Diabetes mellitus is a serious illness which can have multiple complications if it is not diagnosed quickly and well-controlled.
Immediate complications of untreated or uncontrolled diabetes are states of hyperglycemia, or high glucose levels. There are two states, depending on which type of diabetes that you may have. For those with type I diabetes- it is called Diabetic Ketoacidosis- which presents as a state of dehydration, with weak and rapid pulse, and a fruity smelling odor. Those with type II diabetes have what is called hyperosmolar coma, which shows as polyuria, thirst, neurological symptoms and can even cause stupor. Both states require immediate medical attention and hospitalization. Treatment entails IV fluids, insulin, and potassium replacement.
Hypoglycemia, or low blood sugar, is also an acute complication, most likely secondary to multiple medications used for diabetes control. This can be seen as agitation, sweating, weakness or fatigue. If severe- it can lead to loss of consciousness. This is again an emergent situation if the patient is taking medications that are in one’s system for a long period of time. Immediate action can be taken- such as giving glucose, but the patient should see a health professional immediately.
Another acute complication is the risk of infection. Those with uncontrolled diabetes are have compromised immune systems and are at higher risk for infections like pneumonia and influenza.
There are multiple long term complications of diabetes and they are found throughout the body. They can be classified as microvascular ( affecting small blood vessels) and macrovascular ( affecting bigger vessels, including arteries).
Diabetic effects on the cardiovascular system are macrovascular and include cerebrovascular, coronary artery and peripheral vascular impairment. This means that it can result in injuries such as stroke, heart attack and intermittent peripheral claudication- or spasms and pain of the legs. Muscular myonecrosis or muscle wasting is also seen.
Micro vascular complications are: diabetic neuropathy- abnormal and decreased sensation of the hands and feet, leading to diabetic foot and also diabetic amyloidopathy- or weakening of muscles secondary to neuropathy. Diabetic retinopathy is damage of the small vessels of eye, causing macular degeneration and retinal damage and causes visual loss and blindness. Diabetic nephropathy is the damage of the kidney, which eventually lead to chronic renal failure and dialysis. Diabetic cardiomyopathy is damage to the heart, which will eventually to heart failure.
Diabetic foot is a combination of neuropathy and vascular damage. The loss of sensation leads to trauma to the foot and skin ulcers and infections, which worsens and can cause necrosis and gangrene. It is the most common non-traumatic reason for amputations of toes and feet in the developed world.
Prevention is crucial in the stopping the complications of diabetes. Tight glucose control, foot exams every three months and an annual ophthalmology follow-ups should be kept. Urine should also be tested by your doctor for nephropathy.
Treatment depends on the type of diabetes a patient has and varies from insulin injections to various types of oral medications. Your doctor will recommend the best treatment plan for the type of diabetes that you have. |
