Diabetes complications
What is diabetes complications ??
High blood sugar level can damage your body part seriously. These effect may shown in diabetics patient is called diabetics complication.
It may divided into two types-
- Acute complications
- Chronic complications
Acute complications
- Hypoglycemic effect- when your blood glucose are too low. It this stage stroke risk are development.
- Hyperglycemia- when your blood glucose are too high. In this stage various chronic complication are development.
- Diabetic ketoacidosis-It is life threatening diabetics complication that developed gradually due to lack of insulin.
Ketoacidosis
Uncontrolled production of ketones bodies like acetoacetate, beta-hydroxybutyrate and acetone.
Causes
Lack of insulin body tried to Utilize fat as a fuel source of energy then form excess Ketone bodies .
Symptoms
- Sweating
- Tachycardia
- Palpitation
- Fatigue
- Loss of concentration
- Confusion
- Hunger, headache first
Diagnosis
Confirm in laboratory test
- Glycosuria and Ketone urea
- Glucose, urea, creatine, electrolyte, Venous Bicarbonate would be increase
- Distinct glucose test show 22 mmol/l.
Treatment of ketoacidosis
- Expand fluid volume ( 0.9% sodium chloride)
- Infusion insulin
- Prevent hyperkalemia
What is chronic diabetes complications ?
Chronic diabetes complications is also called long term diabetes complications where it is in serious blood vessel damage of the organ and developed gradually in serious stage. Chronic complication may affect and damage the parts of the body discus bellow.
1. Cardiovascular disease
- Myocardial infarction
- Hypertension
- Dyslipidemia
- Atherosclerosis
- Peripheral vascular disease
- Atherosclerosis cramping pain & reversible muscle pain.
2. Retinopathy
Retina is important part for vision of the eye. Retinopathy is characterized by decreasing vision capacity of eye or disease of retina. It is a long term complication of diabetics patients. More then 80% people have had diabetics more then 20 years or longer affected in retinopathy. Two types ratinopathy like non-proliferate due to swelling of the blood vessel around retina and 2nd proliferate due to lacking of oxygen are shown.
Prevent retinopathy-
- Prevent should tight control blood glucose, blood pressure and blood fat.
- Early detected site may be saved by laser photo coagulation in advance case surgery required.
- Pregnancy may worse, moderate to sever retinopathy.
- Don’t smoking
- Treatment may done by using anti vascular endothelial growth factor (VEGF) in the retina and corticosteroids.
Nephropathy
Kidney is essential organ of human body. It balance acid base, electrolytes, detoxified toxic elements, filtrate the blood of the body. Kidney disease increase the mortality due to failure its function.
In diabetic renal disease the kidney become
- Enlarged
- Blood pressure increase
- You may diagnosis kidney disease by uric acid test in blood.
- GFR initially increase then decrease and progress reduction of GFR
- GFR diagnosis by albumin creatinine ratio.
protienurea
GRF -Male equal or greater than 2.5 mg per mmol and female 3.5 mmol.
Macroalbuminia
GRF =>30 mg/mmol at end stage 200 mg/mmol.
Protection of kidney
Medication
Should tight control of hyperglycemia and blood pressure. Drug may be treated- ACE inhibitor ( Enalapril) and ARBs ( olmesartan) are preferred by class.
Neuropathy
Diabetic neuropathy is a condition characterized by nerve damage resulting from prolonged high blood sugar levels in individuals with diabetes. This damage can affect nerves throughout the body. Those most at risk include individuals with long-standing diabetes and poor glucose management, particularly if they smoke. Approximately 60-70% of people with a long history of diabetes experience some form of neuropathy, although not everyone will exhibit symptoms.
The most prevalent forms of diabetic neuropathy are those that impact the limbs and those that affect internal organs and muscles.
Peripheral neuropathy
The first type, known as peripheral neuropathy, distal polyneuropathy, or DPN, affects the sensitivity and movement of your feet, legs, hands, and arms. Symptoms of DPN include:
- Pain, tingling, and burning sensations
- Numbness and loss of feeling
- Muscle weakness
- Skin ulcers (open sores)
Around half of those with DPN may not exhibit symptoms other than a loss of sensation in their feet. Due to this numbness, they might injure their feet without realizing it. If these foot injuries are left untreated, they can develop into ulcers and infections, sometimes leading to amputation.
Autonomic neuropathy
The second type (called autonomic neuropathy) affects your urinary tract, digestive system, sex organs, sweat glands, eyes, and heart. Symptoms of autonomic neuropathy include:
Bladder problems (loss of bladder control, not being able to fully empty the bladder, frequent urinary tract infections)
Digestive system problems (bloating, nausea, vomiting, diarrhea, constipation)
Erectile dysfunction in men and sexual problems in women
Too much or too little sweating
Dizziness when you stand up, from sudden drops in your blood pressure
Your doctor will do a physical exam and ask about your symptoms. You should be checked once a year for DPN, or more often if you have foot problems. The doctor will check for loss of feeling in your feet by seeing whether you can feel light touch, pinpricks, vibrations from a tuning fork, and the touch of a thin piece of nylon fiber against your foot The doctor may also check the reflexes in your ankles and the position of your toes. You might have tests to see how well your nerves are working. Your doctor will also make sure you don’t have other conditions, such as blood flow problems or vitamin deficiency.
See your doctor as soon as possible if you have:
Frequent numbness or pain in your feet, legs, hands, or arms An ulcer (sore) on your foot or leg that isn’t healing
A swollen foot or a leg infection
Digestive problems such as bloating, nausea, vomiting or constipation
Problems with urination or sexual function
Dizziness when you stand
Good blood glucose control (keeping blood glucose from being too high or too low) may prevent further nerve damage but usually can’t reverse damage that’s already happened. Your doctor may prescribe medicines for pain that occurs with some types of nerve damage and suggest certain vitamins if needed.
The most effective way to prevent damage is to keep your blood glucose level under good control. You can do so by eating a healthy diet, exercising regularly, and reaching a healthy weight. Avoiding smoking and limiting alcoholic beverages can also help. Your doctor or diabetes educator can help you plan your healthy lifestyle.
You also can do a lot to prevent leg ulcers and amputations. Protect your feet by:
- Checking them every day (see the tips below)
- Always wearing shoes (or slippers) and clean, dry socks
- Choosing shoes that are comfortable and fit well
- Seeing a podiatrist (foot doctor) regularly for foot care if you need help Good foot care
- Wash and dry your feet and check them every day. Choose a regular time, such as after your shower in the morning.
- Look for blisters, calluses, bruises, redness, swelling, cracked skin, sores, or cuts
- Cut your nails once a week or as needed.
- Put lotion on dry skin but not between your toes.
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