There is little doubt that diabetes is a serious disease. There is also little doubt that people with diabetes can live long, healthy, happy lives if they keep their diabetes under control. But do you know that how well you manage your disease on a day-to-day basis can have a dramatic impact on your degree of risk for the complications of diabetes?

The complications of diabetes are both numerous and serious, including:

Diabetes is one of the major, modifiable risk factors for heart disease and stroke. If you have other risk factors, like high blood pressure and high cholesterol, you have an increased chance of developing problems with your blood vessels. A clogged or narrow vessel in your heart can lead to a heart attack, while the same problem in your brain can lead to a stroke. This means that people with diabetes must not only keep their blood sugar levels under control, but also effectively control their blood pressure and cholesterol levels, as well.

People with type 2 diabetes are at increased risk for three types of vision problems: glaucoma , cataracts , and retinopathy (a general term for disorders of the retina caused by diabetes). Fortunately, most diabetes-related vision problems can be slowed or stopped if caught early and can be prevented with good blood sugar control.

High levels of blood sugar make the kidneys filter too much blood.  Eventually, the kidneys begin to leak, causing needed protein to be lost in the urine and waste products to build up in the blood. If diagnosed early, there are several treatments that may prevent your kidney disease from getting worse.  If caught later, kidney failure usually follows. People whose kidneys are no longer working need to have their blood filtered by machine (dialysis ) or a kidney transplant.

Diabetic neuropathies are a family of nerve disorders caused by diabetes. Neuropathy is the most common complication of diabetes and can be both painful and disabling.  Over time, diabetes can damage the nerves throughout the body. This may lead to numbness and sometimes pain and weakness in the hands, arms, feet, and legs. It may also affect other organ systems, such as the digestive tract and the cardiovascular system.

A common type of neuropathy is called peripheral neuropathy. When the nerves of your foot are damaged, for example, you may not notice sores (or ulcers) on your foot. These sores can lead to serious complications, like gangrene and even the need for amputation.

Glucose control seems to play a role in neuropathy. This means that the longer a person has diabetes, the greater their risk of developing nerve damage, particularly if they have difficulty controlling their glucose, cholesterol, and blood pressure levels. Fortunately, maintaining good blood sugar control seems to help prevent or delay neuropathy.

As many as 33% of people with diabetes will have some type of skin disorder during their lifetime. Indeed, skin problems are sometimes the first indication that a person has diabetes. Common, diabetes-related skin disorders include itchy skin, bacterial infections, fungal infections, and diabetic dermopathy (patches of brown, scaly skin). Fortunately, many of these conditions can be either prevented or easily treated if caught early.

If you have diabetes, you are at higher risk for gum disease than people who do not have the disease. This is because diabetes may weaken your mouth's ability to fight germs. And while it’s true that anyone can get gum disease, having diabetes can make it worse and make it more difficult to control.

Frozen shoulder affects about 20% of people with diabetes, compared with 5% of people without diabetes. A frozen shoulder, technically known as adhesive capsulitis, often begins as tenderness or soreness in the shoulder joint, usually following a bout with another musculoskeletal condition such as tendinitis or bursitis . As the shoulder becomes stiffer and more painful, people tend to use it less and less. Unfortunately, this eventually only adds to the stiffness and pain, creating a vicious cycle in which the shoulder’s range of motion decreases while the pain and stiffness increases.

Researchers aren’t sure exactly why diabetes is a risk factor for frozen shoulder. One theory is that high (uncontrolled) levels of glucose in the blood may contribute to abnormal deposits of collagen (a major part of the ligaments that hold the bones together in a joint) in the cartilage and tendons of the shoulder. This buildup can cause the affected shoulder to stiffen.

In addition to the above complications, there are many other conditions that have been associated with diabetes. While thinking about your long-term health may feel overwhelming, there are steps that you can take today to reduce your chance of future health problems:

Last Reviewed December 2011