Kidney Damage (Nephropathy). Kidney disease develops in about a third of type 1 diabetics and is the primary cause of disability and death in these patients. The risk for this complication increases with coronary artery disease, hypertension, and problems in the urinary tract. Symptoms include swelling in the feet and ankles, fatigue, and pale skin color.

Other Complications. People with diabetes are at higher risk for influenza and its complications, including pneumonia, possibly because the disorder neutralizes the effects of protective proteins on the surface of the lungs. Scaly and hardened skin may develop after a patient has had diabetes for many years. Such skin changes may be indicators of other complications, including retinopathy. There has been some concern that type 1 diabetics are at risk for bone-density loss, although a recent two-year study found little basis for alarm. Longer studies are needed. Type 1 diabetes also appears to increase the risk for celiac disease, an allergy to gluten, found in corn and wheat. Both women and men with diabetes appear to have a higher risk for colon and rectal cancers.

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