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Health Conditions

Diabetes

Your body gets energy by making glucose from foods high in carbohydrates like bread, potatoes, rice, pasta, milk and fruit. To use this glucose, your body needs insulin. Insulin is a hormone that helps your body to control the level of glucose (sugar) in your blood. There are two types of diabetes:

Type 1 Diabetes is a disease in which the pancreas does not produce insulin. If you have Type 1 Diabetes, glucose builds up in your blood instead of being used for energy. The cause of Type 1 Diabetes remains unknown. People are usually diagnosed with Type 1 Diabetes before the age of 30, most often during childhood or their teens.

Type 2 Diabetes is a disease in which your pancreas does not produce enough insulin, or your body does not properly use the insulin it makes. If you have Type 2 Diabetes, glucose builds up in your blood instead of being used for energy.

Diabetes is associated with the following complications:

People with diabetes are at increased risk of Heart Disease and Stroke , also known as cardiovascular disease (CVD) and stroke (cerebrovascular disease). High blood glucose is a primary risk factor, but people with diabetes often have a number of other risk factors including being overweight, inactive lifestyles, high blood pressure and high cholesterol. Up to 80% of people with diabetes will die as a result of a heart attack or stroke.
Depression affects approximately 15% of people with diabetes. The association between depression and diabetes is unclear. Depression may develop because of stress but also may result from the metabolic effects of diabetes on the brain. Depression is associated with poorer self-care behaviour, poorer blood glucose management, health complications, decreased quality of life and psychological well-being, increased family problems, and higher healthcare costs.
Digestive Problems are relatively common disorder that causes delayed emptying of the stomach. Normally, the stomach contracts to move food down into the small intestine for digestion. The vagus nerve controls the movement of food from the stomach through the digestive tract. Gastroparesis occurs when the vagus nerve is damaged and the muscles of the stomach and intestines do not work normally. Food then moves slowly or stops moving through the digestive tract. Gastroparesis may occur in people with Type 1 Diabetes or Type 2 Diabetes. High blood glucose levels associated with diabetes cause chemical changes in nerves and damage the blood vessels that carry oxygen and nutrients to the nerves. Over time, this process damages the vagus nerve.
Vision - People with diabetes are more likely to develop cataracts at a younger age and are twice as likely to develop glaucoma, but diabetes' effect on the retina is the main threat to vision. Diabetic retinopathy is the most common cause of blindness in people under age 65 and the most common cause of new blindness in North America. It is estimated that approximately 2 million individuals in Canada (i.e. almost all people with diagnosed diabetes) have some form of diabetic retinopathy.
Foot problems are very common in people with diabetes. Diabetes affects the circulation and immune system, which in turn impairs the body's ability to heal itself. Over time, diabetes can damage sensory nerves (this is known as "neuropathy"), especially in the hands and feet. As a result, people with diabetes are less likely to feel a foot injury, such as a blister or cut. Unnoticed and untreated, even small foot injuries can quickly become infected, potentially leading to serious complications.
Kidney Disease – known as nephropathy – is a serious complication associated with long-term diabetes. Over the years, high blood glucose levels and high blood pressure can damage the kidneys and prevent them from functioning properly or even cause them to fail completely. About one-third of people who have had diabetes for more than 15 years will develop kidney disease, but good diabetes management and regular screening can prevent or delay the loss of kidney function.
Celiac Disease is an autoimmune condition in which the body cannot tolerate gluten – a protein found in wheat, rye, barley and triticale. Celiac disease is found in 4 to 9% of children with Type 1 diabetes but, in 60 to 70% of these children, the disease is asymptomatic ('silent' celiac disease). Children with Type 1 diabetes are at increased risk for celiac disease during the first 10 years of diabetes.
Erectile Dysfunction (ED) is defined as the persistent inability to get or maintain an erection that is satisfactory for sexual activity. In up to 12% of men with diabetes, ED is the first sign that leads to the diagnosis of diabetes.

Fifty percent of men will experience ED within 10 years of diagnosis of diabetes. Older men with a longer duration of diabetes, poor blood glucose control, and who smoke, have high blood pressure, high cholesterol and heart disease, are at highest risk.

Diabetes causes damage to the walls of the blood vessels, which affects circulation and blood flow to the penis. In addition, nerve damage can affect erection quality. ED can also be a side effect of drugs that are often prescribed to men with diabetes (these include some blood pressure-lowering drugs and anti-depressants).

From: The Canadian Diabetes Association, 2011