stroke, heart failure, heart attack or kidney failure.
• People living with diabetes may also need to take medications to manage cholesterol (lipids) and blood pressure because of increased risk of cardiovascular disease.
• Heart disease and stroke account for about 2 out of 3 deaths in people with diabetes.

For more information on cardiovascular disease, please visit the Cardiovascular Disease section on the PHAC website or the website of the Heart and Stroke Foundation of Canada

Kidney Disease

According to the Kidney Foundation Of Canada, signs of early kidney damage can develop in as many as 50 per cent or more of people with diabetes. If left untreated, this could lead to more kidney damage or kidney failure.

People living with diabetes could have serious kidney damage without being aware of it. There are usually no specific symptoms of kidney disease until the damage is severe.

However, people with diabetes should be tested once a year to see if diabetes has affected their kidneys. Their doctor can arrange a urine test for protein (a random urine test for “albumin to creatinine ratio”), and a blood test to check how well their kidneys are functioning (the “serum creatinine”).

For more information on diabetes and kidney disease, please visit the website of the Kidney Foundation of Canada

Blindness

• Diabetic retinopathy is the leading cause of vision loss in Canadians under 50.
• Nearly all people with type 1 diabetes and 60% of those with type 2 develop some form of diabetic retinopathy during the first 20 years they have the disease.
• Over 100,000 people have a vision threatening form of diabetic retinopathy. This number is increasing by over 2500 people per year.

For more information on diabetes and vision health please visit the Canadian Diabetes Association

Diabetic Foot Ulcers

According to the Canadian Association of Wound Care, diabetes foot ulcers are the leading cause of amputations.

The Canadian Association of Wound Care also states that foot ulcers and wounds are one of the most devastating complications of diabetes.  Ulcers and wounds arise from poor circulation associated with peripheral vascular disease and neuropathy, injury and infections.  Diabetes affects circulation and immunity, and over time the sensory nerves in the hands and feet may be damaged.  Canadians with diabetes often may not feel a foot injury, blister or cut.  Small sores, ulcers or wounds may become infected leading to serious complications that may result in amputation.

Nevertheless, the evidence is clear that diabetes foot ulcers and wounds that result in amputation may be prevented by early detection, prevention measures such as regular foot checks, stopping tobacco use and effective wound care.

Diabetes foot infections are the most common reason for admission to hospital for Canadians living with diabetes.  At highest risk of amputation for diabetes foot ulcers are Canadians with diabetes who are over 40, who smoke, and have lived with diabetes for 10 years or more.

For more information on caring for your feet, please visit the website of the Canadian Association of Wound Care

Other complications

People with diabetes are more susceptible to many other illnesses. For example, diabetics may be more likely to die of pneumonia or influenza than people who do not have diabetes.