- When diabetes is poorly controlled, blood glucose levels rise. In high concentrations, glucose has a damaging effect on blood vessels and nerves, which can later lead to the development of chronic complications of diabetes mellitus.
- glycated hemoglobin value of less than 6.5%, the risk of developing chronic complications of diabetes is minimal. However, not for all people with diabetes, this level of glycated hemoglobin is the target. You should discuss your individual glycated hemoglobin targets with your endocrinologist .
- It is necessary to regularly (at least once a year) be examined at a diabetes center to exclude chronic complications of diabetes. The examination plan should include determination of the level of glycated hemoglobin, urinalysis for microalbuminuria , ECG, examination by an endocrinologist (including examination of the legs), examination by an ophthalmologist.
- Hypoglycemia, low blood glucose, is one of the side effects of insulin treatment and hypoglycemic tablets ( sulfonylureas , glinides ). The lower the level of glycated hemoglobin, the more often the development of episodes of hypoglycemia may occur. An effective method to prevent hypoglycemia is to frequently measure blood glucose levels.
- With the frequent development of episodes of hypoglycemia, the loss of precursors of hypoglycemia (hunger, anxiety, weakness, palpitations, increased sweating) may develop. This condition is very dangerous, since a person does not feel a decrease in blood glucose levels, and as a result, nothing is done. The level of glucose may drop critically and the person may lose consciousness, the help of unauthorized persons will be required to administer glucose or glucagon. This condition is called severe hypoglycemia and is life threatening .
- Another complication of insulin therapy is the formation of lipodystrophy – painless seals of subcutaneous fat, leading to impaired absorption of insulin from these areas. The method of preventing this complication is the alternation of insulin injection sites.
- Diabetic ketoacidosis is a life- threatening condition caused by a lack of insulin in the body. Most often this happens due to the refusal of insulin injections, the presence of an acute infection in the body or the onset of diabetes mellitus. Patients using an insulin pump should be especially careful, as in this case there is no reserve of basal insulin in the body, unlike people using multiple injections of insulin.
- Diabetic hyperosmolar coma is a condition primarily characteristic of patients with type 2 diabetes mellitus, who have preserved insignificant insulin production. This condition is characterized by hyperglycemia and dehydration.
- Diabetic retinopathy is a chronic complication of diabetes in which blood vessels in the retina of the eye are damaged. All people with diabetes need to visit an ophthalmologist once a year and undergo a complete ophthalmological examination for prevention.
- Diabetic nephropathy is a chronic complication of diabetes mellitus, in which the vessels of the kidneys are damaged. For prevention purposes, people with diabetes need to perform a Rehberg test (daily urine collection) once a year and assess the daily protein loss.
- Diabetic distal neuropathy is a chronic complication of diabetes mellitus in which high blood glucose levels cause damage to the peripheral nerves. This complication is manifested by a burning sensation, numbness, “goosebumps” in the legs, and then in the hands.
- Diabetic autonomic neuropathy is a condition in which the nerves of internal organs and blood vessels are damaged. This condition is characterized by the development of gastroparesis (slowed down by the emptying of the stomach) or orthostatic hypotension (when the body moves to a vertical position, blood pressure sharply decreases). Of particular danger is the development of a painless form of coronary heart disease.
- Diabetic foot is a serious complication resulting from the long-term presence of diabetic neuropathy. The means of prevention is a regular and thorough examination of the legs for the presence of wounds, chafing , darkening of the skin. It is also necessary to remember that people with reduced sensitivity in the legs should not walk barefoot!
- Diabetic fetopathy is a serious complication of pregnancy in women with poor control of diabetes during pregnancy. Diabetes mellitus is not a contraindication to pregnancy. With satisfactory glucose control at the planning stage and during pregnancy, women can have absolutely healthy children.
- The only effective way to avoid the occurrence of chronic complications of diabetes is to maintain blood glucose levels close to the normal values of a person without diabetes!!!