Doctors classify diabetes mellitus as a dangerous chronic disease that significantly impairs human life. Pathology forces the patient to constantly adhere to the diet, carefully monitor the glucose level, and undergo treatment in a timely manner. Any deviation from these rules is fraught with the development of complications of diabetes. It is very difficult to deal with the consequences of the disease, and with some of them it is even impossible.
Complications of type 1 diabetes
In type 1 diabetes, the nervous system and blood vessels are most commonly affected. The entire human body is permeated with small capillaries. The greatest accumulation of blood vessels is observed in the lower extremities, kidneys, and retina. Therefore, complications of diabetes initially affect these areas of the body. Diabetes mellitus can lead to the consequences indicated below.
This is a pathology in which the kidneys are affected. The disease develops very slowly and secretly. Therefore, it remains unnoticed for a long time. When a patient has complaints (mainly about intoxication of the body), the kidneys are already affected and practically cannot be restored. It is possible to determine the nephropathic complication of diabetes in the early stages according to the following criteria:
- Analysis of urine. It will show proteinuria (the presence of protein in biomaterial). With nephropathy, the glomerular filtration rate decreases. This indicator indicates a pathological process in the kidneys.
- Blood analysis. The study will show an increase in azotemia. In the blood serum with such a complication of diabetes mellitus, high concentrations of creatinine and urea will be detected.
- High blood pressure. Excessive stress on the kidneys always causes arterial hypertension, which is difficult to treat with medication.
- Increased swelling. This symptom joins over time. The lower extremities, face begin to swell, fingers are poured.
Cataract and blindness
Visual impairment is recognized as a common complication of diabetes. It gradually leads to blindness. Pathology develops in about 40% of patients with diabetes mellitus. An ophthalmologist can determine the development of cataracts during an examination of the fundus. Additional studies are connected if necessary. In order to prevent complications on the eyes, doctors strongly recommend visiting an ophthalmologist 1-2 times a year for diabetes mellitus, depending on the patient’s condition.
Damage to blood vessels leads to a variety of diseases. Many patients are diagnosed with atherosclerosis. Coronary artery disease develops on its background . Vascular complications of diabetes are often asymptomatic. At the same time, they provoke a serious load on the heart and worsen the blood supply to the peripheral capillaries. Without causing a negative clinical picture, macrovascular disorders gradually progress and lead to the following severe pathologies:
- myocardial infarction;
- cardiogenic shock;
- heart failure.
Periodic shortness of breath may indicate latent ischemic disease against the background of diabetes mellitus. The pathology is characterized by tachycardia, arrhythmia. Insufficient blood circulation can provoke the development of dental pathologies. Gingivitis, stomatitis, periodontal disease often become complications of diabetes. Sometimes patients complain about the loss of perfectly healthy teeth.
Complications of type 2 diabetes
Type 2 diabetes mellitus is characterized by the development of kidney disease, eye ailments and disorders in the lower extremities. Such consequences are similar to those changes that occur with type 1 ailment. Diabetes complications that are nonspecific for type 2 may appear – pathologies of the cardiovascular system.
Almost 90% of all diabetics suffer from type 2 pathology, i.e. from acquired ailment. To independently assess the risks of developing diabetes in a 10-year period, you can use the special FINDRISK scale developed by leading doctors.
The organs of vision are very sensitive to high glucose levels. Therefore, they are subject to various violations. Ophthalmic complications of diabetes are often secretive, leading to severe, sometimes refractory problems. Doctors note the following changes:
- Disturbances in the peripheral fundus area cause a slow and gradual decrease in visual acuity. The patient usually does not notice such abnormalities until the retinal detachment occurs.
- If the central part of the fundus is affected, then complications of diabetes develop intensively. The patient has time to notice that visual acuity falls catastrophically.
Against the background of high sugar, the number of hemorrhages in the eye increases. The mechanism of proliferation of connective tissue is triggered. The number of defective vessels increases, which lead to massive hemorrhages. Such processes provoke the death of visual cells and increase the risk of retinal detachment. All of these disorders are called diabetic retinopathy by doctors.
If pathological symptoms are timely identified by an ophthalmologist and the correct treatment is selected, then the development of blindness can be stopped. Long-term drug therapy is required to normalize blood glucose. Complement the treatment with laser photocoagulation (pathological areas of the retina are cauterized with a laser).
The prolonged course of diabetes mellitus leads to a decrease in the filtering capacity of the kidneys. Along with urine, albumin (protein) begins to be excreted from the body. The defeat of paired organs leads to a persistent increase in blood pressure. The patient develops nephropathy. As well as in type 1 diabetes mellitus, the pathology is hidden for a long time. If a person begins to suffer from unpleasant symptoms caused by poisoning of the body, then nephropathy is already rapidly progressing.
With timely detection of kidney damage, the doctor selects the appropriate treatment and prescribes a diet that restricts protein intake. Such measures allow to stop the pathological process of damage to the filtering paired organs.
Poor blood supply, damage to the nerve endings gives complications to the legs. The limbs are less sensitive. Most often, the pathological process covers the feet. Against the background of neurological disorders, the patient does not feel pain and does not perceive temperature changes. Therefore, any minor injuries can go unnoticed for a long time. And if an infection joins, then the inflammatory process starts. Supported by a high blood sugar concentration, it leads to tissue decay. If the patient is faced with neurological lesions of the legs, then he will have the following symptoms:
- leg pain;
- burning sensation;
- numbness of the feet;
- tingling sensation in the lower extremities;
- feeling of “running goose bumps”.
In addition to types 1 and 2 diabetes mellitus, doctors distinguish a special form of the disease – gestational diabetes. This pathology occurs only in pregnant women. The disease is very similar to type 2 diabetes and in the absence of timely correction can lead to complications. After childbirth, the pathology goes away on its own.
Acute complications of diabetes
Acute complications of diabetes pose a serious threat to human life. This category includes processes that develop suddenly and rapidly. They can appear in a matter of hours or within a few days. The pathophysiology of diabetes complications is dictated by abrupt changes in blood glucose. Depending on the type of ailment and the age of the patient, the following early consequences can be diagnosed.
Ketoacidosis occurs in patients with type 1 diabetes. The pathology is based on a violation of carbohydrate metabolism, in which decay products are not excreted from the body. The increased concentration of ketone bodies in the blood is especially dangerous. Doctors cite the following causes of ketoacidosis :
- inaccuracies in insulin dosages;
- psycho-emotional shock, stress;
- cardiovascular ailments;
- infectious process in the body;
- surgical interventions;
- improper nutrition.
A ketoacidosis complication of diabetes can occur in both children and adults. The following symptoms are characteristic of the disease:
- sudden loss of consciousness;
- functional disorders in the work of internal organs;
- A ketoacidotic coma can develop in a couple of hours.
This pathology can occur in all patients with diabetes mellitus, regardless of age. Hypoglycemic coma is a rather serious complication of the disease, in which the sugar concentration in the patient’s blood sharply decreases. Glucose values can reach 2 mmol / g (at a rate of 4-5.5 mmol / g). The following factors can provoke an acute condition:
- overdose of insulin or hypoglycemic drugs;
- excessive physical activity;
- alcohol consumption;
- untimely or insufficient food intake.
Hypoglycemia is manifested by the following symptom complex:
- sudden dizziness;
- loss of consciousness;
- excessive sweating;
- the development of seizures;
- lack of reaction of the patient’s pupils to the light source.
This condition develops in patients with type 2 diabetes mellitus and most often in the elderly. The complication develops against the background of an excessively high concentration of glucose in the blood. Sugar values can vary between 13-15 mmol / l. Such a high concentration is considered a renal threshold at which osmotic diuresis develops (the withdrawal of a large amount of urine containing active substances).
Pathology is very dangerous. According to statistics, mortality from hyperosmolar coma reaches 60%.
The following reasons can provoke the development of a hyperosmolar coma:
- reducing the dose of insulin or antidiabetic drugs;
- the use of glucocorticosteroids ;
- infectious diseases;
- deviation from diet and abuse of sweet foods.
The following symptoms are characteristic of hyperosmolar coma:
- an unquenchable thirst develops;
- urination increases and becomes more frequent;
- the symptoms of dehydration are rapidly increasing;
- loss of consciousness and coma.
Sometimes, hyperosmolar coma can develop in children. Such a pathology is characteristic of improper treatment of diabetes mellitus or lack of timely correction of therapy.
This is another complication of diabetes that is common in older people. It can occur with an ailment of both types 1 and 2. Pathology is a non-specific complication. With a lactic acid coma, an excessive concentration of lactic acid ( lactate ) is diagnosed in the patient’s blood , which is formed during the breakdown of glucose. Another characteristic symptom of this condition is blood acidification (pH below 7.2). At the heart of laktotsidoticheskoy coma are:
- overdose of drugs of the biguanide class ( Metformin , Siofor );
- infectious process;
- the development of cardiovascular disease.
This complication of diabetes has the following consequences:
- loss of consciousness;
- a sharp decrease in pressure;
- lack of urination;
- breathing disorder.
Chronic complications of diabetes
The category of chronic complications (they are also called late) includes disorders that develop in the body gradually. They appear approximately 10-15 years after the main diagnosis. With a high concentration of glucose in the blood, such chronic pathologies can be observed:
- Diabetic retinopathy. This is an ailment in which the retina of the eye is affected and blindness gradually develops. Pathology occurs in almost 90% of people with diabetes.
- Diabetic neuropathy. The functionality of the peripheral nerves is impaired. This is one of the most common complications of diabetes. Neurological pathology is characterized by loss of sensitivity in the foot, which further leads to amputation of the lower limb.
- Diabetic nephropathy. As a result of metabolic disorders, toxic substances act on the kidneys for a long time. This leads to damage to the filtering organs.
- Diabetic encephalopathy. Against the background of diabetes mellitus, the brain is gradually affected. Encephalopathy is manifested by high fatigue, decreased attention, weakness. Patients complain of headaches, anxiety, memory impairment. Over time, the thought process deteriorates significantly.
- Skin lesions. Metabolic disorders are fraught with the accumulation of decay products in the body. Such substances change the structure of the epidermis. Visually, this manifests itself in the form of various rashes, pigmentation. In the future, coarse areas develop, peeling appears. The skin acquires a yellowish tint, hair loss begins, the nail plate is deformed and destroyed.
- Diabetic foot. A complex complex of symptoms that appears in almost half of patients suffering from diabetes mellitus. Initially, brown spots or ulcers appear on the foot (sometimes on the hands). In advanced cases, gangrene develops, forcing surgery to amputate the limb.
Prevention of complications of diabetes
To prevent the development of complications in diabetes mellitus, doctors recommend adhering to the following simple prevention rules:
- Sugar control. All patients diagnosed with diabetes should purchase a blood glucose meter and measure their glucose values regularly, several times a day. This will allow timely detection of life-threatening acute conditions.
- Correct diet. Most often, it is nutritional disorders that become the source of the development of early complications. People who have diabetes mellitus need to adhere to a diet for their entire life and completely give up alcohol.
- Feasible loads. Sports and hardening are recommended for patients. This strengthens the immune system. But physical activity and hardening procedures should not be excessive.
- Thorough hygiene. People with diabetes mellitus need to take special care of the oral cavity. It is important to avoid the development of gum disease and tooth decay. The feet deserve special attention. Especially if there is a decrease in sensitivity. It is strictly forbidden to use sharp, abrasive (pumice), stabbing objects for foot care. It is they who inflict injuries that further lead to gangrene.
- Regular examinations. To eliminate the risk of developing latent complications, it is necessary every 6 months (sometimes the doctor advises more often) to be examined by the attending physician. If a woman was diagnosed with gestational diabetes during pregnancy , then the patient is recommended to visit an endocrinologist once a year, since in the future there is a risk of developing a type 2 ailment.
All people need to be attentive to their health. The appearance of unpleasant symptoms is a good reason to see a doctor. Improper treatment or lack of therapy leads to the development of complications. Indeed, even against the background of simple diseases (tonsillitis, chickenpox, measles) secondary diabetes mellitus can develop.