Because diabetes is a chronic disease you will have it for a long time. If you have Type 1, you will have it for the rest of your life. Younger children are taken care of by their parents who look after their eating and drinking habits, check their blood glucose levels, ensure their child has enough insulin (either by injecting or using an insulin pump) and attend regular check-up appointments with their doctor or clinic. As you get older, you will start to do more and more of these tasks by yourself until you can manage diabetes alone.

When you get older, you will start doing these things for yourself. You will become familiar with your body and your illness and organize your life around it. This is important because you are the one who must learn to take responsibility for your own health. This will not always be easy, and you may not always want to do it. But it is important that you learn to keep your diabetes under control. Especially for your future. Therefore, it is necessary that you understand what negative effects diabetes can have later in life (long-term effect) and how to avoid them

Negative long-term effects of diabetes are caused by high levels of blood sugar, especially when they occur often and for a longer period. They especially affect cells that do not need insulin in order to process glucose.

This applies, for example, to your blood vessels (both large arteries and small blood vessels, for example within your organs) and the nervous system (nerves and brain). It takes a long time to notice the long-term effects of high blood sugar levels, so you are not aware of the damage until the harm has already been done. Organs that are very sensitive to high blood sugar levels are your eyes, kidneys, nerves, brain, your heart and vascular system.

Because of the high blood sugar levels you also have a higher risk of infection, so you are more likely to become ill. These infections are not only difficult to handle and uncomfortable, they can also cause damage to the infected organ or body part.

Negative long-term effects diabetes:

• damage to the eyes;
• kidney problems;
• damage to the nervous system
• heart and vascular disease;
• heart and vascular disease;
• skin problems;
• disturbance of the fat balance in the blood

Damage to the eyes:

Diabetes can damage the retina in your eyes, this is also called diabetic retinopathy. The retina is a very thin membrane that lies in the back of your eye and enables you to see clearly. The retina has many small blood vessels running through it. If you have high blood sugar levels the vessels in your retina can grow too fast and start to leak. This will reduce your vision, and you can eventually become blind. Regular check-ups at the ophthalmologist are very important if you have diabetes so that any changes to the vessels in your retina can be detected and treated in time. It is important to prevent high blood pressure, because too much pressure can cause the weak vessels to burst, causing bleeding in the retina.

Kidney problems:

Diabetes can damage kidneys and is often called diabetic nephropathy. Lots of small blood vessels run through your kidneys. These vessels have an important job; filtering (cleaning) your blood. They transport electrolytes, sugars and proteins through your urine and ensure that there is enough left behind in your blood. If your kidneys are working well, they keep everything in balance. However, if damage is caused by diabetes, the balance is disturbed and your kidneys are not able to do the job of filtering efficiently, allowing too much protein and salts to enter your urine. This, in turn, causes other problems such as high blood pressure, fluid retention, susceptability for or itching.

Because of the high blood sugars, you also have a higher risk of a urinary tract infection. This is harmful to the kidney tissue, which also prevents them from doing their job properly. So checking your blood pressure, kidney function and your urine regularly is also very important.

Damage to the nervous system and brain:

Diabetes can damage the nervous system in your body, this is also called diabetic neuropathy. There are nerves running all around your body; all your organs and all your tissues are controlled by them. Nerve function is indispensable. They ensure that almost everything works in your body. If damage is caused by diabetes, you may suffer from the following problems:

• high blood pressure
• your stomach holds food for too long, which may cause nausea, bloating, constipation or diarrhoea
• your skin is less sensitive so that you feel less cold, heat or pain
• tingling or pain in your hands or feet
• less feeling in your legs, cramping or reduced muscle strength
• a lot of sweating
• wounds take longer to heal

Diabetes can also damage the brain. The damage is caused by the high blood sugar levels themselves and their effects, such as high blood pressure and vascular damage. The damage can change the blood flow in your brain, causing a stroke. During a stroke (cerebral infarction) a blood vessel in the brain is closed so that part of the brain tissue no longer receives oxygen-rich blood and it dies.

Heart and vascular disease:

The high blood sugar levels caused by diabetes damage the walls of your blood vessels (arteries, capillaries and veins). The sugars accumulate mainly in the walls of the small vessels, these blood vessels become thicker and harder and can leak and the blood flow will diminish. Your skin and nerves suffer most from these effects. In addition, the fats accumulate in the vascular wall, especially in the larger arteries, causing the vascular wall to become thicker and the opening of the blood vessel to become narrower. This means that even less blood can flow through the vessels. This is also called (stroke) artherosclerosis.

Diabetes can damage the heart. The blood vessels and nerves in your heart muscle are damaged by high blood sugar levels. The damage caused reduces the blood supply to the heart muscle, resulting in too little oxygen going to the heart. This causes a feeling of pressure in the chest (chest pain) when exercising (angina pectoris) and can also cause a heart attack, as a blood vessel in the heart muscle is closed. Part of the heart muscle therefore no longer receives oxygen-rich blood and dies. If your neural pathways are also damaged, it may be that you do not feel the pain sufficiently, so you do not recognize the alarm signal. A heart attack can therefore 'quietly' proceed without you noticing it but still cause damage.

Foot problems:

Because diabetes can cause damage to your blood vessels, resulting in less blood streaming to your feet, this can lead to foot problems. Your feet might become less sensitive because the nerves will experience some damage at some time; this leads again to the appearance of wounds and infections that can be cured less easily. Good shoes and taking good care of your feet (by a specialized pedicure) are important, therefore. This is how you can prevent problems.

Skin problems:

Due to reduced blood flow and reduced sensitivity, diabetes can cause skin problems. You easily get wounds and infections (including fungal infections), which in turn heal badly. Changes in the colour of your skin, dry skin or excessive sweating can also occur.

Wrong fat balance in the blood:

Diabetes can cause an unfavorable fat balance in the blood. There are different types of fats in your blood, including cholesterol (HDL and LDL) and triglycerides. A certain amount of each type of fat is good for you, you actually need it. Too much or too little, however, is harmful to your body. You are therefore more likely to develop cardiovascular disease.