Diabetes Complications

Diabetes is a complex heterogeneous disease where multiple levels of abnormalities are present in various tissues. Defects of diabetes mellitus include short term  complications and long term damage, dysfunction and failure of various organs of our body. Short term complications and long term complications are also known as acute and chronic complications. 

Diabetic is closely associated with many other diseases like high blood pressure, kidney failure, skin diseases etc. So there are very large number of diabetes complications. Some are major complications and some are minor. We can remember all these complications easily with the help of a flow chart:

Diabetes Complications 

Major Complications:

Hypoglycemia : Hypoglycemia is a condition when a patient has low blood sugar level. Though diabetic patients have high blood sugar level, hypoglycemia can occur due to overdose of anti-diabetic drug and injection of insulin. Excess blood sugar is harmful for our body but to maintain normal body function, moderate level of blood sugar should be maintained. If blood sugar is increased, there is no chance of immediate harm, but decreased blood sugar or hypoglycemia can be harmful. It's because our brains feed on glucose and nothing else. So, if blood sugar or glucose level is lowered significantly, brain does not get any food and it leads to loss of consciousness and amnesia. It is more common in type 1 diabetes due to injection of insulin. Insulin can lower blood glucose level very fast.

Hyperglycemia : It is opposite to hypoglycemia and defined by high blood sugar level. It is a more common occurrence in type 2 diabetes patient than type 1 patient. Hyperglycemia can give rise to blood sugar level as high as 15 mmol per liter which is very high compared to normal blood sugar level which is below 6 mmol per liter. Hyperglycemia has no short term complication but if it persists log longer period of time it can increase the viscosity of blood and can damage the blood vessels. Also hyperglycemia can lead to high blood pressure. 

Diabetic ketoacidosis : Ketosis of ketoacidosis is a condition where there is excess ketone body present in blood and urine. Excess ketone bodies in blood is called ketonemia and excess ketone bodies in urine is called ketonuria. Ketone bodies are break down products of body fats. Diabetic keto acidosis occurs if the patient is deprived of hydration and food consumption. To meet the body's energy needs, body fats are then utilized. Fats of fatty acids go through oxidation process to yield energy. Ketone bodies are the byproduct of this reaction. Two main ketone bodies produced are  acetoacetate and beta hydroxybutyrate . The condition is called ketoacidosis or ketosis becasue ketone bodies contain acidic ketone group and acidic in nature. Some times diabetic ketoacisosis can be life threatening.

Diabetic Coma : Diabetic coma is a emergency situation that can result from untreated diabetes mellitus. Main causes are severe hypoglycemia and prolonged ketoacidosis.

Diabetic Retinopathy : Retinopathy is a disease of the retina that can result in loss of vision.  Diabetic retinopathy is leading cause of blindness of working age adults.

Diabetic Nephropathy: Nephropathy is a disease of nephrons affecting the kidney. Diabetic nephropathy is the leading cause of end stage renal disease. 

Diabetic Neuropathy: Neuropathy refers to any pathology of peripheral nerves. It is a leading cause of non traumatic lower extremity amputations or surgical removal. 

                                                   Figure: Diatetic Neuropathy

                                           

Stroke: Stroke is a sudden loss of consciousness resulting when the rupture or occlusion of a blood vessel leads to oxygen lack in the brain. Long term diabetes patients have 1.2 to 1.8 fold increased risk of stroke.

Minor Complications:

1) Foot ulcer

2) Reduce resistance to infection

3) Skin rash and skin disease

4) Weakness of bones and teeth

5)  Excess sweating