February 23rd, 2015
Diabetes is the most disabling and notorious metabolic condition that affects approximately 9.1% of the entire US population (1). This corresponds to about 29.1 million Americans according to the estimates of 2012. Unfortunately a fair chunk of this diabetic population (approximately 8.1 million individuals that include both children and adults) are unaware of their disease status. This suggests that these individuals are at much higher chance of developing diabetic complications due to non-availability of pharmacological intervention or much needed dietary or lifestyle modification.
Diabetes is marked by persistently high blood glucose concentration due to partial or complete deficiency of insulin (type 1 diabetes). In type 2 variety, insulin production is normal (or even higher) but the peripheral tissues are not responsive/ sensitive to insulin. In either cases, hyperglycemic state can damage blood vessels, nerves and organ.
Most common complications of poorly managed diabetes can be discussed as:
Persistently elevated blood sugar levels can lead to retinopathy (damage to the visual apparatus) due to osmotic swelling of lens. Healthcare providers recommend diabetic patients to see their eye doctor at periodic intervals for dilated eye exam. Most common eye problems in diabetics include:
Classic symptoms include:
Appearance of protein/ sugar or other vital metabolites in the urine is a sign of renal damage. Co-existing circulatory or systemic disturbances can further aggravate the risk of nephropathy; such as high blood pressure, advanced atherosclerosis and related issues. Symptoms of a kidney problem include:
Advanced or poorly managed diabetes significantly aggravates the risk of cardiovascular dysfunction or circulatory defects; such as heart attack, stroke, angina, sudden cardiac death and strokes. Optimal management of blood glycemic state as well as other risks such as high blood pressure and high fats (cholesterol) can minimize the risk of circulatory complications several folds.
High blood sugars can lead to poor blood flow and progressive nerve damage (also referred to as peripheral neuropathy). This can lead to:
Neuropathy is a disorder of the nervous system that can affect people with diabetes. There are different forms of neuropathy, including:
In advanced cases of neuropathy, patients may develop erectile dysfunction, loss of sensation, gastric discomfort, digestive ailments, Bell’s palsy and related symptoms.
The risk of developing long term complications in the setting of diabetes is fairly high in individuals with poor glycemic control. Speak to your primary care provider regarding appropriate pharmacological options and lifestyle modification to maintain normal quality of life.
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