Diabetes can affect the entire body. Here’s how to ensure you stay healthy.
Diabetes can truly affect the entire body. “On its most basic level, it’s a metabolic disease,” says Paul Knoepflmacher, MD, clinical instructor in medicine at The Mount Sinai Hospital. “It affects sugar control and sugar metabolism, but it has an impact on your whole system.”
“One of the main goals of diabetes therapy is to reduce your risk of complications,” says Sonal Chaudhry, MD, endocrinologist at NYU Langone Health.
Here are some of the most serious risks of diabetes you need to be aware of:
1. Diabetes and Heart Health
A main concern among people with type 2 diabetes is the risk of heart disease, according to Nieca Goldberg, MD, medical director at NYU Langone Health and Joan H. Tisch Center for Women’s Health. High blood sugar can damage blood vessels over time; the longer you have diabetes, the higher your risk of developing heart disease, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Because of the risk of heart disease, people with diabetes should get their blood pressure and cholesterol checked at doctor visits. (Here’s how often you should visit the doctor with diabetes.)
Depending on certain factors, you might want to ask your doctor about additional tests for your heart health. “If you’re an older patient and you’re beginning an exercise program or intensifying an exercise program, it’s important to talk to your doctor about this,” says Sonal Chaudhry, MD, endocrinologist at NYU Langone Health. “They may want to do an EKG. They may do stress testing to assess your cardiovascular risk.”
2. Diabetes and Eye Health
Blood vessel damage affects more than just your heart health. Your eyes also have tiny blood vessels that fuel healthy vision; pressure in these vessels can damage the retina, leading to diabetic retinopathy. Because the retina is responsible for converting images to signals to the brain, retina damage can lead to reduced vision and even blindness. (Learn more about eye complications for diabetes here.)
“Fortunately, we can treat many of those problems before they steal your vision,” says Marc Werner, MD, ophthalmologist in Manhattan and Long Island. It’s critical to see your eye doctor regularly and get a dilated eye exam at least once a year, for starters.
3. Diabetes and Foot Health
Diabetes affects foot health in two main ways, according to Dr. Knoepflmacher: damaging the nerves of the feet (neuropathy) and restricting blood circulation.
“Patients with diabetes should be seen regularly for foot evaluations,” says William Spielfogel, DPM, chief of division of podiatry at Lenox Hill Hospital. Staying on top of these appointments can prevent serious complications like hammertoes, ulcerations, and amputations. Here’s more information about managing foot problems with diabetes.
“It’s very important that if somebody notices a wound or a cut on their foot, that they don’t ignore it and think that it will go away,” says Dr. Spielfogel. Without enough red blood cells from inadequate blood flow, wounds may heal slowly or not at all, and seemingly minor cuts can become a huge issue.
4. Diabetes and Kidney Health
“Diabetes is the most common reason for end-stage kidney disease and the reason why people get a dialysis,” says Dr. Knoepflmacher. Blood vessels damaged from high blood glucose levels don’t function as well as they should, and this can damage the kidneys. About a quarter of U.S. adults with diabetes have kidney disease, according to NIDDK.
“Your doctor can do blood tests to check the kidney function, but more importantly, he or she can check your urine for the presence of protein,” says Dr. Knoepflmacher. “If you have too much protein in the urine, that means the kidneys are not healthy.”
5. Diabetes and Oral Health
People with diabetes are at a higher risk of cavities and gum disease, according to Dr. Chaudhry. In fact, your dentist might be the first to detect your diabetes: During a regular cleaning, your dentist may notice symptoms of diabetes including bleeding gums, dry mouth, oral thrush and other infections, and persistent cuts or cold sores that won’t heal.
Practice good oral hygiene, which includes brushing teeth twice a day and flossing at least once. Visit your dentist for a regular cleaning and oral exam once or twice a year, according to the American Dental Association.
6. Diabetes and the Immune System
Having diabetes can impact your ability to fight off infections. “It’s extra important for diabetics to get regular vaccines,” says Dr. Knoepflmacher. The Centers for Disease Control and Prevention recommend people with diabetes stay up-to-date with the following vaccines:
Tdap (tetanus, diphtheria, and pertussis)
Zoster (to protect against shingles)
People with diabetes are more likely to catch infections, and they are also more likely to experience complications from an infection. For example, influenza may raise blood sugars to a dangerous level, according to the CDC.
These possible complications from diabetes may seem overwhelming, but there’s good news: “Preventing and controlling a person’s diabetes and keeping their sugars low [can help] mitigate and reduce the risk of these complications happening,” says Dr. Knoepflmacher.
Dr. Chaudhry is an endocrinologist at NYU Langone Health in New York City.Paul Knoepflmacher
Dr. Knoepflmacher is a clinical instructor of medicine at The Mount Sinai Hospital in New York City, where he also maintains a private practice.Nieca Goldberg
Dr. Goldberg is a cardiologist and medical director of the NYU Langone Health Joan H. Tisch Center for Women’s Health.Marc Werner
Dr. Werner is an ophthalmologist and partner with Stahl Eyecare Experts in New York City and Long Island.William Spielfogel
Dr. Spielfogel is the chief of podiatry in the department of orthopaedic surgery at Lenox Hill Hospital in New York City.
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(energetic, light piano music)
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-: One of the main goals of diabetes therapy
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is to reduce your risk of complications.
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-: I think a good way to think of diabetes
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is that it's a condition that affects your whole body.
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On the most basic level, it's a metabolic disease,
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meaning it affects sugar control and sugar metabolism,
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but it has an impact on your whole system.
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-: Probably one of the most common connections
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between heart disease and diabetes is the role it plays
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in accelerating the rate of coronary artery disease.
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-: All diabetics should have their blood pressure
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measured every time they go to see the doctor.
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Diabetics should have their cholesterol levels
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checked at diagnosis.
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So, if you're an older patient and you're beginning
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an exercise program or intensifying and exercise program,
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it's important that you talk with your doctor about this.
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They may wanna do an EKG.
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They may do a stress testing
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to access your cardiovascular risk.
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-: What's really, really important that if you have diabetes,
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type one or type two, that you at least
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get an annual eye exam.
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The serious problems from diabetes occur
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in the back of the eye in the retina.
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If you have retina problems from diabetes,
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you can really have profound irreversible vision loss.
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Fortunately, we can treat many of those problems
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before they steal your vision.
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-: We know that diabetes affects foot health a lot
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and the reason is because diabetes affects the nerves
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in the feet and it affects blood flow.
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-: Patients with diabetes should be seen regularly for foot
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evaluations and it's really just as a preventive measure
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because we want to avoid the complications of diabetes,
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such as ulceration and amputations.
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It's very important that you wear proper fitting shoes.
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It's very important that if somebody notices a wound
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or a cut on their foot, that they don't ignore it
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and think it will go away.
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-: Diabetes is the most common reason
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for end-stage kidney disease and the reason
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why people get on dialysis.
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Diabetes is bad for the kidneys.
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Your doctor can do blood tests to check the kidney function,
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but more importantly, he or she can check your urine
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for the presence of protein.
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If you have too much protein in the urine,
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that means that the kidneys are not healthy.
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-: Having a diagnosis of diabetes does increase your risk
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of cavities as well as gum problems,
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so it's important to take really good care of your teeth
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because some of these infections in the mouth or in the gums
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can also raise your blood sugar.
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-: Diabetes affects your immune system,
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so if you have diabetes, you may not fight off infections
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as well, so it's extra important for diabetics
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to get regular vaccines.
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-: Typically, diabetic patients should have
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their flu vaccines.
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They should be up to date with their pneumonia vaccines
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and many other vaccines may also be indicated,
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so it's important to discuss this with your physician.
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-: But our hope is is that in preventing and controlling
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a person's diabetes and keeping their sugars low,
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that we will mitigate and reduce the risk
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of these complications happening,
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so that's our focus is to try and prevent these things
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from developing or from getting worse.
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5 ways diabetes can affect your mouth. Chicago, IL: American Dental Association. (Accessed on May 3, 2021 at https://www.mouthhealthy.org/en/diabetes-slideshow.)
Diabetes, heart disease, and stroke. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases. (Accessed on May 3, 2021 at https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/heart-disease-stroke.)Diabetic kidney disease. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases. (Accessed on May 3, 2021 at https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/diabetic-kidney-disease.) Diabetes type 1 and type 2 and adult vaccination. Atlanta, GA: Centers for Disease Control and Prevention, 2016. (Accessed on May 3, 2021 at https://www.cdc.gov/vaccines/adults/rec-vac/health-conditions/diabetes.html.)