What you need to know about type 1 diabetes complications

The topic of type 1 diabetes complications can be an intimidating subject for many living with the condition.

Long spoken of in hushed tones or discussed as an inevitable threat, empowered patient movements have begun to go mainstream. Initiatives such as #talkaboutcomplications bring the conversation out into the open to help remove the stigma and replace it with knowledge that helps people thrive.

If you're living with type 1 diabetes (T1D), rest assured that you're one of many — and others are looking out for you. You don't have to deal with your complications alone! Here's what you need to know about potential short- and long-term issues, as well as tips for ensuring your well-being.

Short-term complications of T1D

While conversations about T1D complications often center around the long-term effects of diabetes, there are complications that can pop up amid regular management. Here are three issues to stay aware of:

1. Site infections. With fingerstick blood glucose checking, multiple daily injections (MDI), insulin pump site insertions and continuous glucose monitor (CGM) sensor insertions, there is often a risk of infection. Cleaning the site before and after with alcohol or soap and water, performing site rotations and monitoring for signs of inflammation can help prevent situations that require medical intervention.
2. Out-of-range glucose levels. Hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) are two common complications of living with T1D. Frequent monitoring of your blood glucose levels and preparedness to treat either situation are the best defense. Low blood sugar needs to be treated urgently as the potential danger lies in the moment. High blood sugar is not always an immediate concern, but cumulatively it can cause serious issues in the long term.
3. Diabetic ketoacidosis (DKA). This condition is a complication of diabetes that can occur in the short term with dangerous implications both in the moment and over time. Caused by a lack of insulin in the body to process carbohydrates into glucose for energy and often exacerbated by dehydration or illness, DKA is something that requires immediate medical attention. The Mayo Clinic states that symptoms of DKA may develop quickly, and if left untreated, can cause coma, brain swelling or death.

Long-term complications of T1D

Daily management can prevent issues in the short term, and habitually following these routines can help ensure your health in the long term. However, there are complications that can affect your well-being over time:

• Issues related to hyperglycemia. The effects of T1D on the body are still being studied to further understand why some people experience diabetes complications and others do not. What is known at this point is that blood glucose levels that are very high over a long period of time can cause damage to various areas of the body, including teeth, gums, nerves, feet, kidneys, eyes and heart.
• Issues related to hypoglycemia. At the same time, individuals who experience low blood sugar levels over a long period may be at risk for other complications. For instance, prolonged episodes of very low blood sugar can cause brain damage, affecting learning and memory.

The unseen complications of T1D

Most people living with T1D make a great effort to take care of themselves in the short term, knowing that these cumulative acts of care can significantly help prevent long-term complications. Working extraordinarily hard in the hopes that "nothing" will happen can be exhausting and is a contributing factor to diabetes-related anxiety, depression and burnout.

In recent years, the mental and emotional impacts of living with T1D have been at the forefront of research. According to Mental Health America, people living with T1D are at an increased risk of developing depression, anxiety and eating disorders. It is estimated that 33% to 50% of people living with diabetes will experience diabetes distress — a condition characterized by stress, depression and anxiety — as it relates to managing diabetes (including social determinants of health).

How can you encourage short-term and long-term well-being with T1D?

All of these short-term, long-term and unseen complications can be scary things to think about, so people often avoid talking about them altogether until symptoms occur. Sometimes, by then, it is too late and drastic measures need to be taken. Working as a community to talk about these issues will help fund research for the treatment and prevention of type 1 diabetes complications, as well as eliminate the guilt and stigma surrounding this topic.

Additionally, an increased focus can fuel the important conversations that should be happening between patients and providers. This can help people cope and live their healthiest lives. Here are a few ways you can maintain your well-being while managing diabetes:

• Keep your blood glucose within the healthy range you and your doctor have established.
• Stay in tune with your body so you can seek help if something feels "off" to you.
• Schedule regular appointments with your endocrinologist, as well as your ophthalmologist, podiatrist, cardiologist and/or any other members of your care team who can help you stay on top of changes in your health needs.
• Eat a balanced diet that supports your blood glucose goals.
• Participate in safe physical activities that you enjoy to assist with both the physical and emotional health aspects of living with T1D.
• Practice self-care for stress management and seek mental health support when needed.
• Learn to advocate on your own behalf and model the language you would like others to use when discussing T1D complications.
• Make necessary changes. If you smoke or have a nicotine addiction of any kind, there's no time like the present to work on overcoming the habit, as smoking and smokeless tobacco increase risk for diabetes complications.

As a person living with T1D, it can be overwhelming to think about complications. This is understandable and common! Just know that all complications are not yet fully understood — and although you may do your best to avoid them, they may still occur. This doesn't mean that you have done something wrong. Some people develop them after a short time, others may live many years with T1D and have minimal to no complications at all. Keep your focus on living your healthiest life with T1D, one day at a time.

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