What are the complications of diabetes?

31 Aug 2013

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Short-Term Complications

Diabetics must constantly monitor and work to regulate their blood sugar. However, no matter how vigilant you are, there is the possibility that short-term blood-sugar-related problems might arise. These short-term complications, such as hyperglycemia, hypoglycemia, and ketoacidosis, can be emergencies requiring immediate care. If ignored, they can result in seizures or loss of consciousness.

Hyperglycemia (High Blood Sugar)
If this serious complication occurs frequently or over long periods of time, it can lead to nerve and organ damage. Your blood sugar can rise to dangerous levels for many reasons, including fasting or overeating, stress, illness, or not taking enough glucose-lowering medication. Very high spikes in blood sugar do not necessarily mean diabetes; these can occur due to stress, illness, or medication use and lead to drowsiness, confusion, or even coma.
Hypoglycemia (Low Blood Sugar)
For a person with diabetes, a drop in blood sugar levels can occur for a number of reasons, including skipping a meal and getting more physical activity than normal. If you are on a drug regimen that includes glucose-lowering medications that promote the secretion of insulin or if you’re receiving insulin therapy, you are more likely to experience low blood sugar on a regular basis.
This is a complication of diabetes that occurs when the body cannot use sugar (glucose) as a fuel source because the body has no insulin or not enough insulin. If your cells are starved for energy, your body may begin to break down fat.  Byproducts of fat breakdown, potentially toxic acids called ketones, build up in the body; this can lead to dehydration, abdominal pain, and breathing problems.
Long-Term Complications
Long-term complications of diabetes develop gradually, and the longer a person has had diabetes, the higher their risk for complications. Proper preventive care can help you control or avoid many or all of these diabetes complications. The better a person is at managing their blood sugar levels, the lower their risk of developing any of these complications.
Most diabetes complications are connected to problems with blood vessels. Long periods of high glucose levels can cause blood vessels to narrow and reduce the flow of blood to many parts of the body, including the eyes, kidneys, and nerves. Reduced blood flow, in turn, can cause serious malfunctions that can be disabling or even life-threatening. If you are experiencing any of these complications, it is essential that you see a doctor immediately.
Eye Problems
Diabetes can damage blood vessels in the eyes, causing vision problems or even blindness. Conditions may include:
Cataracts: Cataracts happen to many people without diabetes, but diabetics are significantly more likely to develop the condition. Cataracts cause the eye’s clear lens to cloud, blocking light from getting in. Mild cataracts can usually be treated with sunglasses and glare-control lenses. Severe cataracts may be treated with a transplanted lens.
Glaucoma: Glaucoma is when pressure builds up in the eye and pinches the blood vessels that carry blood to the retina and optic nerve. Glaucoma causes gradual loss of eyesight. There are drugs that can help slow down the process of glaucoma.
Diabetic retinopathy: Diabetic retinopathy is a general term that describes any problems of the retina caused by diabetes. In non-proliferative retinopathy, capillaries in the back of the eye enlarge and form pouches. This condition can lead to macular edema. It can also lead to proliferative retinopathy, where the blood vessels of the retina become so damaged that they close off and force new blood vessels to form. These new vessels are weak and can leak blood in the eye, which blocks vision.
Macular edema: This condition can be thought of as a complication of retinopathy. It occurs when capillary walls lose their ability to control the passage of substances between the blood and retina. Fluid can leak into the macula of the eye and cause it to swell with fluid. This condition causes blurred vision and potential loss of vision. Fortunately, treatment is usually effective and can reverse vision loss.
Foot and Skin Problems: People with diabetes are more likely to have foot problems because of nerve and blood-vessel damage and restricted blood flow to the extremities. If you’re a diabetic, it is crucial that you do not take foot problems lightly; if untreated, small sores or breaks in the skin may turn into deep skin ulcers. Without proper care, even a minor foot injury could become a serious infection, possibly leading to tissue death (gangrene) or amputation.
Heart Problems: If you have diabetes, you have two to four times the risk of heart disease or stroke as someone without diabetes. Studies indicate that your risk of a heart attack is the same as someone who has already had a heart attack. Your risk of artery disease and narrowing of the arteries (atherosclerosis) is also greater. Other problems with the heart and blood vessels that are associated with diabetes include:
  • Peripheral artery disease (damage to blood vessels that supply the legs and feet)
  • High blood pressure (hypertension)
  • High Cholesterol
Neuropathy: Excess sugar in the body can injure the blood vessels and damage the nerves in extremities such as the feet—leading to tingling, numbness, pain, and burning sensations. If numbness becomes severe, eventually you may not even be able to notice an injury until a large sore or infection develops.
Other Complications:
  • Skin infections
  • Urinary tract infections
  • Kidney disease and kidney failure
  • Erectile dysfunction
  • Death
What is Hypoglycemia?
Hypoglycemia means abnormally low blood sugar (glucose). In patients with diabetes, the most common cause of low blood sugar is excessive use of insulin or other glucose-lowering medications to lower the blood sugar level in diabetic patients in the presence of delayed or absent meal.
  • When low blood sugar levels occur because of too much insulin, it is called an insulin reaction. Sometimes, low blood sugar can be the result of an insufficient caloric intake or sudden excessive physical exertion.

  • Symptoms of hypoglycemia include, dizziness, confusion, weakness and tremors. This is because, blood glucose is essential for proper functioning of brain cells.
  • When does it occur? Hypoglycemia could occur when the blood sugar is less than 65mg/dl. If left untreated, severe low blood sugar can lead to coma, seizures and in the worst case scenario, irreversible brain death. This is because, at this point, the brain is suffering from lack of sugar and this usually occurs when the levels are around <40mg/dl.
Treatment:The treatment of low blood sugar consists of administering a quickly absorbed glucose source. These include glucose containing drinks, such as orange juice, soft drinks (not sugar-free), or glucose tablets in doses of 15-20 grams at a time (for example, the equivalent of half a glass of juice). Even cake frosting applied inside the cheeks can work in a pinch if patient cooperation is difficult. If the individual becomes unconscious, glucagon can be given by intramuscular injection.