Diabetes (Mellitus, Type 1 and Type 2) (cont.)
Complications of Diabetes
Both type 1 and type 2 diabetes ultimately lead to high blood sugar levels, a condition called
hyperglycemia. Over a long period of time, hyperglycemia damages the retina of the eye, the
blood vessels of the kidneys, the nerves, and other blood vessels.
- Damage to the retina from diabetes (diabetic
retinopathy) is a leading cause of blindness.
- Damage to the kidneys from diabetes (diabetic nephropathy) is a leading cause of
- Damage to the nerves from diabetes (diabetic neuropathy)
is a leading cause of
foot wounds and ulcers, which frequently lead to
and leg amputations.
- Damage to the nerves in the autonomic nervous system can lead to paralysis of the stomach (gastroparesis),
chronic diarrhea, and an
inability to control heart rate and blood pressure during postural changes.
- Diabetes accelerates atherosclerosis, (the formation of fatty plaques inside the arteries), which can lead to blockages or a clot (thrombus). Such changes can then lead to heart attack, stroke, and decreased circulation in the arms and legs (peripheral vascular disease).
- Diabetes predisposes people to elevated blood pressure, high levels of cholesterol and triglycerides. These conditions
both independently and together with hyperglycemia, increase the risk of heart disease, kidney disease, and other blood vessel complications.
Diabetes can contribute to a number of acute (short-lived) medical problems.
- Many infections are associated with diabetes, and
infections are frequently more dangerous in someone with diabetes because the
body's normal ability to fight infections is impaired. To compound the
problem, infections may worsen glucose control, which further delays recovery
- Hypoglycemia or low blood sugar occurs
intermittently in most people with diabetes. It can result from taking too much diabetes medication or insulin (sometimes called an insulin reaction), missing a meal, exercising
more than usual, drinking too much alcohol, or taking certain medications for other conditions. It is very important to recognize hypoglycemia and be prepared to treat it at all times.
dizzy, poor concentration, tremor of the hands, and sweating are common symptoms
of hypoglycemia. A person can faint or have a
seizure if blood sugar level
- Diabetic ketoacidosis
(DKA) is a serious condition in which uncontrolled hyperglycemia (usually due to complete lack of insulin or a relative deficiency of insulin) over time creates a buildup
of ketones (acidic waste products) in the blood. High levels of ketones can be very harmful. This typically happens to people with type 1 diabetes who do not have good blood glucose control. Diabetic ketoacidosis can be precipitated by infection, stress, trauma,
missing medications like insulin, or medical emergencies such as a stroke and heart
- Hyperosmolar hyperglycemic nonketotic syndrome is a serious condition in which the blood sugar level gets very high. The body tries to get rid of the excess blood sugar by eliminating it in the urine. This increases the amount of urine significantly, and often leads to dehydration so severe that it can cause seizures, coma, and even death. This syndrome typically occurs in people with type 2 diabetes who are not controlling their blood sugar levels, who have become dehydrated, or who have stress, injury, stroke, or are taking certain medications, like steroids.
Diagnosing Complications of Diabetes
A person with diabetes should be checked regularly for early signs of diabetic complications.
A health care professional can order some of these tests; for others, the patient should be referred to a specialist.
- The patient should have their eyes checked at least once a year
by an eye specialist (ophthalmologist) to screen for diabetic retinopathy, a
leading cause of blindness.
- The patient's urine should be checked for protein
(microalbumin) on a regular basis, at least one to two times per year. Protein
in the urine is an early sign of diabetic nephropathy, a leading cause of
- Sensation in the legs should be checked regularly
using a tuning fork or a monofilament device. Diabetic neuropathy is a leading
cause of lower extremity ulcers in individuals with diabetes, which frequently lead to amputation
of the feet or legs.
- The health care professional should check the feet and
lower legs of the patient at every visit for cuts, scrapes, blisters, or other lesions that
could become infected. Adults with diabetes should check the soles of their
feet and their legs daily with a hand-held mirror, either by themselves or with
the assistance of a relative or caretaker.
- The patient should be screened regularly for conditions that may contribute to heart disease, such as high blood pressure and high cholesterol.
Medically Reviewed by a Doctor on 6/12/2015
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