It is common knowledge that patients with type 1 or type 2 DM can develop changes to their small vessels and develop complications of retina, kidneys, and nerves, named as diabetic retinopathy, nephropathy, and neuropathy. It is interesting to note, that microvascular complications are certainly associated with elevated blood glucose, poorly controlled blood pressure, and poorly controlled cholesterol, but not every single individual with diabetes will develop these complications. A person’s genetic risk factors determine if and which microvascular complications will be triggered with worsening control of diabetes.
While talking about microvascular complications, we physicians usually emphasize on the retina, kidneys, and nerves as primary organs because these organs carry burdens of morbidity and mortality with worsening diabetes. However other organs suffer microvascular complications too! For example risk of dementia is 1.5 to 2.5 times greater in patients with type 2 DM and it is due to increased incidence of vascular dementia. ( too tight of glycemic control with hypoglycemia can trigger neuronal loss as well!). Diabetes can increase the incidence of brain atrophy and lacunar infarcts of the brain. Diabetes also alters the blood flow to muscles, adipose tissue, and skin and causes changes such as muscle atrophy and poor wound healing. Certainly not to forget small vessel changes in the heart since it is the most important muscle in our body. Diabetes can alter the very architecture of the heart muscle and can lead to heart failure even though one has never suffered a heart attack and has clean coronary arteries!!
Diabetic neuropathy in form of tingling and numbness in the legs and sometimes in the hands is common. But nerve damage from diabetes is not just restricted to your extremities. This nerve damage shows up in forms of sexual dysfunction, trouble with digesting food and emptying of the stomach( gastroparesis), inability to maintain blood pressure with changes in posture, temperature, altitude etc ( autonomic neuropathy). These changes can severely affect a person’s quality of life.
In summary, diabetes truly affects your entire body on a microscopic level. Hence It is prudent to discuss symptoms that may signal the potential onset of complications at your doctor’s visit. Early intervention can go a long way in modifying the trajectory of these common as well as rare complications!