Non-communicable Diseases

Preventing and managing complications of diabetes

You rarely see them coming.

Sometimes until it is too late.

Diabetes complications develop gradually but their effect is long-lasting and drastically change the quality of the patient’s life.

Erick Njenga, a consultant physician at the Aga Khan University hospital notes that most of the complications arise as a result of poorly managed diabetes which increases the risk of having complications.

“By keeping a close watch of your your blood glucose level within the recommended health range and following through the meal plans, physical activity, and adhering to medications, you can avoid long-term complications of diabetes,” said Dr Njenga.

Physician and Senior Instructor at Aga Khan University School of Medicine

These complications are disabling and life-threatening because they affect various body systems leading to a poor quality of life,” notes Dr Njenga.

Dr Njenga classifies diabetes complications into two groups depending on whether it affects the major or minor blood vessels.

“Damage to your tiny blood vessels causes microvascular complications like poor vision leading to blindness, erectile dysfunction, nerve damage and Chronic Kidney Disease which can eventually lead to renal failure. If the large vessels are affected, it leads to causes macrovascular complications such as a stroke, heart attacks and blockage of the large vessels in the leg which could lead to amputation, “ said Dr Njenga.

Dr Njenga takes us through some of the diabetes related complications;

Heart disease

Diabetes can increase your chances of developing heart failure as well as narrowing and blockage of the major vessels in the heart leading to chest pain (angina) as well as heart attacks.

Nerve damage

This is known as neuropathy which occurs when excess sugar injures the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in your legs.  This cause a burning sensation that usually begins at the tips of the toes or fingers and gradually spreads upwards.

Erectile dysfunction

poorly controlled diabetes can also affect blood flow in the tiny vessels supplying the penis as well as the nerve tissue which can lead to erectile dysfunction in men. This can have serious psychological consequences in men and can lead to marital discord and depression.

Low libido

Poorly controlled diabetes in women causes low libido and can affect the quality of their sexual health due to recurrent vaginal (candidiasis)  and urinary tract infections. Women can also experience vaginal dryness as well as partial incontinence as a result of nerve damage in the setting of poorly controlled sugars.

brown kidney decor


Poorly controlled blood sugars will also damage the small blood vessels in the kidneys as well as damage to the filtering unit called nephrons.  This leads to progressive kidney failure termed as Chronic Kidney Disease which can eventually culminate in irreversible end-stage kidney disease, which may require dialysis or a kidney transplant.

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Poorly managed diabetes can cause blindness. Sadly, in the initial stages of vision loss for diabetes patients, the symptoms may not be obvious to the individual until it has progressed to an advanced stage. The high blood sugar damages the back of the eye known as the retina and this can cause blindness if it goes undiagnosed and untreated. This is known as diabetic retinopathy. Patients are advised to have annual eye health checks to go simultaneously with their regular diabetes checks.

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Foot damage

When the nerves in the feet are damaged or there is poor blood flow to the feet, serious infections that are mostly slow healing can lead to amputations of toes or legs. Loss of sensation in the feet can expose one to foot trauma such as pin prick or thorn prick  which may not be perceived. This may lead to a serious infection known as diabetic foot. This is an infection which can involve the skin as well as deeper structures such as muscles, tendons and even bone. If not diagnosed and treated early, it can lead to severe infection and amputation.

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For persons with poorly controlledType 2 diabetes, have a higher risk of developing memory impairment at a much earlier age compared to their non-diabetic counterparts.

Complications of gestational diabetes for both mother and the baby

  • Pregnant women who have been diagnosed with gestational diabetes may give birth to larger babies, a condition known as macrosomia. This refers to a baby whose birth weight is more than 4 Kgs. This is attributed to the extra glucose can crosses the placenta, which triggers the baby’s pancreas to make extra insulin and hence lead to babies who weigh more than normal.
  • Mothers with gestational babies who give birth to large babies have a higher risk of complications such as vaginal and cervical tears , post partum haemorrhage and development of fistulas later in life. They are also more likely to require cesarean to deliver their babies.
  • Large babies also have a higher risk of developing cerebral palsy due to prolonged labour where their brain issue is starved of oxygen and leads to long-term brain damage.
  • In other cases, the babies born may have low blood sugar and this may call for emergency care where prompt feedings and sometimes an intravenous glucose solution can return the baby’s blood sugar level to normal.
  • Babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
  • In severe cases, untreated gestational diabetes can result in a baby’s death either before or shortly after birth.
  • For the mothers with gestational diabetes have a higher risk of developing, high blood pressure in pregnancy known as preeclampsia
  • A mother with gestational diabetes is at an increased risk of developing diabetes Type 2 later in life.


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