Diabetes is often called a “silent disease” because it can develop quietly, causing damage over time without obvious symptoms. It’s not the diagnosis of diabetes itself that leads to health complications, but rather the chronic, unmanaged blood sugar levels that are the true culprit. The stark reality is that well-managed blood sugar can greatly reduce the risk of complications and may even lead to a reversed diagnosis. As Dr. Bill Polonsky states,

 

This quote captures the essence of diabetes management: when properly controlled, diabetes does not have to result in adverse outcomes. 

The Silent Threat 

Unmanaged diabetes is like an iceberg lurking beneath the ocean’s surface—massive, dangerous, and largely hidden from view. Allowing this condition to go unchecked can have severe consequences, affecting multiple organs throughout the body. Let’s explore how chronic high blood sugar levels can impact organ health.  

Kidney Disease 

High blood sugar levels can damage the kidneys over time, potentially leading to chronic kidney disease. However, this isn’t inevitable—there are many small steps you can take to keep your kidneys healthy! By making simple changes, you can achieve significant results. The best way to prevent or slow kidney damage is to keep your blood sugar levels under control. While this may seem challenging, start by adding a plant-based fiber source to your meals and eating it first (think salad first!). Fiber helps regulate blood sugar by slowing digestion, while colorful plant foods provide essential phytonutrients—natural compounds that support healing and reduce the risk of various diseases. 

Eating a variety of colorful fruits and vegetables is often underestimated, yet the diverse nutrients they provide play a crucial role in creating a balanced environment where the body can function optimally and support long-term health. Here are other ways to promote kidney health: 

• Limiting the amount of salt in your diet 

• Controlling your blood pressure 

• Reducing animal protein intake and increasing fruits and vegetables 

• Staying well-hydrated by drinking enough water throughout the day 

• Engaging in regular physical activity to support circulation and kidney function 

• Avoiding excessive alcohol consumption, which can stress the kidneys 

• Managing stress through relaxation techniques like deep breathing or mindfulness 

• Getting regular check-ups to monitor kidney function, especially if you have risk factors like high blood pressure or diabetes 

• Avoiding medications or supplements that may harm your kidneys 

By making these small but meaningful changes, you can take control of your kidney health and support overall well-being.  

Heart Disease 

Diabetes significantly increases the risk of heart complications, including high blood pressure and stroke (9). However, this does not mean heart complications are inevitable or that there is nothing you can do to prevent them. You’ve likely been focusing on lowering your blood glucose levels, which is a huge win! Now, consider checking your lipid panel levels and working with your Tula dietitian to address them through lifestyle changes. Some key lab values to monitor and lower include triglycerides and low-density lipoprotein (LDL) cholesterol. 

Quitting smoking is a powerful step toward better health. Smoking not only raises total cholesterol, LDL cholesterol, and triglyceride levels but also causes significant internal damage to the body (14). Even if you’re eating the healthiest diet possible, the harmful effects of smoking can still wreak havoc on your health. By quitting smoking, you can reduce these risks and improve your overall well-being. 

Another simple way to support heart health is by checking food labels for trans fats and partially hydrogenated oils. Trans fats are created when hydrogen is added to liquid fat to help it solidify. This process extends the shelf life of foods and makes oils reusable, which is why they are commonly found in fast food and processed snacks. While manufacturers may favor trans fats for their convenience, the body does not. These fats contribute to insulin resistance, visceral fat accumulation, metabolic syndrome, and an increased risk of heart disease (11). 

The next step is making substitutions for foods high in trans fats or containing partially hydrogenated oils. Learning more about what’s in your food can empower you to make healthier choices. Fortunately, many of these swaps are simple and won’t significantly disrupt your lifestyle. 

If you have more questions about your lipid panel levels, sign up HERE to watch a webinar all about the different labs that you may have had drawn or that you would like to ask to have drawn.

Eye Health and Vision Loss

Unmanaged high blood sugar can cause damage to your eyes over time, potentially leading to vision loss or blindness. This damage occurs due to issues such as damaged blood vessels, inflammation, increased eye pressure, or nerve damage. Conditions like cataracts, glaucoma, and diabetic retinopathy can all develop as a result. Specifically, diabetic retinopathy is the leading cause of blindness in working-age adults (12). It occurs when high blood sugar damages the blood vessels in the retina—the part of the eye responsible for vision—causing them to swell and leak, which can result in blurry vision.

Prevention is the best medicine! Scheduling regular annual eye exams is crucial for early detection and management. Prevention also includes quitting smoking, managing blood sugar levels, and reducing high blood pressure.

Symptoms of Eye Damage May Include:

• Blurry vision

• Spots or dark shapes in your vision

• Trouble seeing colors

• Dark or empty areas in your vision

• Vision loss

• Flashes of light (especially with retinal detachment or other retinal issues)

• Eye pain or pressure

If you notice any of these symptoms, it’s important to see your eye doctor immediately. Treatment for diabetic retinopathy is most effective when started early.

Nerve Damage

One of the serious complications of unmanaged diabetes is neuropathy, a form of nerve damage that often affects the legs and feet. High blood sugar levels can injure nerves throughout the body, create inflammation and oxidative stress, impair nerve function, and contribute to the stiffening of blood vessels.

Diabetic neuropathy refers to nerve damage caused by high blood sugar levels in individuals with diabetes. There are several types, including:

• Diabetic Peripheral Neuropathy (DPN): This type primarily affects the extremities, such as the legs, feet, arms, and hands. It often causes symptoms like numbness, tingling, burning pain, or loss of sensation, especially in the lower limbs.

• Autonomic Neuropathy: This affects the autonomic nervous system, which controls involuntary functions like heart rate, blood pressure, digestion, and bladder control. It can lead to issues such as digestive problems, irregular heart rate, or bladder dysfunction.

Each type of diabetic neuropathy presents unique symptoms and complications. Managing blood sugar levels and seeking early treatment are crucial steps in reducing the risk of nerve damage.

Preventing and Managing Neuropathy

One of the most effective ways to prevent worsening neuropathy is through proper blood sugar management. While this can be challenging, discussing any obstacles with your HealthCoach can help you better regulate your blood sugar levels. Additionally, regular exercise, proper hydration, and certain dietary choices can support circulation, which is essential for nerve health.

For natural ways to support neuropathy treatment, consider speaking with your healthcare provider about Alpha-Lipoic Acid supplements and checking your vitamin B12 levels. A B12 deficiency can cause symptoms similar to neuropathy, so it’s important to ensure your levels are optimal.

Addressing circulation issues by promoting vasodilation—the process where blood vessels relax and widen to improve blood flow—can also help deliver oxygen and nutrients to nerves, reducing pain and numbness. Activities like walking and breathing exercises can encourage vasodilation and improve nerve health (19-21).

Nitric oxide plays a key role in vasodilation and circulation health by relaxing blood vessels and improving blood flow (19). Foods rich in dietary nitrates, such as beets, spinach, and arugula, help boost nitric oxide production. Other ways to support circulation and nerve function include:

• Getting regular sunlight exposure

• Staying hydrated

• Eating magnesium-rich foods (leafy greens, nuts, seeds)

• Incorporating polyphenol-rich foods (blueberries, blackberries, and other colorful fruits)

The Importance of Foot Care

Foot care is essential for individuals with diabetic neuropathy. Nerve damage can cause a loss of sensation in the feet, making it difficult to detect injuries. To prevent serious infections, it’s important to:

• Inspect your feet daily for cuts, blisters, or sores.

• Wear proper footwear to protect against injuries.

• Consult a healthcare provider regularly for checkups and guidance on managing diabetes.

If you experience numbness, tingling, or persistent pain in your extremities, seek medical advice promptly. Early intervention can help manage symptoms and improve your quality of life.

Be on the Lookout

Early detection is key to managing diabetes complications. Be vigilant for signs and symptoms of high blood sugar, including:

• Frequent urination, especially at night

• Excessive thirst and hunger

• Unintentional weight loss

• Blurry vision

• Fatigue

• Numbness or tingling in the hands or feet

• Slow-healing cuts, scrapes, or sores

• Dry mouth or skin

• Frequent infections (e.g., urinary tract infections, skin infections)

• Darkened skin patches, especially around the neck or armpits (acanthosis nigricans)

• Feeling lightheaded or dizzy

Change is possible, and it begins with small steps that lead to big improvements in your health and well-being. Remember, you are not alone in this journey—there are countless resources and supportive communities ready to help you every step of the way. Together, we can tackle diabetes head-on and create a brighter, healthier future.

Sending Health Your Way!

The Tula Clinical Team

Reviewed by:
Aubree RN, BSN
Austin MS, RDN, CSR, LDN, CD