A well written post, but I would like to elaborate on the complications of diabetes.
If a diabetic patient does not take care in controlling this disease, he is definitely asking for trouble—big trouble. Several complications arise which are crippling. To understand the “how and why” of the complications, it is recommended that you also read our “Diabetes and cholesterol”
Let us see what these complications are :
1)
Diabetes and Heart: A diabetic runs double the risk of contracting a heart disease or stroke. Chances are that a diabetic, who has had a heart attack once, has a greater risk of getting another one.
Higher sugar or higher glucose levels in the blood cause fats to be deposited on the inner walls of the blood vessels, which causes the walls of the blood vessels to thicken and harden. This results in clogging of the arteries and reduced blood supply to the heart causing a heart attack.
2)
Diabetic retinopathy:
In a patient of long standing diabetes, the retina starts getting damaged gradually. Diabetes is associated with high blood pressure and the combination of these two causes damage to the smaller blood vessels of the eye. These blood vessels get clogged, brittle and weakened causing them to rupture.
Blood gets released into the vitreous fluid, which fills the eye ball. This fluid loses its transparency and the light rays which enter the eye do not reach the retina, resulting in impairment of vision. There may be double vision, or blurring of vision, or flashing lights or dark spots in front of the eyes. The patient also experiences pain in both the eyes and peripheral vision is lost.
It is imperative therefore, that a diabetic patient should get his eyes checked regularly.
3)
Diabetic neuropathy: As this topic requires a more detailed write up, I have written a separate post on it, titled “ Diabetic neuropathy – a serious complication of diabetes”. A brief mention here is made though:
More than 70% of the patients, with a long history of diabetes, have this complication of neuropathy. As explained earlier, in diabetes, the blood vessels get damaged.
As a result of this damage to the small blood vessels supplying the nerves, the nerves do not get sufficient blood supply and thus complications of neuropathy occur. Any nerve or its segment in the body could get affected.
The symptoms of diabetic neuropathy thus depend on the nerve that is affected. The symptoms could therefore be peripheral or autonomous.
Peripheral nerve damage symptoms could thus be those relating to the hands and feet like tingling and numbness, loss of sensation, non healing ulcer on the foot, among other things.
Autonomous nerve damage symptoms could be those relating to heart or the digestive tract or the kidneys and urinary bladder. Explained in detail in
“ Diabetic neuropathy — a serious problem”
5)
Erectile dysfunction: As explained earlier, diabetes causes clogging of the arteries and damage to the nerves. Since penile erection depends on a sequence of events in which blood vessels and the nerves play an important role, erection can be hampered. Erection loss may be partial or total depending on the extent of damage to the blood vessels and the nerves.
6)
Hypoglycemia: is a condition wherein the blood sugar falls below 70 mg/dcl.-- ie. much below the lower normal limit. This is more commonly seen in diabetics who developed an unstable diabetes where the blood sugar levels vary wildly. For a detailed post on causes, symptoms, treatment and care, of Hypoglycemia read my “Diabetes and Hypoglycemia ”
7)
Diabetic nephropathy: As explained earlier, in diabetes, the blood vessels and the nerves are also damaged. As a result , this has a heavy toll on the kidneys.
As the blood vessels get thickened, the blood flow to the kidneys is reduced. The filtration process of the blood by the kidneys is impaired. Protein thus leaks into the urine, which is a sign of kidneys beginning to get damaged,
If the nerves supplying the kidney get damaged in diabetes, the sensation of the bladder being full, is lost. As a result , the urge to urinate is lost and the urine collects in the bladder till the bladder becomes completely full.
The urine passes without the patient realizing it . This is called urinary incontinence. Similarly, urine also collects in the kidneys for a long time . This results in infection setting in the kidneys and the bladder. The kidneys do not function properly and ultimately the kidneys fail.
Digestive complications of diabetes : As a result of diabetic neuropathy, the nerves which supply the various parts of the digestive tract may also be affected. Depending on the nerve and the part it supplies, complications pertaining to that part occur.
A] Eesophagus: difficulty in swallowing
B] Stomach ;
1) As a result of loss of nervous control on the stomach, food in the stomach empties slowly. Digestion does not take place properly.
2) There is persistent nausea and vomiting.
3) Distention of the stomach and loss of appetite.
4) As food is not properly digested, Levels of glucose fluctuate widely.
C] Intestine: Constipation alternates with uncontrolled diarrhea giving rise to loss of weight’
9)
Foot complications in diabetes: as explained earlier, in diabetes, two complications occur:
(1) Reduced blood supply due to clogging of arteries
(2) Nerve damage due to reduced blood supply to the nerves
As a result of these two complications occurring in the lower extremities, there is reduced sensation and reduced blood supply to the foot. The pain of an injury is not felt, and therefore the injury tends to get neglected.
As a result of the reduced blood supply to the foot, the white blood cells do not reach the site of injury in sufficient quantity and therefore the defense mechanism is not efficient enough to fight the infection.
Moreover, the high glucose content in the blood helps the bacteria to grow fast. Infection spreads and the injury worsens as the medicines given, cannot reach the site of infection in the full dosage. The wound deepens and the infection may spread to the bones resulting in osteomylitis. In serious cases, amputation may be the only surgical remedy.
