8 COMMON COMPLICATIONS OF DIABETES

Diabetes Mellitus is a condition in which the body is not able to properly metabolize blood sugar (glucose), leading to problems that influence many other organ systems. Glucose is one of the body’s main sources of energy, and insulin, a hormone secreted by the pancreas, helps your muscles and organs consume it.

The main types of diabetes are type 1, which usually starts during childhood, and type 2, which more commonly starts during adulthood. In type 1 diabetes, the pancreas fails to produce enough insulin to control your blood sugar. In type 2 diabetes, obesity and other genetic factors eventually lead to the inability of insulin to act (insulin resistance). In both types, problems start developing when blood sugar becomes too high, for too long.

Those who fail to put their blood sugar under control may end up with problems impacting the eyes, teeth, kidneys, heart, blood vessels, nervous system, and others. In this article, we discuss 8 common complications of diabetes that can be either delayed or prevented by good blood sugar control.

Cardiovascular diseases

High blood sugar can damage blood vessels and may affect the heart. It is worth knowing that heart disease is in fact the leading cause of death in diabetic people. Damage to the coronary arteries (the blood vessels supplying the heart) can eventually lead to their narrowing, which might cause a heart attack. In the same manner, blood vessels in the brain might also become too narrow, leading to a stroke. By not controlling your blood sugar levels, cholesterol levels, and blood pressure, you might be at higher risk of developing these fatal complications.

Kidney disease

The medical term used to describe kidney disease in diabetics is “diabetic nephropathy”. Diabetes is the most common cause of kidney failure requiring dialysis worldwide. Uncontrolled blood sugar damages the small vessels going into the kidneys to filter waste, causing it to build up in the bloodstream. Doctors always monitor kidney function in diabetic patients by measuring protein in the urine (microalbuminuria). If your doctor suspects that kidney damage is ensuing, they might consider adjusting your medications and diet to slow down the process.

Nerve disease

Also known medically as “diabetic neuropathy”. Nerves receive oxygen and nutrients from tiny blood vessels that supply them. Consistently high blood sugar causes these vessels to narrow down leading to nerve damage. This neuropathy manifests in several forms. When the nerves of the limbs are affected, the person might start losing tactile sensation, feel tingling, or even pain in the hands and feet (this is called peripheral neuropathy). Erectile dysfunction is also another manifestation of the damage sustained by the nerves controlling the genitals.

Foot disease

“Diabetic foot” is actually a complication of diabetic neuropathy, however, it deserves a separate mention for being a very serious and easily preventable complication. Peripheral neuropathy could, as already mentioned, lead to loss of sensation in the limbs. Wounds in the feet can many times go unnoticed, and this may cause serious infections eventually requiring amputation of the toes or even the whole leg. Diabetic people are 25 more likely to need an amputation than non-diabetic people. Extensive education about foot care is vital for the prevention of long term foot complications of diabetes.

Eye disease

Known as “diabetic retinopathy”, a leading cause of blindness worldwide. Longstanding uncontrolled blood sugar can lead to a spectrum of eye diseases, such as cataracts, disturbed vision, and even blindness. Yearly check-ups are recommended to keep your eye health in check.

Oral complications

Diabetic people are at a higher risk of developing inflammation of the gums, also called “periodontitis”. Recent studies suggest a two-way relationship between diabetes and periodontitis, in which each condition can worsen the other. Research has also found that diabetic individuals with periodontitis are more likely to develop kidney and heart complications. Yearly dental check-ups are recommended to prevent and treat this condition.

Pregnancy complications

Expecting mothers who have diabetes are strongly urged to keep their blood sugar levels under control, as hyperglycemia can be dangerous to both mother and child. Babies exposed to high blood glucose during pregnancy might be born overweight and are at higher risk of developing diabetes mellitus later in their life.

COVID-19 complications

Diabetes seems to increase the likelihood of hospitalization, need for intensive care, and the rate of death in people who contract COVID-19. Indeed, the impaired immune function associated with poor blood sugar control puts diabetics at risk of a worse prognosis. Good glycemic control can help maintain a normal immune function and reduce this risk.

Strict blood sugar control is not always easy to achieve, however, it is necessary to prevent and delay the complications of diabetes. Regular follow up, proper education, and compliance to diet and medication are crucial for all diabetic individuals to live a long and happy life, free of complications.

Frequently Asked Questions

How do you know if you have Diabetes? 

There are several signs and symptoms that should raise suspicion of diabetes. The most frequent early signs that might mean you have high blood sugar include: 

• Increased thirst
• Frequent need to urinate (polyuria)
• Waking up at night to pee (nocturia)
• Losing weight despite eating normally
• Feeling hungry all the time 
• Feeling tired all the time

These are all subtle signs that should make your doctor suspect that you have diabetes. Since most of these signs are not very flagrant, years can go by before some people sense something is wrong. 

Many people only go see a doctor when more concerning symptoms of diabetes start to occur. Symptoms of more advanced diabetes include:

• Numbness in the feet and hands (paresthesia)
• Blurred vision (diabetic neuropathy) 
• Symptoms of other illnesses related to uncontrolled diabetes, like heart disease 

Chronically elevated blood sugar can irreversibly damage the blood vessels and nerves. This can lead to altered sensation, especially in the extremities, and heart disease. Many patients are first diagnosed with diabetes when they start complaining of symptoms of heart illness (e.g. chest pain and shortness of breath).

It is wise to check your blood sugar during your regular checks with your primary healthcare provider. If you ever develop any of the early symptoms of diabetes, you shouldn’t delay a doctor’s visit. Diabetes can cause heavy damage to the body if left untreated. 

How to get your blood sugar down in a hurry?

There are several ways to rapidly bring down your blood sugar. In case of an emergency, the quickest way to bring blood sugar down is with insulin. Quick-acting insulin (also called rapid-onset insulin) can reduce blood sugar back to the target range in as little as 5 minutes. So, if you have unusually high values and feel unwell, taking your prescribed insulin injections is the best way to bring down your blood sugar in a hurry. 

Do not take more than the prescribed dose of insulin without calling your doctor first. If you have a blood sugar above 300 mg/dL despite taking your usual insulin dose, you should immediately call your doctor or go to the hospital. 

There are several simple ways to regulate blood sugar and bring it down when high, these include: 

• Get moving - Performing sport can quickly lower blood sugar. It increases glucose metabolism by the muscles and counteracts hyperglycemia. Doing sports, regardless of the type, can decrease blood glucose levels both in the short and long term. 
• Take your pills if you’ve forgotten to - If you’ve missed a dose of your oral diabetes drugs, then take it immediately once you remember. Do not delay it until the time for the next pill. 
• Drink water - Diabetes causes dehydration. This can lead to more blood glucose concentration. Drinking enough water daily can help regulate your blood sugar and keep the numbers within the normal range. 

To sum up, the most effective way to bring down blood sugar quickly is through rapid-acting insulin. Make sure that you are taking the recommended dosage and do not take more before consulting with your doctor. 

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Sources:

• https://www.nejm.org/doi/full/10.1056/NEJM199306103282306
• Https://clinical.diabetesjournals.org/content/diaclin/early/2018/12/16/cd18-0105.full.pdf
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024219/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228943/
• https://www.touchendocrinology.com/insight/covid-19-infection-in-people-with-diabetes/

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