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Surprising consequences of uncontrolled diabetes

February 20, 2020 | UCI Health
woman with diabetes checking her blood glucose levels

Diabetes is a serious disorder that can lead to heart disease, blindness, kidney failure and more. But when it is well controlled — through diet, exercise and medication — diabetics can avoid the most debilitating conditions.

According to the American Diabetes Association, the disease affects more than 30 million U.S. adults and children, or 9.4% of the population. It is the seventh leading cause of American deaths. An estimated 84 million more people have prediabetes, but many of them don’t realize it.

That's why it's important for people diagnosed with diabetes to take their condition seriously and change their lifestyle accordingly, says endocrinologist Dr. Qin Yang of the UCI Health Diabetes Center.

What is diabetes?

Diabetes occurs when the pancreas doesn’t make insulin or enough of it to regulate levels of blood glucose, also called blood sugar, which is the body’s primary source of energy, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Without sufficient insulin to help deliver the energy source to the body’s cells, the glucose stays in the blood. Over time, this can trigger a variety of severe health problems.

Common diabetes complications

Here are some of the ways diabetes affects the body and things you can do to avert the most common health consequences.

  • Eye complications

    High blood sugar can damage blood vessels in the eyes, which can cause diabetic retinopathy and eventually blindness. Diabetic retinopathy is the leading cause of blindness in adults ages 20-74, according to the National Eye Institute. Uncontrolled diabetes also can lead to glaucoma and cataracts.

    “We recommend that our patients get routine eye exams and screenings so we can identify problems in the early stages,” Yang adds. “Ophthalmologists may also prescribe medications that can help prevent eye deterioration.”

  • Nerve complications

    High blood sugar leads to nerve damage, especially in the hands and feet, which is why diabetes specialists recommend that patients inspect their feet daily to check for ulcers or infections.

    “Patients become unable to sense skin damage, which then can develop into ulcers or infections," he says. "In severe cases, this can lead to amputation."

    High blood sugar levels may also cause chronic damage to the delicate blood vessels and nerve cells in the brain, resulting in cognitive impairment and vascular dementia. 

  • Heart disease

    “Cardiovascular disease is a major cause of mortality among diabetics,” Yang says.

    Two out of every three diabetics have high blood pressure, which increases the risk of heart disease and stroke. Very low blood pressure (hypotension) is also dangerous because it can trigger heart attacks.

    He urges patients with diabetes to get screened for additional risk factors for heart disease, including high cholesterol and high blood pressure.

  • Kidney disease

    Uncontrolled blood glucose also puts tremendous stress on the kidneys and can cause them to lose their filtering ability. This, in turn, causes kidney failure.

    “Diabetes is a major cause of kidney failure, which requires dialysis or kidney transplantation,” says Yang.

    Just as with the other complications, keeping blood sugar levels within a normal range is key to keeping kidneys healthy.

Controlling blood sugar

To prevent these serious complications from diabetes, action is imperative to control blood glucose in the body.

“Patients need to control blood sugar early to prevent complications,” Yang says. "When there is enough damage, it might be too late to reverse course." 

The following lifestyle changes are vital to controlling blood sugar:

  • Diet — Patients with diabetes need to make sure they are getting healthy protein and fiber, especially from whole grains, non-starchy vegetables, beans and legumes. Because foods high in sugar and refined carbohydrates can raise blood sugar levels, those should be avoided.
  • Exercise — After consulting with their healthcare providers, people with diabetes should aim for 30 to 60 minutes of daily physical activity. Regular exercise not only lowers blood sugar and blood pressure, it also improves blood flow.
  • Medication — When diet and exercise cannot keep blood sugar levels sufficiently low, medication — typically insulin — may be prescribed. Patients who take medication as directed can keep their blood sugar at healthier levels.

'It's not always easy'

By eating differently, exercising and taking prescribed medications, it’s possible for people with diabetes to live a long and healthy life. But Yang recognizes that it isn’t always easy for some people to stay the course.

“When patients don’t follow these steps, I try to find out why and then address the reason,” he says. “For example, maybe a particular medication is too expensive or maybe the patient doesn’t realize what it means to follow a healthy diet.”

He recommends that his patients work with UCI Health certified diabetes educators to learn how to optimize their diet and exercise regimens for better glucose control.

“It’s important to work with your physician and your diabetes educator to optimize your blood sugar control,” Yang says. “That’s the best way to avoid severe health consequences.”

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