Complications of Diabetes

Diabetes is an important medical issue, many diabetes patients suffer from its complications as a result of abnormal blood glucose level which is the main reason for illness. Complications of diabetes may be severe and lead to amputation or even death. 

 

Studies show that 2 out of 3 diabetes patients die from coronary heart disease and cerebrovascular disease which are the significant complications of diabetes. Other complications of diabetes do not only affect work performance but also quality of life and the patient also spend a considerable amount of money for the treatment.

 

Complications often occur among patients who have diabetes for at least 5 years particularly patients who cannot keep blood glucose level under control. Complications of diabetes can be divided into:

 

      -    Diabetic Retinopathy

      -    Diabetic Nephropathy

      -    Diabetic Neuropathy

      -    Coronary heart disease

      -    Cerebrovascular disease

      -    Peripheral vascular disease which can cause foot ulcer

It can cause numbness in the feet which may lead to foot wounds and ulcers especially among the patients with peripheral vascular disease. Foot ulcers that left untreated may require surgical removal (amputation) of a toe or some parts of a leg causing disability. The risk factors of diabetic neuropathy include blood glucose level, high blood pressure and smoking etc.

The patient may have numbness in the hands and feet, certain patients experience sharp pain, tingling or burning sensation. The symptoms usually occur at the night. The pain symptoms may reduce in the next stage, but the patient will have reduced ability to feel pain (numbness) and decreased sensation. In addition, some patients may also develop muscle weakness in the arms or legs.

 

In United State of America, approximately 8 percent of patients become blind which is caused by diabetes. Diabetic retinopathy is the condition that can occur when patients cannot control their blood glucose in an appropriate level. Diabetic retinopathy can reach a stage where it could threaten your sight and cause vision loss (30 times higher than non-diabetes patient). 

 

Blurred vision, resulting from unequal curvatures of the lens while having high blood glucose level. Blurred vision may also come from cataract or the damage of the retina which is referred to “diabetic retinopathy”. If this problem is not treated properly, it can cause blindness.

 

Having a dark streaks in the vision due to vitreous hemorrhage

 

Double vision from the nerves controlling the eyes muscles have abnormalities

 

It is the common complication and one reason behind death of those with diabetes mellitus both type 1 and type 2 diabetes. Diabetic kidney disease is associated with controlling of blood glucose level and hypertension management.

 

During the initial stage, disease is said to be asymptomatic but small amount of protein (albumin) is found in the urine at approximately 30-300 milligram per day. In the next stage, protein (albumin) passes into the urine, foamy urine and swelling are noticeable. Hypertension is also found in this stage (300 milligram of albumin is found in urine) Afterwards, if the patient does not receive the proper treatment, the kidney function will be affected, and finally lead to kidney failure which requires hemodialysis.

 

Diabetes can damage blood vessel and cause blood vessel to narrow such as coronary artery, and cerebral artery. Therefore, patients with diabetes may experience myocardial ischemia, myocardial infarction, or paralysis. If the blood vessels that supply the legs is narrowed or blocked, blocked blood flow can cause gangrene (tissue death) and this can lead to leg amputation. Besides, hypertension is also found among elderly especially systolic hypertension.

 

18.7 percent of patients with diabetes have heart disease and vascular disease, stroke (4.4 percent) and coronary heart disease (8.1 percent). Compared with non-diabetes patients, those with diabetes have more complications and have one and a half times higher risk to develop heart attack, and two times higher to become dead.

 

About 3.5 percent of patients with diabetes have cerebrovascular disease and most of the patients experience cerebrovascular disease occurring from vessel narrowing (stenosis). Age is the critical risk factor in the prevalence of cerebrovascular disease. Patients age above 70 years old have three times as much risk as younger age group, followed by hypertension and blood lipid profile.

 

Peripheral artery disease (PAD) is a condition in which the arteries are narrowed usually blood vessel that supply the leg. PAD is more common problem that deserves more attention because it is the important reason for amputation in patients with diabetes.

 

Diabetic foot ulcer is caused by many factors including poorly controlled diabetes, peripheral artery disease (PAD) and peripheral neuropathy leading to a loss of feeling in the feet; weakened muscles, unbalanced weight bearing and foot deformity. This eventually progresses to painless wounds that can cause ulcers. Furthermore, poorly controlled diabetes impairs the ability of white blood cells increasing the chance of infection and the infection spreads fairly easily.