Like any long-term illness, diabetes can affect physical, mental and social well-being. The hallmark abnormality with diabetes is high blood sugar, or glucose. Exposure to high glucose levels often damages small and large blood vessels over time, leading to a variety of possible physical complications. Diabetes can also affect mental health, as it is associated with an increased risk for depression and may affect thought processes and memory. The stresses and demands of living with diabetes sometimes affect interpersonal and social relationships as well. The physical, mental and social effects of diabetes are interrelated, influencing short- and long-term health.
Blood Vessel Damage
High glucose levels damage the small blood vessels of the retina, the vision-perceiving tissue at the back of the eye, potentially causing permanent vision loss. Chronic kidney disease commonly develops with longstanding diabetes related to small vessel damage in these organs, which can lead to kidney failure. High glucose also damages large blood vessels, causing hardening of the arteries and the development of blockages that obstruct blood flow to the heart and brain. This type of large vessel damage increases the risk for heart attacks and strokes.
The nerves controlling the functions of various body organs are also commonly damaged due to persistently elevated blood sugar levels. This can lead to a variety of problems. Slowed stomach emptying, bloating and constipation are common manifestations of diabetes nerve damage. Disturbance of the nerves controlling bladder contraction leads to urine retention. Damage to nerves that control the heart and blood vessels often leads to a rapid heart rate and dizziness on standing. Damage to nerves responsible for sensation commonly cause tingling, burning or numbness of the feet and hands.
Diabetes increases the risk for depression. An October 2012 article published in the "Journal of Affective Disorders" showed that depression was 2 to 3 times more common among people with diabetes, compared to those without the disease. Depression risk increases as complications develop. For example, a March 2015 "Foot and Ankle Surgery" study report noted that people with diabetes-related foot problems had higher levels of depression compared to people with diabetes without foot problems.
Diabetes can also affect brain function. A May 2015 research analysis published in "Diabetes Metabolism Research and Reviews" showed that people with type 2 diabetes aged 50 and older are at increased risk for declining memory and mental multitasking, which could indicate an augmented vulnerability to dementia later in life.
Diabetes management requires strict adherence to a self-care regimen, including blood glucose testing, medication, diet and exercise. This often challenges people with diabetes and those who care for them, potentially affecting interpersonal relationships and indirectly affecting glucose control. A June 2012 article published in "Diabetes Care" found that family members’ nonsupportive behavior for adults with type 2 diabetes was associated with less medication adherence and worse blood glucose control.
For teens with type 1 diabetes, lack of peer support can affect compliance with self-care. A March 2012 review published in the "Journal of Pediatric Psychology" noted how some studies show that teens with type 1 diabetes who had conflict with their peers tend to have worse self-care.
Interplay of Diabetes Effects
The physical, mental and social effects of diabetes are interconnected. Negative effects in one of these arenas tends to cause more problems in the other two, and vice versa. Therefore, to achieve optimal diabetes care, all three areas must be addressed.