Diabetes as a risk factor: complications and how to lower the risk

The NHS says diabetes is a condition that causes your blood glucose level to become too high. It is caused by your body not making enough or any of a hormone called insulin, or by the insulin not working properly, which is called insulin resistance. Insulin helps the body use glucose for energy.

The NHS describes three common types: type 1 diabetes, often diagnosed in childhood but possible at any age and not preventable; type 2 diabetes, which some people are at higher risk of due to ethnicity, age, or living with obesity or overweight; and gestational diabetes, which can happen during pregnancy and usually goes away after birth.

The NHS says complications of diabetes can develop over time and are linked to high blood glucose levels. For type 2 diabetes it specifically describes damage to the blood vessels, which can cause coronary heart disease and stroke. Nerve damage and foot problems, sight problems, kidney problems and gum disease follow the same general pattern.

Because of this, diabetes is described as a risk factor in its own right for conditions such as heart attack, stroke and kidney disease. The size of the added risk in an individual depends on the type of diabetes, how long it has been present and how well the glucose has been controlled, and the sources used here do not give figures.

The NHS lists the long-term complications of type 2 diabetes in these groups. Several of them are things you can see a GP or diabetes nurse about early.

• Heart and blood vessels: damage that can cause coronary heart disease and stroke.

• Feet: ulcers and infections that can sometimes result in the need for surgery to remove a foot or leg.

• Eyes: problems such as diabetic retinopathy and blindness.

• Kidneys: kidney problems.

• Nerves: nerve damage (peripheral neuropathy), which can cause pain, tingling or numbness.

• Gums: gum disease.

The NHS says you can lower your chances of complications by managing your blood glucose as well as you can and by making healthy lifestyle changes, such as eating a balanced diet, exercising and not smoking. It also says it is important to go to all of your diabetes appointments and not miss any tests, because this helps to find and treat complications as soon as possible.

The NHS notes that treatment depends on the type: insulin for life and regular glucose checks for type 1; lifestyle changes and sometimes medicines such as metformin or insulin for type 2 and gestational diabetes. People with pre-diabetes may be eligible for the NHS Diabetes Prevention Programme.

The NHS says to see a GP or diabetes nurse if you have blisters or cracked skin on your feet, any pain, tingling or numbness in your body, problems having sex, constipation or diarrhoea, which could be signs of nerve damage, or if your vision gets worse.

It says to call 999 or go to A&E if you have type 2 diabetes and are peeing a lot, feel very thirsty, feel sick, feel confused or very sleepy, feel drowsy or get short of breath. These could be signs of hyperosmolar hyperglycaemic state (HHS) or diabetic ketoacidosis (DKA), which can be life threatening if not treated quickly. HHS is rare in type 2 diabetes and is usually caused by an infection and being dehydrated.

The most common symptoms are feeling thirsty all the time, peeing more than usual, feeling very tired and losing weight without trying. The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you or your child has any symptoms of diabetes. Not everyone with diabetes has symptoms, so the NHS says it is important to get checked if you have a higher risk of developing diabetes.