Complications of Diabetes — Eyes, Kidneys, Nerves, Heart — And How to Protect Them

Complications aren’t inevitable. With steady habits and routine checkups, most can be prevented, delayed, or caught early when they’re most treatable.

What to know

  • Why complications happen: Over time, high glucose, blood pressure, and cholesterol can damage small vessels (eyes, kidneys, nerves) and large vessels (heart, brain, legs).
  • Microvascular complications:
    • Eyes (retinopathy): may have no symptoms until late. Regular dilated eye exams can prevent vision loss.
    • Kidneys (nephropathy): early damage shows up as albumin (protein) in urine; blood tests track kidney function (eGFR).
    • Nerves (neuropathy): numbness, tingling, pain—often starts in feet; can affect digestion, bladder, and sexual function.
  • Macrovascular complications:
    • Heart disease and stroke: people with diabetes have higher risk; controlling BP, lipids, and smoking matters as much as glucose control.
  • Prevention works:
    • A1c near individualized target, blood pressure control, LDL lowering, smoking cessation, vaccines, and routine screening dramatically reduce risks.

Take action

  • Know your numbers and targets (individualized with your clinician):
    • A1c (often <7% for many adults), blood pressure, LDL cholesterol, weight, kidney labs (eGFR, urine albumin-to-creatinine ratio).
  • Annual screenings (or as advised):
    • Dilated eye exam; urine albumin and eGFR; foot exam; dental checkups; neuropathy assessment.
  • Daily habits:
    • Glucose monitoring and pattern management; 150+ minutes/week of activity; fiber‑rich meals; limit added sugars and refined carbs; stop smoking or vaping.
  • Medications that protect organs:
    • Statins for most adults; ACE inhibitor/ARB if you have hypertension or albuminuria; SGLT2 inhibitors and some GLP‑1 RAs for certain heart/kidney benefits.
  • Vaccines:
    • Stay current on influenza, pneumococcal, COVID‑19, hepatitis B, Tdap, shingles as recommended.

Talk to your doctor about

  • Your personal A1c, BP, and LDL goals and how to reach them.
  • Whether SGLT2 inhibitors or GLP‑1 RAs with proven heart/kidney benefits fit your profile.
  • Frequency of eye, kidney, foot, and dental checks.
  • Symptoms to report early (vision changes, foot wounds, chest pain, numbness).

Quick glossary

  • Retinopathy: changes in the retina’s blood vessels that can affect vision.
  • Albuminuria: protein in urine—early sign of kidney stress.
  • Neuropathy: nerve damage causing pain, tingling, or loss of sensation.

Safety note

Sudden vision changes, chest pain, weakness on one side of the body, or a foot wound that doesn’t heal are urgent—seek care promptly.

References

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