Diabetes Resource Center: Managing Complications

Protect Your Long-term Health

Diabetes affects more than just blood sugar—it increases your chances of developing other serious medical conditions. Regular check-ups and screenings can help protect you.

Lifestyle Changes to Reduce Your Risk

Quit Smoking

Smoking doubles your heart attack risk, but quitting lowers it within 24 hours. After one year, your risk is halved, and after five, it approaches that of a non-smoker.

Stay Active

Even a small increase in physical activity can benefit your overall health. Discuss with your provider team how to become more active in ways that are safe for you.

Lose Weight

If you’re overweight, losing about five to seven pounds for every 100 pounds you weigh can help your body use insulin more effectively.

Take Care of Your Teeth

High blood sugar can lead to gum problems and make diabetes harder to manage. Brushing and flossing protect your teeth, heart, and overall health.

Caring for Your Vision

Diabetes affects the entire body, and if not managed properly, it can lead to complications, including damage to blood vessels and nerves in the eyes.

Diabetic eye disease is not a single condition but a group of problems that can occur in those with diabetes.

Diabetic Retinopathy

When you have diabetes, it can harm the small blood vessels in the retina—the layer at the back of the eye—which can affect your vision. This condition is known as diabetic retinopathy and it has two main stages, nonproliferative and proliferative:

Nonproliferative Retinopathy: Small areas of swelling occur. The blood vessels in the retina start to leak. This leakage can lead to inadequate circulation, oxygen, and nutrients in certain areas of the eye.
Proliferative Retinopathy: Closed-off blood vessels trigger a series of events. Due to a lack of oxygen and nutrients reaching the cells in the eye, new abnormal blood vessels begin forming in the retina. These fragile new vessels can bleed, causing further complications.

If diabetic retinopathy goes untreated, it can result in blurred or cloudy vision and, in severe cases, complete loss of vision.

Get Your Eyes Checked

Because diabetes can cause several eye problems, regular eye exams are essential, even if your vision seems normal. These check-ups can catch problems early and help prevent permanent damage or blindness.

If you notice any changes in your vision or have concerns, see an eye doctor as soon as possible. Regular exams and good diabetes management are key to protecting your eye health.

Schedule an Ophthalmology Appointment

Protecting Your Feet

Diabetes can reduce feeling and blood flow in your feet, raising the risk of sores and infections. Daily foot care and regular check-ups can help prevent serious complications.

Schedule a Podiatry Appointment

How can diabetes hurt my feet?

People with diabetes are at higher risk of serious foot infections. Over time, high blood sugar can cause nerve damage, which reduces feeling in your feet. You may not feel pain, heat, or cold, and could injure your foot without realizing it.

Reduced feeling can also change the way you walk, causing different pressure points and the formation of new calluses that can become infected.

Diabetes can also reduce blood flow to your legs and feet, making it harder for sores and wounds to heal.

What happens if I get a sore on my foot?

A person with diabetes may develop a sore on their foot and not even know it. If the sore becomes infected and isn’t treated with antibiotics, it can worsen. In some cases, the sore may never heal.

Severe infections can lead to gangrene, which may cause the tissue to turn black and smell bad. If this happens, the affected area may need to be surgically removed (amputated) to stop the infection from spreading.

How should I take care of my feet?

Check your feet every day. Look for sores, cuts, blisters, or redness—especially between your toes. Use a mirror or ask someone for help if you can’t see the bottoms of your feet.
Wash your feet daily with warm (not hot) water. Test the water with your elbow first. Dry your feet well, especially between the toes.
Keep your toenails trimmed. Cut them straight across after a bath or shower, when they’re soft. Many people with diabetes see a foot doctor (podiatrist) every three months for nail care.
Moisturize if needed. If your feet are very dry, apply lotion after bathing—but avoid the areas between your toes.
See a foot doctor regularly. Get a foot exam at least once a year. Schedule an appointment right away if you notice redness, swelling, cuts, numbness, or other changes.
Always wear shoes or slippers. Don’t walk barefoot.
Never wear shoes without socks. Socks help prevent blisters and keep your feet dry. White socks can make it easier to spot blood or drainage.
Wear well-fitting shoes to avoid pressure points, blisters, or sores.
Tell your healthcare provider about any changes in your feet as soon as you notice them.

Keeping Your Heart in Mind

Having type 2 diabetes increases your risk of heart disease. In fact, adults with diabetes are twice as likely to have a heart attack or stroke compared to those without diabetes. Your risk of heart disease and stroke increases the longer you have diabetes.

How Diabetes Affects the Heart

Diabetes raises your heart disease risk by:

Damaging blood vessels and nerves
Reducing blood flow to vital organs
Increasing inflammation in the body

Your risk goes up even more if you also have:

High blood pressure
High cholesterol
Excess weight

What Is Cardiovascular Disease?

Cardiovascular disease (CVD) is a condition that affects the heart and blood vessels in which your arteries are slowly narrowed by fatty “plaque” buildup, preventing the flow of blood to your vital organs. The arteries can eventually become entirely blocked, causing a heart attack or stroke.

Every part of your body relies on healthy blood flow, but diabetes makes it harder for blood to flow properly. CVD is the leading cause of death among people with diabetes, according to the Centers for Disease Control and Prevention.

Watch for Signs of CVD

Many people don’t know they have CVD until a major event, like a heart attack or stroke! If you have diabetes, be alert for symptoms such as:

Fatigue
Shortness of breath
Pain in your chest, neck, throat, jaw, back, or upper abdomen
Weakness, numbness, or pain in your arms or legs

How to Protect Your Heart

You can lower your risk of CVD by managing your diabetes and overall health:

Monitor your blood sugar regularly.
Control your blood pressure and cholesterol.
Stay physically active—aim for at least 30 minutes most days.
Eat a heart-healthy diet.
Take your medications as prescribed.
Get regular check-ups with your health care provider.

Chronic Kidney Disease

Kidney disease, or chronic kidney disease (CKD), is one of the most common complications of diabetes. CKD is a silent disease with no symptoms until significant damage has already occurred. People with type 2 diabetes who develop CKD are three times more likely to have a heart attack or stroke.

However, many risk factors can be managed, and regular testing can help catch kidney damage early. There are two main tests for checking kidney function:

Urine Albumin-to-Creatinine Ratio (UACR) Test

The UACR test measures the amount of albumin (a type of protein) in your urine. Too much albumin can be a sign of kidney damage.

What Do the Numbers Mean?

A score of 30 or above may indicate kidney damage.

Talk to your healthcare provider about a treatment plan, and start doing UACR tests more regularly to monitor improvement. Lower levels over time can indicate the treatment is working!

How Often Should You Test?

Once a year if you’ve had type 1 diabetes for five years or more
Once a year if you have type 2 diabetes
More often if you’ve had high results in the past

Estimated Glomerular Filtration Rate (eGFR) Test

The eGFR test measures the level of creatinine in your blood. Creatinine is a waste product of digestion and muscle tissue that is normally filtered out by your kidneys. Higher levels of creatinine in your blood can mean your kidneys are not working well.

What Do the Numbers Mean?

90–120: Ideal score (normal kidney function)
60–89: Possible early-stage kidney disease. Talk to your healthcare provider about how to keep your kidneys healthy and how often to get tested.
Below 60: May indicate kidney disease. Talk to your healthcare provider about how to improve your kidney health.
Below 15: Your kidneys are likely failing. Discuss treatment options with your healthcare provider as soon as possible.

How Often Should You Test?

Once a year if you’ve had type 1 diabetes for five years or more
Once a year if you have type 2 diabetes
Twice a year if you’ve had signs of kidney damage in the past

Take Steps to Prevent Kidney Disease

When you have diabetes, taking steps to prevent kidney disease is crucial. Here are a few ways you can take control of your kidney health:

Control your blood pressure. Aim for a reading below 140/90. Talk to your healthcare provider about blood pressure medications. ACE inhibitors and angiotensin receptor blockers (ARBs) not only manage blood pressure, but also help slow kidney damage—even for people without high blood pressure.
Manage your blood sugar. Talk with your healthcare provider about the best blood sugar targets for you.
Take your medications as prescribed. Follow your healthcare provider’s advice and take all your medications exactly as they tell you. Don’t change doses or stop taking any medications without talking with your healthcare provider first.
Get regular check-ups and tests. Schedule routine check-ups with your healthcare provider. Get your kidney function checked at least once a year.
Find an eating plan that works for you. Work with your healthcare provider, or if you need more detailed help, ask for a referral to a dietitian.

By taking these steps, you can help slow down the progression of kidney disease or prevent it entirely.

Spotting the Signs of Diabetic Neuropathy

Nerves carry messages between your brain and the rest of your body. Over time, diabetes can damage these nerves—a condition known as diabetic neuropathy. This complication becomes more likely the longer you’ve had diabetes.

There are two main types of diabetic neuropathy:

Peripheral neuropathy causes tingling, pain, numbness, and weakness in the feet and hands.
Autonomic neuropathy leads to a range of issues, including digestive problems, bladder problems, sexual difficulties, dizziness, sweating, and changed or reduced warning signals from your body of serious medical situations like a heart attack or low blood glucose.

Diagnosing nerve damage can be challenging due to mild symptoms or confusion with other conditions.

If you think you have neuropathy, discuss your symptoms with your health care provider.

Protect Your Whole Body

Diabetes affects more than just blood sugar. Regular check-ups like eye exams, foot checks, and mental health screenings help protect your whole-body health.

Vaccines. Ask your healthcare providers to make sure you have the vaccines you need. You may need a vaccine or booster for COVID-19, pneumonia, tetanus, hepatitis B, or influenza (flu).
Foot exam. Have your feet examined at least once a year.
Dilated eye exam. Have an eye exam every one to two years.
Dental exam. Have an exam every six months.
Hearing loss test. Have an exam at least once a year.
Sleep apnea test. If you are chronically tired during the day or snore while sleeping, ask your healthcare provider about getting tested for sleep apnea.
Depression screening. Tell your healthcare provider if you are struggling with managing your health, no longer find joy in regular activities, or have a change in your overall appetite or ability to sleep.

Explore the Resource Center

Learn how to manage your diabetes with our guides, tips, and videos.

Diabetes information found on these pages should not replace education or instruction from your healthcare provider or certified diabetes educator. We encourage all patients to personalize their diabetes management in collaboration with their healthcare team.