Type 1 Diabetes Complications

You Can Prevent Short- and Long-term Complications

Written by Daphne E. Smith-Marsh PharmD, CDE
Reviewed by W. Patrick Zeller MD

Type 1 diabetes is complicated—and if you don’t manage it properly, there are complications, both short-term and long-term. “If you don’t manage it properly” is an important if statement: by carefully managing your blood glucose levels, you can stave off or prevent the short- and long-term complications. And if you’ve already developed diabetes complications, controlling your blood glucose levels can help you manage the symptoms and prevent further damage.

Diabetes complications are all related to poor blood glucose control, so you must work carefully with your doctor and diabetes team to correctly manage your blood sugar (or your child’s blood sugar). 
Short-term Diabetes Complications
There are three levels of hypoglycemia, depending on how low the blood glucose level has dropped: mild, moderate, and severe. If you treat hypoglycemia when it’s in the mild or moderate stages, then you can prevent far more serious problems; severe hypoglycemia can cause a coma and even death (although very, very rarely).
The signs and symptoms of low blood glucose are usually easy to recognize:
For more information about hypoglycemia and how to treat it, please read our article on hypoglycemia . If you're a parent with a child who has type 1 diabetes, you can also read our article about managing hypoglycemia in children with type 1 diabetes.
Diabetes develops gradually and so people may not realize that they have it—until it becomes very serious very quickly and they have diabetic ketoacidosis.  However, it’s also possible to develop diabetic ketoacidosis after you’ve been diagnosed with diabetes—if you aren’t taking care of your blood glucose levels as you should.
Here’s how diabetes ketoacidosis develops: When the body runs out of insulin—and that will happen as the effects of diabetes take their toll—you can’t use glucose properly or effectively. Without glucose to fuel your body, it starts to use fat to get its energy.
When fat is broken down by the body, ketones are released.  When too many ketones build up in the blood, it makes the blood acidic, leading to diabetic ketoacidosis if the situation isn’t dealt with.
The signs and symptoms of DKA are:
If you think you (or your child) has DKA, you can quickly confirm it with two at-home tests:
Diabetic ketoacidosis must be treated, so as soon as you confirm DKA, call your doctor. If you don’t have any ketone strips available but still suspect DKA, go to the nearest hospital emergency room immediately to be evaluated.
Long-term Diabetes Complications
By tightly controlling your blood glucose level (or your child’s blood glucose level), you can avoid long-term complications of type 1 diabetes. Basically, if you work to avoid the short-term complications, you’ll also be doing some long-range planning and avoiding the complications listed in this section.
These complications develop over many years—usually at least 10 years—and they all relate to how blood glucose levels can affect blood vessels. Uncontrolled blood glucose can, over time, damage the body’s tiny and large blood vessels.
Damage to your tiny blood vessels causes microvascular complications; damage to your large vessels causes macrovascular complications.
Microvascular Complications: Eye, Kidney, and Nerve Disease
You have small blood vessels that can be damaged by poor blood glucose control. Damaged blood vessels don’t deliver blood as well as they should, so that leads to other problems, specifically with the eyes, kidneys, and nerves.
Macrovascular Complications: The Heart
Type 1 diabetes can also affect the large blood vessels, causing plaque to eventually build up and potentially leading to a heart attack. To prevent heart disease as a result of diabetes, you should manage your diabetes well. However, you should also make heart-healthy choices in other areas of your life: don’t smoke, keep your blood pressure under control, and pay attention to your cholesterol.
These are the main complications, both short-term and long-term, that are associated with type 1 diabetes. By carefully controlling your blood glucose, you can prevent these complications.


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Type 1 Diabetes Prevention