Ask Your Family Doctor

Developed by the College of Family Physicians of Canada

How does diabetes affect my body?

Diabetes causes your blood sugar levels to be higher than normal. High blood sugar levels can damage your blood vessels and the nerves that run throughout your body.
Damage to your blood vessels can cut off the oxygen to your body's tissues. Damage to your nerves (called diabetic neuropathy) may cause your nerves to have trouble working, so that messages aren't sent as well to and from your brain and body.
Damage to your blood vessels and nerves can lead to a number of problems, including damage to your eyes that can lead to blindness and trouble with your feet that can lead to the need for surgery. You can help prevent these problems by following the tips in the box to the right.

What kind of eye problems am I at risk of?

You could get diabetic retinopathy. This is when the small blood vessels of the retina are damaged. Your retina is located at the back of the eye. It's the part of the eye that's sensitive to light and sends messages to your brain about what you are seeing.

When the blood vessels of your retina become weakened, fluid can leak from them. This can cause swelling in your macula. The macula is the part of your eye that gives you sharp, clear vision. Swelling in your macula blurs your vision.

If your retinopathy worsens, your eye begins to form new blood vessels over the surface of the retina. These vessels can break easily. Once broken, they bleed into the middle of your eye. Scar tissue may form, which can cause the retina to break away from the back of the eye. When retinopathy is found early, before it has done major damage, laser treatment can help you keep your vision. If it's not treated, diabetic retinopathy can lead to blindness.

How should I take care of my eyes?

The main thing is to have your eyes examined regularly. You won't notice the early signs of diabetic retinopathy because the changes in your eyes can only be seen through special equipment.

When you have diabetes, start having your eyes examined right away and have eye exams every year. See your doctor if you notice any of the symptoms in the box above.
Eye exams are also important if you're pregnant. If you have diabetes, pregnancy can cause you to start developing diabetic retinopathy or can make it worse. But gestational diabetes (the type that starts during pregnancy and goes away after giving birth) doesn't put you at risk for diabetic retinopathy.

Tips on preventing foot and eye problems

	Control your blood sugar, blood pressure and cholesterol.
	Exercise.
	See your family doctor regularly. See an eye and foot specialist as needed.
	Follow a good diet. Talk to your doctor about what to eat.
	Quit smoking.
	Avoid alcohol.
	Look after your feet daily.

See your doctor if you

	Have blurred vision
	Suddenly lose vision in one or both eyes
	See black spots, cobwebs or flashing lights

What about my feet?

Your feet may not be receiving a good blood supply due to damaged blood vessels. Also, the damage to your nerves may cause you to lose feeling in your feet. Diabetes can also damage your body's ability to fight infection. All of these things can work together to turn even minor foot injuries-such as blisters, calluses or ingrown toenails - into very serious infections that could lead to the loss of your entire foot if the injuries aren't prevented or taken care of properly.

How can I take care of my feet?

Check your feet every day for blisters, scratches or sores. See your doctor if you notice such things as foot pain, coldness, a shiny appearance of your skin, loss of hair on the foot or toes, or thickened nails.

Tips on caring for your feet

	Wash your feet daily with warm (not hot) water and soap.
	Gently pat (don't rub) your feet dry.
	Use lotion, but not between your toes.
	Change your socks and shoes once a day.
	Wear soft leather shoes (deerskin is best) that provide plenty of room for your toes.
	Don't go barefoot.
	Avoid wearing new shoes for more than an hour at a time when breaking them in.
	Avoid wearing anything that might restrict the blood flow to your lower legs.
	Avoid sitting with your legs crossed.
	Put lamb's wool between your toes if they rub each other.
	To cut your toenails, first soak your feet in warm water for 10 minutes to soften your nails. Cut your nails straight across. Don't cut into corners or close to your skin.
	Keep your feet warm but avoid getting your feet too close to hot surfaces (water bottles, heaters, fireplaces). This may cause burns.
	Don't treat corns or calluses yourself. See your doctor.
	Walk to relieve painful tingling.

Be sure to have your feet checked by your doctor at least once a year. The tips above may also help prevent foot problems.

For more information about diabetes, call the Canadian Diabetes Association at (1-800-226-8464)

Revised 2007 The College of Family Physicians of Canada

This information provides a general overview on this topic and may not apply to everyone. To find out if this information applies to you and to get more information on this subject, talk to your family doctor. This health education material has been favorably reviewed by the Patient Education Review Committee of the College of Family Physicians of Canada: Dr Cathy MacLean, Halifax, NS (Scientific Editor) Dr C. Richard Fischer, Pickering, ON Dr Patrice Laplante, Fleurimont, QC Dr Richard Moffatt, Red Deer, AB Dr David Nunn, Kentville, NS Dr Cornelius Woelk, Winkler, MB The College of Family Physicians of Canada, one of the nation's largest medical groups, is committed to promoting and maintaining high standards for family physicians - the doctors who provide ongoing, comprehensive care for people of all ages. This patient education information was developed by The College of Family Physicians of Canada in cooperation with the American Academy of Family Physicians.

Support for this program has been provided by an educational grant to the Research and Education Foundation by Scotiabank.