Complications of diabetes

Diabetes both type 1 and type 2 can lead to acute complications or chronic complications

• Acute complications occur over a short period of time and suddenly. The three common acute complications are:

Hypoglycaemia or low blood sugar.
Diabetic Ketoacidosis (DKA) - sudden increase in blood sugar levels, more common in type 1 diabetes. This can lead to coma or death, if not detected and treated promptly.
Hyperglycaemic hyperosmolar nonketotic state (HONK) - very high blood sugars in type 2 diabetes especially in elderly people can result in this condition.

• Chronic complications occur over a long period of time and usually involve blood vessels. Uncontrolled diabetes over a period of time can damage blood vessels.

In Macrovascular complications, large blood vessels are involved such as :
o Blood vessels supplying blood to the heart, brain and limbs (more commonly legs) can get damaged leading to heart attack, stroke or peripheral arterial disease.
In Microvascular complications, small or minute blood vessels are involved

o Commonly small blood vessels in the eye, kidney and those supplying blood to nerves can get damaged in diabetes, leading to retinopathy (damage to retina of the eye that can lead to blindness), nephropathy (damage to kidney that can lead to kidney failure and the need to do kidney transplantation) and neuropathy (that can lead to pain, loss of sensation, weakness in the limbs etc.) respectively.

Complications of diabetes develop over time, due to the accumulation of too much glucose in your system. These complications do not happen overnight, but rather take many years to develop. You can do a lot to prevent the complications of diabetes.

Controlling blood glucose is the first step, but diabetes affects the whole body including blood vessels and nerves. Therefore, controlling cholesterol and blood pressure can decrease risks for complications even more! Your healthcare provider will perform the following tests, but then you need to learn the results of the tests and what they mean.

HbA1C – A blood test that measures average blood glucose over the past 2 to 3 months and is the best way to measure overall glucose control. It should be measured 2 to 4 times a year with a goal of less than 7 %.(ADA)

Blood pressure- High blood pressure is more common in persons with diabetes and increases risk of stroke, heart attack, kidney and eye diseases. It should be measured at every visit, or at least once a year, with a goal of 130/80 mm Hg or lower.

Cholesterol- Blood fats (lipids) should be tested once a year with an LDL cholesterol goal of at least less than 100 mg/dl, and in people who are at high risk, such as those with diabetes and coronary heart disease, the LDL goal is now recommended to be 70 mg/dl. Further, the HDL cholesterol goal should be greater than 40 mg/dl for men and 50 mg/dl for women; the total cholesterol goal should be less than 200 mg/dl; and the triglyceride goal should be less than 150 mg/dl. Medications can be used to lower your cholesterol if needed, along with a meal plan low in saturated and Trans fat.

Microalbumin – A urine test that measures how well your kidneys are working. If you catch problems early, they can be treated. Microalbumin measures small amounts of protein in the urine and should be measured at least once a year with a goal of less than 30 micrograms per milligram creatinine..

Eye exam –To protect your eyes you should have a dilated eye exam every year. Drops will be put in your eyes to dilate your pupils. This makes it easier to see inside your whole eye.

Foot exam – Remove your shoes and socks for a foot check at each appointment with your healthcare provider. Check your feet daily to prevent problems.

By doing the best job you can with your diabetes day-to-day, you are lowering your risks of developing complications later on, and you are slowing the progress of complications that may be just beginning.