Diabetes And Its Complications
Complications Of Diabetes
Short Term Complications Of Diabetes
If you have diabetes and your blood glucose level is not controlled and it becomes either too high or too low, you can have very dangerous complications that require immediate medical treatment.
Low Blood Sugar
Low blood sugar is a term used to describe a condition that occurs when your blood glucose level drops too low. The medical term for this condition is “hypoglycemia”, meaning “too little glucose in the blood”.
Your blood sugar level may drop if your oral medication for lowering the blood sugar level are too strong, if you take too much insulin, if you do not eat enough or you miss or delay a meal, or if you over-exercise. You may have this reaction shortly before your mealtime, while you are exercising, right after the exercise or upto 12 hours later.
Make sure you know the following signs of an insulin reaction so that you can recognize them if they occur and act immediately. People have different symptoms, and your own symptoms may change over a period of time. For this reason it is important to be familiar with the way you feel when your blood sugar level is too low. You may feel any of the following :-
As soon as you feel an insulin reaction coming on, stop what you are doing and test your blood sugar level. If the level is low, i.e. below 70 mgs%, immediately take glucose tablets or drink a sugary drink such as fruit juice or eat sugar candy. If you are not able to test your blood sugar level, the safest thing to do is to eat. If your blood sugar level is NOT low, eating will cause it to go up ONLY little.
Long Term Complications Of Diabetes
Diabetes can have serious long-term complications. Over a period of time, uncontrolled diabetes can damage your blood vessels, kidneys, eyes and nerves. The best way to avoid these serious complications is to maintain your blood sugar level in a healthy range and see your doctor regularly – even when you are feeling fine.
To monitor how well you are controlling your blood glucose level, your doctor can give you a blood test that measures a type of haemoglobin ( the oxygen-carrying protein in red blood cells ) that glucose sticks to. The amount of glucose that sticks to the haemoglobin ( glycosylated haemoglobin ) shows how well your glucose level has been controlled over the past 3 to 4 months. If the level of glucose is too high, your doctor will adjust your treatment program to bring the level back to normal.
Learning the early signs of the following serious complications will enable you to recognize them if they occur and get prompt treatment to prevent them from getting any worse.
Heart Disease And Stroke
If you have diabetes, you are at increased risk of developing heart disease as a result of changes in your blood chemistry. One of the effects of these changes is the build-up of fatty deposits inside your arteries, the blood vessels that carry blood to your heart, also called coronary arteries. These deposits, which are made up mostly of cholesterol, can narrow the arteries and reduce the blood flow to the brain and the heart. If a fatty deposit is too large, it can totally block the blood flow through the blood vessel, causing a heart attack ( damage to the heart muscle due to lack of oxygen ) or stroke ( damage to the brain due to lack of oxygen ). Diabetes can also cause your blood to clot more easily. The formation of blood clots can block the blood vessels and cause a heart attack or stroke. Having diabetes also puts you at increased risk of having high blood pressure, which is a major cause of heart disease and stroke.
You can prevent heart disease by being diligent about your cholesterol level being below 200mgs%, your blood pressure below 140/90 mm of hg and your weight at a healthy level for you. If you are a smoker, quitting will reduce your risk of heart disease more than almost anything else you do.
You may experience the following symptoms if you have heart disease :
- Mild tightness or heaviness in your chest.
- Severe pain or pressure in your chest.
- Chest pain or shortness of breath during physical activity, such as climbing a flight of steps.
- Nausea, sweating, or dizziness.
- Difficulty in breathing or shortness of breath.
Nerve damage, medically known as neuropathy, affects 50% of people with diabetes. An uncontrolled high level of blood glucose reduces the ability of nerves to carry messages, such as sense of feeling to various parts of the body, including feet and bladder, digestive tract and reproductive system.
Depending on the nerves that are affected, you may experience one or more of the following symptoms :
- Loss of feeling ( sensations )
- Muscle weakness
- Tingling, burning, or jabbing feelings
- Frequent bladder infections
- Sexual problems, such as impotence in men or inability to achieve an orgasm in either sex.
Peripheral Vascular Disease
Diabetes can cause narrowing of the blood vessels that deliver blood to your feet and legs. The condition is called peripheral vascular disease.
Without a regular supply of nourishing oxygen-rich blood, the tissues that are farthest away from the heart can die. In several cases, part of or all of a foot or leg may need to be cut off surgically due to formation of a gangrene.
Peripheral vascular disease can cause the following symptoms :
- Pain in your thigh, calf, or buttocks during physical activity that is relieved when you stop the activity.
- Infections that heal poorly.
- Itchy skin.
- Shininess of the skin of your legs.
- Loss of hair on your legs.
Diabetes can damage the nerves and blood vessels in your feet, reducing their sense of feeling and limiting the circulation of blood to them. If you do not have any feeling on one of your feet, you can injure it and not even know it. This reduced blood flow can slow the healing of even small cuts, which can become infected. An infection that does not heal can cause the tissue to die, a condition called gangrene. In severe cases toes may have to be chopped off surgically in order to save the rest of the foot and leg.
Here are some guidelines to help you avoid these serious but common complications of diabetes :
- Inspect your feet every day for scratches, cuts, blisters, ingrown toenails, or warts on the soles of your feet.
- If you notice any of these problems, see your doctor right away.
- Immediately report to your doctor any signs of infection, burning, tingling, or numbness in your feet.
- Do not cut or treat corns or calluses yourself. Leave it to the doctor.
- Make sure your doctor examines your feet at each visit.
- Wash your feet daily and dry them well, especially between the toes.
- Check inside your shoes for pebbles, gravel or other objects that could cause a cut or a blister.
- Break in new shoes slowly.
- Wear comfortable, well-cushioned shoes that do not pinch at the toes or scrape at the heel. Try wearing shoes that are a half size larger than what you normally wear. Do not wear high heels.
- Change your socks every day. Cotton socks which absorb moisture are ideal. Smooth your socks over your feet carefully, leaving no bumps that could cause blisters.
- Never walk barefoot – even in your own home.
- Do not smoke. Smoking reduces blood flow to your feet.
- To prevent ingrown toe nails and infections, be extra careful when you trim your toenails. Cut your nails straight across from side to side. If you have numbness in your feet, you should not trim your nails by yourself.
- Do not test the temperature of water in your bath with your feet.
Diabetic Complications in Eyes :
Diabetes can damage the small blood vessels that supply the retina of the eye, causing them to leak blood or other fluid into the eye. The condition called Diabetic Retinopathy, is a major cause of blindness in people between 25 and 75 years. Having diabetes also increases your risk of other vision-robbing eye disorders such as cataracts ( clouding of the lens of the eye ) and glaucoma ( building of pressure from fluid inside the eye ).
You will probably not notice any symptoms from any of these eye disorders unless they have progressed so far that they are affecting your vision. For this reason, if you have diabetes, you should see an eye specialist or ophthalmologist every year for a complete eye examination. Detecting retinopathy early can help prevent you from becoming blind.
See your eye doctor immediately if you notice any of the following symptoms, which can indicate eye disease :
- Blurred vision
- Seeing double – diplopia
- Seeing spots before eyes – floaters
- Pain in one or both eyes
- Feeling of pressure in one or both eyes
- Inability to see on one side
- Difficulty in reading
Diabetes affects Kidneys too
Diabetes can cause narrowing of the blood vessels that carry blood to your kidneys, reducing the organ’s ability to filter out and eliminate wastes from your body. Diabetes can also harm these organs by causing frequent infections to the urinary tract. You can prevent damage to your kidneys by keeping your blood glucose level under control and by keeping your blood pressure at a healthy level.
Kidney disease in diabetics is called Diabetic nephropathy and it seldom causes noticeable symptoms until the kidneys are seriously damaged. For this reason urine should be regularly tested for the presence of sugar and albumin. If present, it indicates that your kidneys are not working properly. Renal Function Tests are also done to evaluate the condition of the kidneys.
To conclude, I would like to comment that even though diabetes is a disease which has many varied complications that affect the body over a period of time, you can lead a fairly normal life if you keep your diabetes well under control by observing a proper diet, exercise, keep your body weight within normal limits, take your medicines, and visit your doctor regularly.
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