Updated 28 June 2017

Type 2 diabetes and other health problems

Type 2 diabetes can worsen the symptoms of many other health problems that occur frequently in the elderly.


Many elderly people have diabetes. Type 2 diabetes used to be called adult onset diabetes and occurred most frequently in middle-aged and elderly people – this is no longer the case. Many young people today have Type 2 diabetes. But regardless of when its onset is, the fact remains that a growing number of elderly people have diabetes.

Most people who have developed diabetic complications have been diabetic for some time. Most diabetics are diagnosed in routine checkups, or when they show some of the other symptoms of diabetes, such as increased thirst, or frequent urination, or inexplicable weight loss or gain.

But people who have been diabetic for some time should be on the lookout for any signs of heart trouble, such as chest pain, blurred vision or a tingling sensation in the lower legs and feet. Circulatory problems, high blood pressure and heart problems are particularly prevalent among the elderly. These problems can be compounded by uncontrolled blood glucose levels. It is therefore essential that elderly diabetics should take even greater care of their health.

Many elderly people have back problems, which is often confused with kidney pain. Kidney problems could be a sign of diabetic complications. Therefore elderly people should be on the lookout for these signs. This should also be a call to take action and get to a doctor.

The following complications can occur in people who have been diabetic for a lengthy period.

Diabetes and the eye

When left untreated, diabetic retinopathy can cause blindness in diabetics. Diabetes is the leading cause of blindness among adults between the ages of 16 and 74. But not all diabetics will go blind, and much can be done to prevent and treat eye problems.

So why does diabetes damage the eyes?

At the back of the eye is a light-sensitive lining called the retina. If your blood sugar levels are consistently high, the tiny blood vessels at the back of the retina will become damaged. If you are diabetic, you should see an opthalmologist at least once a year, for a thorough checkup.

Glaucoma, high pressure in the eye, or cataracts, a thickening of the lens, as well as blurred vision are all eye problems associated with diabetes. Today, with laser surgery, much can be done to reverse eye damage caused by diabetes, but, as with all complications, it is always advisable to catch them early.

A test specifically for diabetics is called fluorescein angiography, helps detect early retinopathy, even before a diabetic patient may be aware of any damage to his or her vision. Laser therapy can control most of the damage which has been done.

Diabetes and your kidneys

Kidney problems result from damage to the blood vessels in the kidneys. High blood sugar levels, or heavily fluctuating blood sugar levels, can cause this damage. This condition is called nephropathy.

As a result of this, the kidneys’delicate filtering system is affected, reducing their ability to remove waste from the body. High blood pressure can increase kidney damage in diabetics, and kidney damage, in turn, can also cause high blood pressure. This occurs frequently in elderly people. The kidneys serve as a filtration system for many minerals and hormones in your blood. Damage to the kidneys can also put severe strain on the heart.

If the kidneys no longer function properly, it means that their diuretic function is impaired, and the body starts to retain fluids rather than getting rid of them. Hence the puffy appearance of people with severe kidney malfunction. If it gets to this stage, dialysis or a transplant may be the last resort.

If albumin, a protein, is found in your urine, it means that the filtration system in your kidneys is not functioning at its best. It is recommended that all diabetics have annual blood and urine tests to measure the functioning of the kidneys.

If the kidneys no longer function properly, it means that their diuretic function is impaired, and the body starts to retain fluids rather than getting rid of them. Hence the puffy appearance of people with severe kidney malfunction. If it gets to this stage, dialysis or a transplant may be the last resort.

While kidney damage is irreversible, much can be done to reduce further damage, such as keeping blood sugar and blood pressure under control. It is also important that any urinary tract infections be dealt with promptly in order to prevent further damage to the kidneys.

Diabetes and the circulatory system

When blood glucose levels become uncontrolled, and the glucose levels in the blood remain dangerously high, the blood vessels in certain parts of the body become damaged. This affects the body’s ability to circulate blood as effectively as usual.

The lower legs and feet are particularly susceptible to this, therefore a tingling sensation in these parts of the body should be a warning to all diabetics. If this is experienced, immediate medical attention is needed. Foot infections, coupled with reduced circulation could easily lead to gangrene and the necessity for amputations.

Diabetes and the brain

When nerve damage takes place, the nerves that control sensation, are damaged. This can lead to loss of sensation in that part of the body or to unsteadiness, pain and numbness. This type is known as peripheral neuropathy.

Autonomic neuropathy could damage the nerves that control automatic body functions, such as your digestive and urinary systems. Symptoms of autonomic neuropathy could include constipation, vomiting, diarrhoea, impotence and difficulty urinating.

Diabetes and the heart

High blood sugar levels can damage the blood vessels of the heart. Diabetics are more inclined to develop atherosclerosis of the heart, which could lead to angina, a hart attack or heart failure.

Keeping blood sugar levels under control helps prevent atherosclerosis.

Increasing cholesterol buildup can also lead to heart problems. Keeping blood pressure and cholesterol levels low are important for diabetics, because coronary artery disease seems to occur more commonly especially amongst elderly diabetics.

Diabetes and gangrene

Peripheral arterial disease caused by atherosclerosis is more likely to affect diabetics. This condition impairs the circulation in arteries, most notably, the ones leading to the brain, legs and feet. This often happens during the normal ageing process, but high blood sugar levels compound this process. The nerve damage that this condition causes can also lead to impotence.

This condition can lead to strokes and injuries that do not heal and in a worst case scenario, to gangrene, which might necessitate amputation. Much can be done to prevent these, footcare being top of the list.

Small cuts and blisters, or Plantar’s warts and ingrown toenails can lead to a minor infections, followed by a bacterial invasion. Nerve loss can also make you unaware of developing sores, deep ulcers, or slightly infected cuts. Severe sores that don’t heal can become gangrenous and lead to amputations. Those with diabetes should take extra care to buy well-fitting shoes, and not to neglect any cuts or blisters. It is preferable to have toenails cut by a professional.

When tingling sensations, or burning and pain is felt in the lower legs and feet, it is a good idea to see your doctor. Nerve loss can also make you unaware of developing sores or slightly infected cuts. Severe sores that don’t heal can become gangrenous and lead to amputations. - (Health24, updated February 2010)


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Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.

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