Long-Term Complications of Type I Diabetes
The long-term complications from Diabetes type I can be divided into microvascular complications when it affects the very small arteries and macrovascular disease when diabetes affect the larger arteries. When Diabetes destroys very small blood vessels, microvascular disease, the person with diabetes may face blindness, kidney failure, and neuropathy (a condition in which people experience pain due to nerves providing inappropriate pain signals, as well as experiencing inappropriate numbness, particularly their feet and hands). In fact, Diabetes( both type I and type II) is the most common cause of blindness in the United States and the most common cause of kidney failure and dialysis. Diabetes type I can also affect large blood vessels, a process which physicians refer to as macrovascular disease. This can lead to poor circulation to the feet, impotence in males, heart attacks, and strokes. Impotence can sometimes serve as a warning sign of more serious cardiovascular problems, and can alert physicians to the presence of macrovascular disease. The combination of poor circulation and neuropathy often leads to foot damage, and as a result, people with Diabetes are about 100 times more likely to develop injuries to their feet that lead to amputations than people without diabetes. Because it is an autoimmune disease, these patients and their families are more likely develop other autoimmune diseases such as Sprue hypothyroidism, and Adrenal insufficiency. Some people believe they are also more likely to develop or have a family history of autism but the statistical analysis to prove or disprove this believe has not been completed. There is also evidence that people with diabetes are more likely to develop cognitive impairments (ability to think and reason) similar to those people who have Alzheimer’s disease.
Although diabetes does present grave long-term health problems, advances in technology have made it possible for people with type I diabetes to have a life span comparable to those people without Diabetes. Some people with Type 1 Diabetes live a normal lifespan and they are being evaluated to determine what elements they have in common that enable them to do so well. While statistics apply to a group, individuals can change their lifestyle and embrace the newest technology to lower their chances of developing these complications. While there is no cure for diabetes, if we look back over the last 30 years since I became an endocrinologist, many advances have occurred which have enabled physicians to help their patients improve their control and lower their chances of developing or dying from these complications. In addition to being better able to control blood sugar, we have recognized other risk factors such as abnormal cholesterol and high blood pressure which increase the chance of developing complications In addition to advances in controlling sugar, we have many more medications to help normalize a patient’s lipid panel (the HDL or good cholesterol, the LDL or bad cholesterol, as well as Triglycerides). Scientists have also developed many medications to help normalize blood pressure as well. The worst risk factor is still smoking and we now have medications to help patients quit this destructive habit. In addition, treatment for the secondary complications has also advanced. By utilizing all of these tools, people with Diabetes type I have the potential for a normal life span.
