Diabetes Complications

What is diabetes?

If you have diabetes, your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. A hormone called insulin helps the glucose get into your cells to give them energy.

With type 1 diabetes, your body does not make insulin. With type 2 diabetes, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood.

What health problems can diabetes cause?

Over time, having too much glucose in your blood can cause complications, including:

• Eye disease, due to changes in fluid levels, swelling in the tissues, and damage to the blood vessels in the eyes.
• Foot problems, caused by damage to the nerves and reduced blood flow to your feet.
• Gum disease and other dental problems, because a high amount of glucose in your saliva helps harmful bacteria grow in your mouth. The bacteria combine with food to form a soft, sticky film called plaque. Plaque also comes from eating foods that contain sugars or starches. Some types of plaque cause gum disease and bad breath. Other types cause tooth decay and cavities.
• Heart disease and stroke, caused by damage to your blood vessels and the nerves that control your heart and blood vessels.
• Kidney disease, due to damage to the blood vessels in your kidneys. Many people with diabetes develop high blood pressure. That can also damage your kidneys.
• Nerve problems (diabetic neuropathy), caused by damage to the nerves and the small blood vessels that nourish your nerves with oxygen and nutrients.
• Sexual and bladder problems, caused by damage to the nerves and reduced blood flow in the genitals and bladder.
• Skin conditions, some of which are caused by changes in the small blood vessels and reduced circulation. People with diabetes are also more likely to have infections, including skin infections.

What other problems can people with diabetes have?

If you have diabetes, you need to watch out for blood glucose levels that are too high (hyperglycemia) or too low for you (hypoglycemia). These can happen quickly and can become dangerous. Some of the causes include having another illness or infection and certain medicines. They can also happen if you don't get the right amount of diabetes medicines. To try to prevent these problems, make sure to take your diabetes medicines correctly, follow your diabetic diet, and check your blood glucose regularly.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Eye Diseases

What diseases can affect the eye?

Even if your eyes feel healthy, you could have a problem and not know it. That's why regular eye exams are so important. Refractive errors are the most common type of vision problem that makes it hard to see clearly. But some eye conditions or diseases don't have any symptoms and can lead to a permanent loss of vision.

Some common eye diseases and conditions include:

• Cataracts, which happens when the clear lens in the front of your eye becomes cloudy. Cataracts are common as you get older and can lead to vision loss.
• Optic nerve disorders, which includes glaucoma. Glaucoma usually happens when the fluid pressure inside your eyes slowly rises.
• Retinal disorders, which are problems with the nerve layer at the back of your eye.
• Macular degeneration, which is a disease that destroys your sharp, central vision.
• Diabetic eye problems, which can cause vision loss and blindness.
• Conjunctivitis, which is an infection also known as pink eye. It can cause pink or red itchy eyes. Some types of pink eye can spread very easily.

What are the symptoms of eye diseases?

Some eye conditions and diseases do not always have symptoms. Early detection through a comprehensive dilated eye exam could help your eye care provider detect diseases in the early stages. Proper treatment could help slow or prevent vision loss.

Get regular eye exams and call your eye care professional right away if you notice any of these symptoms:

• A sudden change in vision
• Everything looks dim
• Flashes of light
• Eye pain
• Double vision
• Fluid coming from your eye
• Inflammation (swelling)

Who is more likely to develop eye diseases?

Getting older increases your risk of some eye diseases. Other things that may put you at a higher risk of some eye diseases can include if you:

• Are overweight or obese
• Have a family history of eye disease
• Are African American, Hispanic, or Native American
• Have certain health conditions such as Diabetic eye problems, or high blood pressure

What are the treatments for eye diseases?

Treatment may depend on the eye condition or disease but can include:

• A new prescription for eyeglasses or contacts
• Use of bright lights or magnifying lenses for reading and other activities
• Medicines
• Prescription eye drops or ointments
• Laser treatment
• Surgery

Depending on your eye condition or disease, treatment may slow vision loss but may not restore vision. Talk to your provider about what treatment is best for you.

Can eye diseases be prevented?

Your best defense is to have regular checkups. Be sure to tell your provider if any eye diseases run in your family.

You can also help take care of your vision by making lifestyle changes to lower your risk of health conditions that can cause vision problems. This could include by:

• Protecting your eyes from the sun
• Wearing protective eyewear while using tools or playing certain sports
• Getting regular physical activity
• Staying at a healthy weight
• Quitting smoking (or not starting)
• Eating a healthy diet

NIH: National Eye Institute

Healthy Sleep

What is sleep?

While you are sleeping your brain and body functions are still active. Sleep is a natural process that helps your body restore energy, supports learning and memory, and keeps you healthy.

During sleep, your brain cycles through different stages of non-rapid eye movement (non-REM) sleep and rapid eye movement (REM) sleep. Non-REM sleep has three stages that range from light to deep sleep, while REM sleep is when most dreaming occurs. During each stage, your brain waves, breathing, heart rate, and body temperature change throughout the night. Certain phases of sleep help you:

• Feel rested and energetic the next day.
• Learn new information, get insight, and form memories.
• Give your heart and blood vessels a rest.
• Release growth hormone, which helps children grow and assists in muscle repair and tissue healing for everyone.
• Release sex hormones, which contribute to puberty and fertility.
• Maintain a healthy balance of hormones that control hunger and fullness.
• Strengthen your immune system by producing cytokines (hormones that help the body fight infection).

You need all the stages to get a healthy sleep.

How much sleep do I need?

The amount of sleep you need depends on your age, lifestyle, health, and sleep patterns. The general recommendations for sleep are:

• Babies (4-12 months): 12-16 hours a day (including naps)
• Children (1-2 years): 11-14 hours a day (including naps)
• Children (3-5 years): 10-13 hours a day (including naps)
• Children (6-12 years): 9-12 hours a day
• Teens (13-18 years): 8-10 hours a day
• Adults (18 years and older): 7-9 hours a day

During puberty, teenagers' biological clocks shift. They tend to fall asleep later and wake up later, which can conflict with the early school start times. This is one reason many teenagers don't get enough sleep.

Some people think adults need less sleep as they age, but there is no evidence to support this. However, older adults often get less sleep or spend less time in the deep, restful stages of sleep. They also wake up more easily.

It's not just the number of hours of sleep you get that matters. The quality of the sleep you get is also important. People whose sleep is frequently interrupted might not get enough of certain stages of sleep. If you are wondering whether you are getting enough sleep, including quality sleep, ask yourself:

• Do I have trouble getting up in the morning?
• Do I have trouble focusing during the day?
• Do I doze off during the day?

If you answered yes to any of these questions, you may need to improve your sleep habits.

What are the health effects of not getting enough sleep?

Sleep is important for overall health. When you don't get enough sleep (sleep deprivation), it does more than just make you feel tired. It can impair your ability to think clearly, react quickly, and form memories. This increases your risk of making mistakes, taking risks, or getting into accidents.

Sleep deprivation can also affect your mood, leading to:

• Irritability
• Problems with relationships, especially for children and teenagers
• Depression
• Anxiety

It can also affect your physical health. Not getting enough sleep, or getting poor-quality sleep, increases your risk of:

• High blood pressure
• Heart disease
• Stroke
• Kidney disease
• Obesity
• Type 2 diabetes

Not getting enough sleep can also lower your levels of hormones that help children grow and help the body build muscle, repair tissue, and fight infections.

Sleep deprivation also magnifies the effect of alcohol. A tired person who drinks too much alcohol will be more impaired than a well-rested person who drinks the same amount.

How can I get better sleep?

You can take steps to improve your sleep habits. First, make sure that you allow yourself enough time for sleep. Getting enough sleep each night may help you feel happier and more productive during the day.

To improve your sleep habits, it also may help to:

• Go to bed and wake up at the same time every day.
• Avoid caffeine, especially in the afternoon and evening.
• Avoid nicotine.
• Exercise regularly, but not too close to bedtime.
• Avoid alcoholic drinks before bed.
• Avoid large meals and drinks late at night.
• Don't take a nap after 3 p.m.
• Relax before bed by taking a bath, reading or listening to calm music.
• Keep your bedroom cool, dark, and quiet.
• Get rid of distractions such as TVs, computers, and phones.
• Get enough sunlight exposure during the day.
• If you can't fall asleep for 20 minutes, get up and do something relaxing.
• See a health care provider if you have continued trouble sleeping. You may have a sleep disorder, such as insomnia or sleep apnea. In some cases, your provider may suggest trying a sleep study or other treatments.

If you are a shift worker, getting good sleep can be more challenging. You may also want to:

• Take naps and extend your total sleep time
• Keep the lights bright at work
• Limit shift changes to help your body adjust
• Limit caffeine to the first part of your shift
• Remove sound and light distractions in your bedroom during daytime sleep (for example, use light-blocking curtains or earplugs)

Hemorrhagic Stroke

What is a hemorrhagic stroke?

A stroke happens when there is a loss of blood flow to part of the brain. Your brain cells cannot get the oxygen and nutrients they need from blood, and they start to die within a few minutes. This can cause lasting brain damage, long-term disability, or even death.

There are two main types of strokes, ischemic and hemorrhagic. A hemorrhagic stroke is less common but often more severe. It occurs when a blood vessel in the brain bursts, causing bleeding (hemorrhage) in or around the brain. This bleeding increases pressure inside the skull and damages brain tissue. Within minutes, brain cells begin to die.

What are the types of hemorrhagic stroke?

Hemorrhagic strokes are classified by where the bleeding happens:

• Intracerebral hemorrhage. Bleeding occurs directly into the brain tissue. This is the most common type of hemorrhagic stroke.
• Subarachnoid hemorrhage. Bleeding occurs in the space between the brain and the thin layers of tissues covering it. This often happens when a weak spot in an artery (called an aneurysm) bursts on the brain's surface.

What causes hemorrhagic stroke?

Common causes include:

• Aneurysm. A bulge or "ballooning" in a weakened artery wall that can burst.
• Arteriovenous malformation (AVM). A tangled group of abnormal blood vessels that can rupture inside the brain.
• High blood pressure (hypertension). Over time, it can weaken blood vessel walls and increase the risk of them breaking open.
• Head trauma. Brain injury can cause bleeding.

What are the symptoms of a hemorrhagic stroke?

Stroke symptoms often happen suddenly. They include:

• Sudden numbness or weakness of the face, arm or leg (especially on one side of the body)
• Sudden confusion, trouble speaking, or understanding speech
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden severe headache with no known cause

The F.A.S.T. test can help you remember what to look for if you think someone is having a stroke. Think "FAST" and look for:

• Face drooping on one side when smiling.
• Arm weakness occurs when the arms are raised, and one arm drifts downward.
• Speech is slurred or strange.
• Time to call 911.

How is a hemorrhagic stroke diagnosed?

To make a diagnosis, your health care provider may do a physical exam, ask about your symptoms and medical history, and use imaging tests to check for bleeding in your brain.

How is hemorrhagic stroke treated?

It is important to treat strokes as quickly as possible. For a hemorrhagic stroke, the first step is to find the cause of bleeding in the brain and stop it. Treatment may involve medicines or, in some cases, surgery to stop the bleeding or relieve pressure on the brain.

After the stroke, rehabilitation can help people recover lost abilities and regain independence.

Can a hemorrhagic stroke be prevented?

The best way to prevent stroke is by making heart-healthy lifestyle changes to lower your risk. If lifestyle changes aren't enough, your provider may prescribe medicine to help manage your risk factors.

NIH: National Institute of Neurological Disorders and Stroke

Liver Diseases

Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons.

There are many kinds of liver diseases:

• Diseases caused by viruses, such as hepatitis A, hepatitis B, and hepatitis C
• Diseases caused by drugs, poisons, or too much alcohol. Examples include fatty liver disease and cirrhosis.
• Liver cancer
• Inherited diseases, such as hemochromatosis and Wilson disease

Symptoms of liver disease can vary, but they often include swelling of the abdomen and legs, bruising easily, changes in the color of your stool and urine, and jaundice, or yellowing of the skin and eyes. Sometimes there are no symptoms. Tests such as imaging tests and liver function tests can check for liver damage and help to diagnose liver diseases.