Skin and Feet
Germs are always on the skin. High blood glucose provides food for germs to grow. High blood sugar over many years can damage small and large blood vessels and nerves.
Some parts of the skin break down easier than others. These include places that are moist, dirty, or not covered by clothing. Areas that bear weight, such as feet, are more likely to break down. Skin breakdown can become very bad with poor blood flow and nerve damage. Nerve damage causes loss of feeling. A small injury can lead to a very bad infection, especially for the feet.
Such infections are most likely to become a problem only after years of high blood sugars. Moist places, such as under the arms and the genital area between the legs, need special care. Yeast infections are very common in these areas. Moisture makes it easier for the skin to break down. To prevent infection, it is important to bathe daily and keep these areas dry.
Teeth and Gums
People with diabetes are at high risk for gum disease and tooth loss. High blood sugars can cause high sugar levels in the mouth. this provides food for germs to grow. Germs can cause cavities that destroy teeth. Germs also cause gum disease.
High blood glucose can cause the collagen protein in the gums to form the wrong way. If collagen is not made right, the teeth can become loose and fall out.
Brushing after each meal helps prevent tooth and gum disease. Dental exams should be made and kept every 6 months to check for dental decay and disease.
Infections
Risks for Infections
People with diabetes can be at higher risk for serious infection if they have any of the following:
Suggestions for Preventing Infections for People with Diabetes
Good personal hygiene is important and can reduce the risk of infection and disease.
Small Blood Vessel Problems
Capillaries are tiny blood vessels that carry oxygen and nutreints to all the cells in the body. Diabetes can cause changes in the walls of these blood vessels, especially in the eyes and kidneys. High blood pressure also makes red blood cells stiff. These stiff cells can damage tiny blood vessels when they pass through them. This can cause them to leak. Small blood vessel damage is also called microvascular disease. Microvascular disease can cause serious eye and kidney problems.
Eye Problems
Retinopathy occurs when the tiny blood vessels in the back of the eye (the retina) leak. This causes damage to that fragile tissue. After many years, most people with diabetes have some eye damage. These changes may take place slowly and may never affect the eyesight.
Some studies suggest that the eye can get better if the blood sugar levels are kept in the target range. The early stages of this eye damage often respond very well to laser treatment. However, advanced eye damage often does not. Therefore, it is strongly recommeded that an opthalmologist do an eye exam each year. Opthalmologists are trained to do special eye tests for people with diabetes.
Keeping blood sugar levels in the target range is the most important way to prevent eye damage. Other measures can be taken as well, such as:
Kidney Problems
The kidneys filter waste products and water from our blood to make urine. If waste products are not removed, life threatening problems can occur. The filtering parts of the kidney are called nephrons. Nephrons have many small blood vessels that can be damaged from high blood sugar and high blood pressure.
At first, the kidneys are able to work harder and make up for this damage. If enough damage occurs, the kidneys cannot filter the blood. Damaged kidneys do not get rid of the waste that should pass from the body through the urine. Damaged kidneys also allow protein that should stay in the body to pass through the urine.
Some signs of kidney problems are:
A urine test for microalbumin can be done to detect kidney problems at an early stage. This test should be done once a year.
If this problem is caught early, good blood sugar and blood pressure control may reduce or stop protein from passing in the urine. Medicines will only be used if needed.
Large Blood Vessel Problems
Diabetes can damage the large blood vessels or arteries that surround the heart and carry blood to the arms, legs, and head. This is called macrovascular complications. Large blood vessel damage occurs when the inner lining of the blood vessel wall thickens. This reduces the size of the vessel through which blood flows. Therefore, the heart must work harder to pump blood through the smaller vessels. This can lead to heart attacks, stroke, high blood pressure and poor blood flow to the arms, legs and head.
People with diabetes have a greater than normal risk of having premature macrovascular disease. Other factors that will increase the risk of vascular disease are:
Damage to the large blood vessels has very few early symptoms. Cuts and sores may heal slowly, due to poor blood flow. Some people have experienced leg cramps that go away when they rest. Some others have gotten dizzy. Things other than blood vessel damage can also cause these symptoms. If your child experiences any of these symptoms, tell your endocrinologist.
Nerve Problems
Neuropathy (damage to the nerves) is usually seen after puberty in people with high blood sugar levels. Nerve damage can affect many parts of the body, including the hands, feet and heart. It is most common in the hands, feet and legs.
Nerve damage can cause dull, aching pain, burning, cramping, coldness, and numbness or tingling feels. It can occur often or just once in a while.
The biggest danger happens when someone is hurt and doesn't know it. With no pain to warn of the injury, it can become badly infected before it is even found. Some cases of nerve damage clear up soon, while others may last up to months or years. The best way to prevent nerve damage is to keep blood sugar levels in the target range.