Diabetes Type 2

Eyes, feet and kidneys

People with type 2 diabetes can experience long term complications including eye problems (retinopathy), damage to the nerves (neuropathy), kidney disease (nephropathy) and heart problems (cardiovascular disease). Several people we talked to wanted to know whether these complications were inevitable. Complications are not inevitable but the ability to avoid them may be beyond the person's control depending on the amount of genetics that may be involved. Whether someone gets complications may be partly due to their blood glucose control and how long they've had diabetes, but there are also genetic factors which we don't know much about.

People with Type 2 diabetes are at risk of developing retinopathy, where the blood vessels in the retina of the eye can become blocked, leaky or grow haphazardly and eyesight is affected.
Some people we talked to described instances of 'bleeding in the back of their eyes' and how, as a result, they had lost some vision, either for a short time or permanently. Medication and improving blood glucose control had helped to improve vision for some people, but losing sight, even for a short time was said to be very alarming.
Yearly retinopathy screening can monitor changes to the eyes and if blood glucose, blood pressure and blood fat levels are kept under control the risk of retinopathy is reduced. Some people's eye problems were first spotted at a routine eye test.

Retinopathy can be treated by laser which is very successful if it is caught early. However, laser therapy cannot restore any vision which has already been lost.

People with type 2 diabetes can develop neuropathy (damage to the nerves). The most common form is peripheral neuropathy which affects the nerves in the feet, legs and sometimes hands leading to loss of feeling and inability to sense pain. Other forms of peripheral neuropathy can lead to tingling, discomfort or burning pains, particularly in the legs and feet.

Several people had developed neuropathy in their feet. Some people had little or no sensation in their feet. Others had occasional loss of feeling in their toes. One man had a little patch on his foot which was numb and he used a cream to soften it. Many said that loss of feeling meant that they had to be very careful to protect their feet from damage. Small cuts or blisters can quickly become more serious and need treatment.

Many people said how important it was to look after their feet. Some had regular pedicures, often paying privately for them. Others bathed or put cream on their feet daily or had their feet checked regularly by the diabetes nurse. One man said his wife gave his feet a twice weekly massage which improved his circulation and helped him to monitor any damage.

Once someone has neuropathy, walking for any distance can be very painful. One man said if he walked for too long, he would stumble or trip. A few people said their balance was affected, when walking up stairs or along the street. Some men could no longer play golf and one woman said the only exercise she can now do is swimming.

Damage to nerves and poor circulation in the feet caused numerous problems. Some people said their feel felt very hot, “Like my feet are on hot coals,” or described having “a burning prickly sensation” in the feet which started at night and made it difficult to sleep. Others experienced pins and needles.

Preventing neuropathy developing or getting worse is very important. The best way to reduce the risk of developing neuropathy, is to control blood glucose levels and to check the feet regularly.
Heart Disease and Kidney Disease
People with type 2 diabetes are up to five times more likely to develop heart disease or have a stroke (NHS Choices 2016).  One in three people with diabetes may go on to develop kidney disease (Diabetes UK). Kidney disease develops very slowly over many years, and is most common in people who have had diabetes for over twenty years, although, as treatments improve, fewer people are affected.

Keeping blood pressure under control is extremely important and everyone with diabetes should have an annual check, which should include a urine test for protein.

Last reviewed March 2016.
Last updated March 2016.


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