Complications of Type 1 Diabetes
- Blindness (retinopathy)
- Kidney disease (nephropathy)
- Heart disease
- Nerve disease (neuropathy)
- Taking too much insulin for the amount of food you ate
- Taking too much insulin to treat "fasting" blood sugar
- Skipping a meal or eating a smaller meal than usual without lowering your insulin dose
- Exercising harder or longer than normal without lowering your insulin dose
- Rapid heart rate
- Pale skin color
- Sudden moodiness or behavior change, such as crying for no apparent reason
- Clumsy or jerky movements
- Confusion or difficulty paying attention
- Tingling sensations around the mouth
- Passing out leading to coma
- 1-2 glucose tablets or the equivalent of glucose gel
- 4 ounces of fruit juice or cola (15 grams of carbohydrates)—In general, 15 grams of carbohydrates should raise blood sugar 25-50 mg/dL (1.4-2.8.mmol/L)
- 3 graham crackers (15 grams of carbohydrates)
- 5-6 pieces of hard candy
- Taking too little insulin for the food that you ate
- Eating without taking any insulin
- Eating a larger meal than usual without adjusting the insulin dose
- Exercising more or less than you planned without adjusting the insulin dose
- Being stressed from an illness or life events (may require adjusting the insulin dose)
- High levels of sugar in your urine—ask your doctor if you should be monitoring your urine
- Frequent urination (polyuria)
- Increased thirst (polydipsia)
- Blurred vision
- Taking too little insulin when you are sick with an infection, the body may need more insulin. This is the setting in which ketoacidosis typically occurs.
- High levels of ketones in the urine or blood
- Fruity smell to the breath
- Abdominal pain
- Nausea and vomiting
- Dry mouth or signs of dehydration
- Reduced mental function and alertness
- Shortness of breath
- Blurry or double vision
- Rings, flashing lights, or blank spots
- Dark or floating spots
- Pain or pressure in one or both of your eyes
- Trouble seeing things out of the corners of your eyes
- Chest pain (also called angina)—This pain or pressure feeling usually starts in your chest and radiates to your arm and may worsen when you exercise or after a full meal. People with long-term diabetes may not have chest pain. They need to be aware of other signs like sudden weakness or shortness of breath.
- Heart attack—This is caused by the blockage of a blood vessel that supplies oxygen and other essential nutrients to your heart. When part of your heart muscle doesn't receive the nutrients it needs to function, it stops working. Symptoms include chest pain or pressure feeling, nausea, indigestion, extreme weakness, and sweating. Symptoms may be blunted in people with chronic diabetes.
- Cardiomyopathy—This is a weakening of the heart muscle caused by the narrowing of small blood vessels throughout the heart.
- Sudden weakness or numbness of your face, arm, or leg on one side of your body
- Sudden confusion, trouble talking, or trouble understanding
- Sudden dizziness, loss of balance, or trouble walking
- Sudden trouble seeing in one or both eyes or sudden double vision
- Sudden severe headache
- Numbness, tingling, or burning of the hands and feet
- Erectile dysfunction
- Foot ulcers resulting from loss of sensation
- A drop in blood pressure upon standing up
- Diarrhea at night
- Difficulty swallowing
- Neurogenic bladder with dribbling, weak stream, or hesitancy
- Sweating after meals
Reduce Your Risk of Complications
- Have frequent (every 3-6 months) measurements of glycosylated hemoglobin (Hba1c) to ensure effective treatment.
- Have yearly eye exam using drops to dilate the pupils.
- Have periodic foot exam with a nylon monofilament to determine that sensation is normal.
- Have yearly urine test to detect microalbuminuria.
- Have careful control of blood pressure, low-density lipoproteins (LDLs), and triglycerides to reduce long-term risk of heart disease and stroke. Talk with your doctor about the right ranges for you.
- Have yearly flu and periodic pneumococcal vaccines to reduce the risk of pneumonia.
- Take low-dose aspirin every day, depending on your age and risk factors.
- Blood sugar levels
- Blood pressure levels
- Vision problems, such as blurriness or spots
- Pale skin color
- Numbness or tingling feelings in hands or feet
- Repeated infections or slow healing of wounds
- Chest pain
- Vaginal itching
- Constant headaches
- Cuts or blisters on your feet
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Diabetes type 1. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us. Updated August 9, 2013. Accessed August 28, 2013.
Hyperglycemic crises in diabetes. Diabetes Care. 2004(Supp 1);27:S94-102.
National Cholesterol Education Program (NCEP) Adult Treatment Panel III. Circulation. 2004;(110):227.
Perkins BA, Ficociello LH, et al. Regression of microalbuminuria in type 2 diabetes. New Engl J Med. 2003;348:2285-2295.
Physical activity/exercise and diabetes. Diabetes Care. 2004; 27(Suppl 1):S58-62.
Report of the Joint National Committee on the Prevention Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7). Diabetes Care. 2003;26:S80-82.
Type 1. American Diabetes Association website. Available at: http://www.diabetes.org/diabetes-basics/type-1/?loc=HomePage-type1-tdt. Accessed December 31, 2012.
2/7/2008 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Armstrong DG, Holtz-Neiderer K, et al. Skin temperature monitoring reduces the risk for diabetic foot ulceration in high-risk patients. Am J Med. 2007;120:1042-1046.
2/7/2008 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Lavery LA, Higgins KR, et al. Home monitoring of foot skin temperatures to prevent ulceration. Diabetes Care. 2004;27:2642-2647.
- Reviewer: Kim Carmichael, MD
- Review Date: 09/2013 -
- Update Date: 09/30/2013 -
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
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