Complications of Diabetes

Hello!

I’m Dr. Shefali Karkhanis so I’m practicing diabetes specialist at Thane, Mumbai.

Today I’m going to give you an overview complications of diabetes. We all know that diabetes is basically a high blood sugar cause because of imbalance between the supply of insulin from the body and the demand the body has about the insulin. I’m going to talk about complications of diabetes because diabetes is going to affect each and every cell of your body, right from your hair from top of your head to the nail in the bottom of your feet.

So the problem with diabetes is that all of these complications are generally silent. So you do not feel that there is a problem. Let the complications develop with time and it depends upon the duration of diabetes as well as the severity of the same. That means the longer that you have diabetes , the more is a risk of you developing complications.

Similarly the higher the control of sugar , the better is your risk of not developing complications - that means if a person is having diabetes for about 10-15 years there is definitely a risk that he have some or the other form of complications with him. But if he is been well controlled for all these ten years, the risk reduces exponential.

On the other hand , if the patient is only diagnosed for the last 3-4 years , but he has very high sugar or a very high fluctuating sugar he is more likely to develop complications very soon.

Complications can be divided into 2 parts.one is acute and one is chronic. Acute complications include very high blood sugar which will lead to acidosis, coma-like conditions and the person has to get hospitalized be on insulin etc. second is low sugar i.e. very low sugar wherein the patients feel he feels dizzy he feels kiddy he has shivers he has sweating he might even land into a unconscious state.

The treatment of these two is very simple. If the sugars are very high take him to a doctor, treat him with insulin, and bring down the sugars, correct the acidosis and everything will be fine. If the patient is having low sugar before going to the doctor you can treat it. Just put in some powdered sugar or a paste of powdered sugar inside the mouth and the patient’s blood sugar will slowly start increasing and you can he can be transferred to the hospital.

The causes of hypoglycemia are - one if the patient is taking erratically erratic medications. If the patient is fasting at times, if the patient's dose is not adequate or he is taking multiple doses at a time or if the patient just skipped a meal all together in spite of taking the medications. So any of these conditions you can get low sugar and the easiest thing to do is put sugar in the mouth.

Do not give water to an unconscious patient because it might cause other complications. Come into the long term complications. Diabetes will affect major organs which get affected are your eyes, your heart, your kidney , your nerves as well as your blood vessels. In your eyes there is something called as retina. Retina is like the brain of the eye and there will be small bleeding spots in the retina , but the vision is 100% normal so you do not realize there is a spot inside.

These aneurysms can be, this micro hemorrhages can be diagnosed at an early stage by an eye doctor and if it is diagnosed , it can be treated and brought to normal immediately. In the second stage these micro hemorrhages become larger in size and there is a bleeding inside your eye and that is when you have vision disturbances , but by then only oral medication is not going to help you.

So depending upon the damage you might require injections, lasers other procedures etc. The same thing happens with your heart. Your heart, the blood vessels to your heart gets affected because of diabetes and this will reduce the amount of blood supply to your heart making you more prone to develop heart attacks.

In diabetic the heart attacks are many times silent , so there might not be a lot of chest pain but there might be wake symptoms like small pain in the back or discomfort or heaviness or you just might feel breathless especially on walking especially on lying down. So all of these things will need to be addressed and you have to undergo a treadmill test regularly to ensure that your heart is fine.

The second thing that happens in the heart is that pumping capacity comes down so your heart does not pump as well as it used to. Again this can be diagnosed with a simple noninvasive technique like an echo which can be done by any cardiologist and this will give you better idea about the condition of your heart.

The third thing that gets affected is your kidneys. Now kidneys are like filters. So the holes are very very small . Because of diabetes , these pores will start increasing in size and the protein in your body will start leaking into your urine. But there will be no signs, no symptoms , no problems what so ever. It is very simple again to diagnose it with a simple urine test called micro albumin and if this is positive , that means your kidney damage has started and it can be reverted back to normal just with medications.

A good control of diabetes as well as blood pressure will help your kidney a long way to run properly. By the time creatinine goes up , it means there is extensive damage in both of your kidneys and then it is difficult to bring it back to normal. However it can still be controlled but at the end of the story probably you will end up in dialysis. So you have to start taking care of your kidneys right at the very beginning.

The last is the nerves and the blood vessels. Now the nerves of your feet are most commonly affected, so some people might have feelings like tingling, numbness, loss of sensation. There might be episodes where the chappal slips out and you don’t realize it, there might be episodes there is a small little ulcer or a small bite but you know it doesn’t pain.

Then there can be loss of hair from your lower limb. All of this is a sign of nerves getting damaged. Secondly the blood supply starts getting hampered. So this is more common in patients who smoke or who have tobacco usage. This will lead to development of small ulcers and there is a higher risk of amputations in these patients.

Every diabetic must check their sugar monthly, both fasting as well as the post prandial just to ensure that the sugars are well under control and hba1c that is the average of the last two to three months-  this test must be performed at least once in six months if not 3 months. Annually every diabetic patient must undergo a routine test to rule out any complications including their eyes, heart , kidneys as well as blood supply to their feet and the blood supply and nerve supply to their feet.

All of these tests are essential for every diabetic patient and I cannot stress this enough because diagnosed in the early stages , everything can be reversible to a large extent. However the moment you wait for your symptoms to appear it is already too late. Remember , diabetes is your life partner, it will not go away and there is no divorcing it - so you have to control your sugars well and if you control them then you can lead not only a long life but a very healthy life also.

So please start taking care of your diabetes from today. if you have any other queries you can contact me via Lybrate. Thank you!