Diabetes mellitus can cause complications in almost all the systems of the body if it is poorly controlled. Our main aim is to keep blood glucose and HbA1c at levels equal to that of the normal population in order to prevent the development of complications. Almost all the complications of diabetes are due to ‘’microangiopathy’’ that is damage to small blood vessels reducing blood supply to different organs of the body.
After 10-15 years of poorly controlled diabetes, eye complications tend to develop. Eye complications are more common in type 1 than in type 2 diabetes. These include:
Kidneys are vital organs for the excretion of all the toxic waste from the body. They have a very rich blood supply which helps in filtering all the wastes from the blood. Poorly controlled and long-standing diabetes causes damage to these blood vessels that are broken down by this filter. As result toxins are not properly filtered out and useful substances like proteins are lost in the urine. High blood pressure along with high glucose level further aggravated the kidney damage. There are the following stages of the progression of kidney disease.
Diabetes is an independent risk factor for heart disease, coronary artery disease. The presence of other risk factors will increase the chance of heart attack. These include
Diabetics usually feel no warning signs or pain during a heart attack. So it is better to take precautions. Keep blood pressure and blood glucose in control, low dose aspirin to keep the blood thin, lower cholesterol with medication, quit smoking, exercise regularly and consult a cardiologist.
Diabetic patients are very prone to getting foot problems, including infection, blisters, ulcers, etc. The reason for this is:
Easy steps to take care of your feet daily:
Diabetic patients present with repeated skin infections, boils, delayed healing of small wounds, or pruritis (itching) and during routine testing, they are diagnosed as having diabetes. Why are skin problems so common in diabetics? Very high sugar level serves as a good culture medium for bacteria and fungus, microangiopathy (narrowing of small blood vessels due to diabetes) causes decreased blood supply to the skin thereby delayed healing of wounds. The cause of some skin problems is decreased immunity and autoimmune conditions in which antibodies present in the body react to skin and subcutaneous tissue.
A certain degree of hearing loss is associated with diabetes. It increases with age. Hearing loss is twice as common in people with diabetes as compared to people of the same age who don’t have diabetes. The reason for hearing loss is the damage to small blood vessels supplying the inner ear. People with hearing loss usually don’t recognize their problem till others point it out. Common complaints are:
How to diagnose hearing loss? Examination by ENT specialist who will order hearing tests (Audiometry). This test will identify the type and intensity of hearing loss.
6. Conductive deafness: where the problem is in the hearing passage e.g earwax causing blockage
7. Sensory-neural deafness: problem with the nerves supplying the inner ear. This is the type commonly seen in diabetics
Sensory neural hearing loss is managed by hearing aids. Nowadays hearing aids are very effective, they are small in size, can fit inside the ear or attached behind the ear, and they make you hear the clear sound without background noise and muffling.
A stroke or brain attack occurs when blood supply to a certain part of the brain is stopped. Diabetics have a 2-3 times increased risk of having a stroke. It presents as weakness of one half of the body, difficulty in speech or swallowing, memory problems, and emotional problems.
Stress can be physical or mental. Both types of stress can upset the blood glucose level. Body considers both types of stress as ‘DANGER’. As a response to danger there is a “FIGHT OR FLIGHT RESPONSE’ of the body. For this fighting or fleeing away, body releases stress hormones that mobilize stored fat and glucose into the blood to be utilized by muscles to fight or run away from danger. In diabetics, insulin is deficient so this extra glucose mobilized to the blood cannot be taken up by muscles. This results in high blood glucose level.