Diabetes is undoubtedly an emerging epidemic all over the world. According to the International Diabetes Federation (IDF), approximately 415 million people suffered from diabetes worldwide in the year 2015. In the same year, around 5 million deaths were attributed to diabetes[1]. It is estimated that around half of the people with diabetes are unaware of their disease and thus, are more prone to develop health complications related to diabetes. High blood glucose levels due to diabetes can have an immediate as well as long term health complications with significant mortality in both type 1 and type 2 patients. Here’s a detailed explanation of how dangerous high blood sugar levels can be and the health complications associated with it.
Diabetes complications you should know about!
The long-term health complications due to diabetes can be broadly divided into microvascular and macrovascular complications. Microvascular complications are caused due to damage to the small blood vessels which include neuropathy (damage to nerves), nephropathy (damage to kidneys) and retinopathy (damage to eyes). Macrovascular complications are due to damage to the larger blood vessels and consists of cardiovascular disease, stroke, and peripheral artery disease (PAD). The other complications include diabetic ketoacidosis and increased risk of dental disease, infections, and complications in pregnant women.
Diabetic neuropathy (nerve disease): High blood glucose levels can affect the nerves by impairing the blood flow to the nerves by causing damage to the small blood vessels. This can lead to numbness and pain in the extremities, decreased sensation and impotence. Early diagnosis and treatment can help prevent or delay these complications.
Loss of sensation can cause injuries to go unnoticed, which in turn can lead to serious infections and risk of diabetic foot. This if left untreated and unattended can up the possibility of amputations. It is reported that the risk of amputation might be more than 25 times higher in people with diabetes as compared to those without diabetes[2].
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Diabetes retinopathy (eye disease): It is one of the leading causes of changes in vision and blindness among diabetics. This is caused when high blood glucose levels damage the small blood vessels present in the eye and retina. It causes progressive loss of vision and even blindness if left ignored. One of the most common symptoms of diabetic retinopathy includes blurred vision although other symptoms might be present. To detect early changes in the retina and diagnose the condition, it is important to go for regular eye examinations.
Diabetes nephropathy (kidney disease): If sugar levels remain elevated over a long period of time, they can cause damage to the smaller blood vessels of the kidneys. This can lead to impaired kidney function and even kidney failure. It may even lead to death if left untreated. Diabetic nephropathy is one of the leading causes of dialysis and kidney transplantation. People with this condition usually do not have any symptoms in the early stages but may show up as the disease progresses. The first symptom is fluid buildup which can cause swelling of the limbs. It may lead to tiredness, poor appetite, stomach upset, weakness and difficulty in concentrating. The diagnosis is based on a simple urine test for protein and blood test for kidney function. The treatment is aimed at diet control, medications, and self-care.
Cardiovascular disease (CVD): High blood glucose levels can cause damage to larger blood vessels of the heart. This not only impairs the blood flow to the heart but can also increase the risk of atherosclerosis, which leads to narrowing of arterial walls throughout the body. This narrowing of arteries can lead to decreased blood flow to the heart muscle (causing a heart attack) or to the brain (leading to stroke), or to extremities (leading to pain and decreased healing of infections).
CVD is the primary cause of death in people with either type 1 or type 2 diabetes. It is reported that people with type 2 diabetes have an increased risk of (around 150-400%) of stroke. The symptoms of these different conditions are varied: ranging from chest pain to leg pain, to confusion and paralysis. Lipid testing, in addition to other screening for heart as recommended by your doctor, should be performed in patients with diabetes at least annually.
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Diabetes ketoacidosis: It is a life-threatening disease in which a person’s cells do not get enough sugar required for energy. As a result, the body starts to break down fats to get the required energy. This causes the production of a compound called ketones which are released in the blood. It occurs when there isn’t enough insulin in the body to use glucose. This is a sign that your diabetes is getting out of control. Although it can happen to anyone with diabetes it is more common in people with type 1 diabetes. It can develop slowly but if you experience vomiting, it can turn into a life-threatening condition within a few hours.
The symptoms of diabetic ketoacidosis include dry mouth, excessive thirst, frequent urination, and high ketone levels in the urine. Over time it can cause difficulty in breathing, feeling tired, nausea, confusion, swelling around the brain, and coma. In rare cases, it can even cause death.
As uncontrolled or long-term diabetes can significantly impact various organs of the body, it is extremely important to keep sugar levels in check. This includes sticking to the medications, following a strict dietary plan and getting blood sugar levels checked at regular intervals as advised by the doctor. Stay healthy, stay happy!
(The article is reviewed by Dr. Lalit Kanodia, General Physician)
Recommended Reads:
Fasting Blood Glucose For Diabetes: Why Is It Important?
Diabetes: 5 Commons Mistakes To Avoid When Using A Glucometer
References:
1. DKA (Ketoacidosis) & Ketones. Complications. Living with Diabetes. American Diabetes Association.
2. Kidney Disease (Nephropathy). Complications. Living with Diabetes. American Diabetes Association.
3. Lim AKh. Diabetic nephropathy – complications and treatment. Int J Nephrol Renovasc Dis. 2014 Oct 15;7:361-81.
4. Complications of diabetes. About diabetes. Diabetes Programme. The World Health Organization (WHO).
5. Diabetes Complications. About Diabetes. International Diabetes Federation (IDF).
6. Papatheodorou K, Banach M, Bekiari E, Rizzo M, Edmonds M. Complications of Diabetes 2017. J Diabetes Res. 2018 Mar 11;2018:3086167.