Who is at a risk for Diabetes Complications?

 

Those who:

  • Have poor blood glucose control
  • Are physically inactive
  • Are overweight
  • Have high levels of blood cholesterol
  • Smokers
  • Have high blood pressure

 

Complications of Diabetes can be broadly classified as:

Acute Complications: The onset is sudden, and are usually reversible.

  • Hypoglycemia: Low blood sugar. Glucose less than 70 mg/dl
  • Hyperglycemia: High blood sugar, more than 200 mg/dl

 

Emergency hypoglycemia may present as:

 I) Diabetes ketoacidosis (DKA): (Complication mainly of type 1)

  • High blood glucose more than 250 mg/dl
  • Presence of ketones in blood and urine.
  • Dehydration, abdominal pain, fluid, and electrolyte imbalance.
  • Can lead to coma and death if not treated.

II) Hyperosmolar Hyperglycemic State (HHS) or Hyperosmolar non-ketotic coma  (HONIC)

(Complication of type 2 diabetes)

  • High blood glucose (more than 600 mg/dl)
  • Dehydration
  • Confusion, lethargy
  • May mimic a stroke
  • May lead to coma and death if not treated.

 

Lactic acidosis:

  • Occurs when lactic acid is produced at accelerated rates.
  • Symptoms include:
  • Vomiting
  • Restlessness
  • Erratic breathing
  • Alteration in level of consciousness

 

Chronic Complications: The onset is gradual, can be irreversible.

 

Chronic complications are further divided into:

 

Macrovascular:

 

Coronary Artery Disease: Diabetes can damage the lining of blood vessels and nerves causing scarring and stiffness.The vessel lining cantrap cholesterol and plaque leading the blockages. The heart muscle must work harder to pump through these blocked vessels thus leading to chronic complications.

 

Peripheral Vascular Disease: Pain in legs and calves. Leg ulcers, gangrene, increased risk of infections. Most common cause of amputation.


Cerebrovascular Disease: Affects the blood vessels and the brain. Can include muscle weakness of one side of the body, paralysis, difficulty in speech.

 

Others – Gastroparesis, Skin complications etc

 

Microvascular:

 

  • Retinopathy: Complications of the eye, which can lead to impaired vision, cataracts, blindness.

 

  • Neuropathy: Damage to the nerves causes numbness, burning and pain. Can lead to trouble walking and maintaining balance.

 

  • Nephropathy: Complications of the kidney. The kidneys can no longer filter wastes out of the body, protein spills in the urine.

           Diabetes is the most common cause of dialysis and kidney transplant.

 

Always report these symptoms:

  • Wounds that do not heal.
  • Changes in vision.
  • Calf pain.
  • Headaches.
  • Swelling (feet, face etc)
  • Chest pain, chest tightness, pressure.
  • Increased fatigue.
  • Difficulty breathing.
  • Change in mental state.

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