One of the most common things I hear from my patients with diabetes is, “I feel fine.” Unfortunately, they aren’t always fine. Having diabetes can be deceptive. It’s like touring a home. On a quick walk through, a house can look fine, but on closer inspection you can find hidden problems like rot in the walls or a sagging roof.
Diabetes is a disease that makes it hard for the body to metabolize sugar. This can lead to high levels of sugar circulating in the bloodstream rather than being concentrated in the muscles where sugar can be put to good use. High blood sugar levels can irritate and damage the smallest, most delicate blood vessels. Although, the damage can be difficult to notice initially, symptoms eventually arise in the parts of the body with lots of these small blood vessels, including the eyes, feet, and kidneys. If the damage caused by diabetes is left unchecked, it can lead to blindness, infections requiring amputation, and kidney failure.
Diabetic retinopathy, a condition where the small blood vessels in the eyes become damaged, is one of the leading causes of blindness in American adults. The damage can be slow, and your body can compensate for the damage for a while before the loss of vision becomes noticeable. Luckily, diabetic retinopathy is preventable. However, this prevention relies on catching diabetes early, controlling your blood sugar, and getting annual retinal exams.
Diabetes can also damage the small blood vessels in the feet, reducing circulation and dulling nerve endings—and the resulting numbness can mask injuries. This is why, once you receive a diabetes diagnosis, it is vital to check your feet daily for hotspots, sores, or blisters. When these injuries go unchecked, they can lead to dangerous infections. Treatment can be expensive and require intense wound care, aggressive doses of antibiotics, and even amputation if the infection reaches the bone.
Another potential impact of poorly controlled diabetes is reduced kidney function. Healthy kidneys filter waste products out of the bloodstream. When kidneys cannot keep up with the body’s waste, it is called renal disease and it can eventually lead to kidney failure. To prevent kidney failure, people go on dialysis, where a machine filters their blood. Dialysis often requires a significant commitment of time and money, and it is required until a kidney transplant can be performed. Thankfully, renal disease can be prevented when diabetes is caught early, and blood sugar is controlled. If you have diabetes, work with your primary care provider to get screened for kidney function and blood sugar levels at regular intervals.
Screening, Screening, Screening
I cannot stress enough the importance of catching diabetes early. Anyone can get diabetes, but some factors increase your risk. They include being overweight, being 45 years or older, having a family history, having a sedentary lifestyle, having diabetes during pregnancy, or being a member of certain ethnic groups, such as African American, Hispanic/Latino American, American Indian, or Alaska Native.
Another indicator that you may be at risk for diabetes is a sensitivity to infections, like recurring yeast infections or athlete’s foot. Those with pre-diabetes and diabetes have a harder time fending off these types of infections.
Diabetes and COVID
Because people with diabetes are at a greater risk of infection and have a harder time fighting infections, COVID can be extra worrisome. This has led some people to avoid public spaces and to delay routine medical visits. However, medical facilities are well-equipped to keep people safe and the consequences of going without routine diabetes screenings can be serious, just like the risks of COVID.
Managing risk is a balancing act. It is certainly important to protect yourself from COVID—to wear a mask, to get vaccinated, and to avoid large, indoor crowds. However, hiding in your home until COVID is over isn’t a good plan. All signs indicate that COVID will become endemic (that is, it is here to stay in some form, so we need to learn to live with its presence in the world). So, schedule your diabetes screening and allow medical professionals help keep you safe from the risks diabetes poses.
Justin Ebert is the medical director at MCHC Health Centers, a community-based and patient-centered organization that serves Mendocino and Lake Counties, providing comprehensive primary healthcare services as well as supportive services such as education and translation that promote access to healthcare.