Diabetes & Complications: Eyes, Kidneys & Skin

If your blood glucose stays high over time, it can damage the tiny blood vessels in the back of your eyes. This damage can begin during prediabetes, when blood glucose is higher than normal, but not high enough for you to be diagnosed with diabetes. Damaged blood vessels may leak fluid and cause swelling. New, weak blood vessels may also begin to grow. These blood vessels can bleed into the middle part of the eye, lead to scarring, or cause dangerously high pressure inside your eye.

Diabetic eye disease includes diabetic retinopathy, diabetic macular edema, cataracts, and glaucoma.

Over time, diabetes can cause damage to your eyes that can lead to poor vision or even blindness.

Often there are no early symptoms of diabetic eye disease. You may have no pain and no change in your vision as damage begins to grow inside your eyes, particularly with diabetic retinopathy.

When symptoms do occur, they may include

• blurry or wavy vision
• frequently changing vision—sometimes from day today
• dark areas or vision loss
• poor colour vision
• spots or dark strings (also called floaters)
• flashes of light

Most people with diabetic kidney disease do not have symptoms. The only way to know if you have diabetic kidney disease is to get your kidneys checked.

Doctors use blood and urine tests to check for diabetic kidney disease in the form of urine for albumin and a blood test to see how well your kidneys are filtering your blood (BUN and creatinine). Other modalities like sonography of the kidney are also used for monitoring.

Yes, in case of end stage renal disease a patient can undergo kidney transplant.

Kidney failure means that your kidneys have lost most of their ability to function—less than 15 percent of normal kidney function. If your kidney function drops to this level, you may have symptoms from the build-up of waste products and extra water in your body.

To replace your lost kidney function, you may have one of three treatment options:

• hemodialysis
• peritoneal dialysis
• kidney transplant

End-stage renal disease (ESRD) is kidney failure that is treated by dialysis or kidney transplant.

• • Bacterial infections

                       Several kinds of bacterial infections occur in people with diabetes:

• • • Styes (infections of the glands of the eyelid)
    • Boils
    • Folliculitis (infections of the hair follicles)
    • Carbuncles (deep infections of the skin and the tissue underneath)
    • Infections around the nails

• • Fungal infections at genital areas, skin, groin, nails and armpits.

• • Localized itching

• • Acanthosis nigricans is a condition in which tan or brown raised areas appear on the sides of the neck, armpits and groin. Sometimes they also occur on the hands, elbows and knees. Acanthosis nigricans usually strikes people who are very overweight

• • Dermopathy: Often looks like light brown, scaly patches. These patches may be oval or circular. This disorder most often occurs on the front of both legs. The patches do not hurt, open up, or itch.

• • Necrobiosis lipoidica diabeticorum : Causes spots similar to diabetic dermopathy, but they are fewer, larger, and deeper.

• • Other Rare ones like Disseminated granuloma annulare, Eruptive xanthomatosis and Digital sclerosis can also occur.

Diabetes can cause changes in the small blood vessels. These changes can cause skin problems called diabetic dermopathy and NLD.When  blood sugar is high , a person will pass more urine. This can result in dehydration and dry skin.

• • Try to reach your blood glucose ie an Hba1c of </= 7% and blood pressure goals (below 140/90 mm Hg).
  • Keep your cholesterol/Lipids in check and controlled
  • Stop smoking.
  • Work with a dietitian to develop a diabetes meal plan and limit salt and sodium.
  • Make physical activity part of your routine.
  • Stay at or get to a healthy weight.
  • Get enough sleep. Aim for 7 to 8 hours of sleep each night.
  • Atleast once a year screen your eyes and kidney by recommended tests.
  • Keep skin clean and dry. 
  • Avoid very hot baths and showers
  • Prevent dry skin. Scratching dry or itchy skin can open it up and allow infection to set in. Moisturize your skin to prevent chapping, especially in cold or windy weather.
  • Treat cuts right away. Wash minor cuts with soap and water. Only use an antibiotic cream or ointment if your doctor says it’s okay
  • Take good care of your feet. Check them every day for sores and cuts.