Diabetes - The complications of diabetes and its diagnosis

Diabetes - The complications of diabetes and its diagnosis

Increased blood sugar levels cause damage to nerves and blood vessels (large and small) over time, resulting in damage to the various organs.

1. ACUTE COMPLICATIONS:associated with acutely high or low blood sugar levels.

* Diabetic ketoacidosis – (glucose levels are very high) This occurs when there is not enough insulin to convert glucose into energy. The result is that the body then uses fat as an energy source. This creates ketones, a substance that is harmful to the body. Symptoms include intense thirst, large amounts of urine, fatigue, nausea and vomiting, often along with abdominal pain. This condition requires immediate medical attention.

* Hypoglycemia - (glucose levels fall below 4.0 mmol/L) This usually occurs either when the dose of diabetic medication is too high, or with insufficient calorie intake or sudden excessive physical exertion. Symptoms of hypoglycemia include dizziness, confusion, weakness, shaking, sweating, and anxiety. Severe hypoglycemia can lead to coma, seizures, and irreversible brain death.

2. CHRONIC COMPLICATIONS:related to damaged nerves and blood vessels.

* Eye complications – diabetic retinopathy. Diseased small blood vessels cause protein and blood to leak into the retina. Small aneurysms and new but brittle blood vessels (neovascularization) can also occur. Spontaneous bleeding from these abnormal blood vessels can affect vision. Cataracts and glaucoma are also more common in diabetics. A diabetic is 25 times more likely to go blind than a non-diabetic.

* Renal complications – diabetic nephropathy. Initially, protein comes out of the urine. Later, kidney failure can occur, in which the kidneys can no longer clean and filter the blood. In this case dialysis is required.

* Nerve damage – diabetic neuropathy. Symptoms of nerve damage include numbness, burning, and pain in the feet and lower limbs. This can eventually lead to what is known as “diabetic foot.” The loss of sensitivity leads to the foot not being recognized and protected from injury. Due to poor blood circulation, minor injuries may not heal and serious infections may occur. Diabetes is the most common cause of lower extremity amputations. Nerve damage can also cause erectile dysfunction and gastroparesis (delayed stomach emptying).

* Accelerated arteriosclerosis - this hardening and narrowing of large blood vessels can lead to coronary heart disease (angina and heart attacks), strokes and claudication (pain in the legs when walking due to reduced blood flow to the legs).

DIAGNOSIS OF DIABETES

Your doctor will diagnose diabetes if any of the following criteria are met:

* For significantly elevated glucose levels with acute hyperglycemic complications (e.g. diabetic ketoacidosis, hyperosmolar non-ketotic hyperglycemic coma), no further tests are required for diagnosis.

* For typical diabetes symptoms, a one-time blood test that confirms one of the following points is sufficient:

– Random blood sugar values ​​> 11.1 mmol/l,

– Fasting blood sugar level > 7.0 mmol/L or

– 2 hours after exercise (the oral glucose tolerance test) glucose of > 11.1 mmol/l

* If you do not have the typical diabetes symptoms, you will need to have 2 blood tests on separate occasions, both of which show glucose levels outside the above ranges.

Inspired by Dr Ang Corey Damien