Diabetes Mellitus complications

Diabetes Mellitus Complications

1. There are diabetes mellitus complications in patients who do not take care of themselves.
2. Patients who do not control their blood glucose levels may have complications.

Diabetes  Complications are:

Acute complications:

1. Low blood glucose levels that is more common in Type 1 diabetes than type 2.
   1. These are primarily associated with insulin use.
   2. It may be seen in the use of sulfonylurea and meglitinide medicines.
2. Ketone bodies formation:
   1. These are also common in type 1 diabetes mellitus than in type 2.
   2. Diabetic ketoacidosis may be seen in children with type 1 diabetes.
   3. Ketone bodies may be seen in children with type 1.
   4. In the case of ketones, patients on oral hypoglycemic agents should be shifted to insulin.
3. Hyperglycemic hyperosmolar state:
   1. It is seen when blood glucose rises to a dangerous level.
   2. This will lead to dehydration and changes in mental functions.
   3. It may be seen in:
   4. Infections.
   5. Medication.
   6. Substance abuse.
   7. Undiagnosed diabetes mellitus.
   8. Treatment:
   9. This is an emergency and requires immediate treatment.

Chronic complications:

1. Hypertension associated with diabetes mellitus:
   1. More than 1/3 of the youth with type 2 DM had hypertension.
   2. It usually appears after 4.5 years of the diagnosis of DM.
   3. There are more chances for diabetic nephropathy.
2. Abnormal lipids:
   1. Children/adolescents with type 2 DM may have decreased HDL (good cholesterol).
   2. These patients have increased LDL (bad cholesterol).
   3. Also, there is an increase in triglycerides.
   4. Advised that yearly screening is needed.
3. Microalbuminuria:
   1. It refers to protein in the urine (proteinuria).
   2. It is mainly seen after 4.5 years of the diagnosis of DM in 16.6% of the youth.
   3. Advise screening for microalbuminuria every year.
4. Retinopathy:
   1. Eye screening is needed every year to find retinopathy.
   2. It is done with dilated eyes.
   3. This is an early diabetes complication.
   4. It is found that 13.7% of the youth have type 2 DM and had retinopathy after 4.5 years post-diagnosis.
5. Obstructive sleep apnea:
   1. It is seen in patients who are overweight.
   2. It is seen with snoring and long breathing pauses when sleeping.
   3. The patient becomes restless, has a morning headache, and feels sleepy during the day.
   4. Advise the sleep study.
6. Erectile dysfunction:
   1. When DM is present for a long time, it may lead to erectile dysfunction.
7. Microvascular complications:
   1. Diabetic retinopathy.
   2. Diabetic nephropathy.
   3. Diabetic neuropathy.
8. Macrovascular complications:
   1. Stroke.
   2. Coronary artery disease.
   3. Peripheral arterial disease, like poor leg circulation, may be a risk of amputation.
9. Increased risk of infections:
   1. Diabetic foot ulcer and infection.
   2. Delayed wound healing.
   3. Gum disease.
   4. Risk for pneumonia.

Diabetes Mellitus complications

Prevention and control of the complications:

1. Stricket blood glucose control.
   1. You can check blood glucose by pricking your fingers or using the Libra sensor 3 plus or another CGM system.
   2. Regular check-up of the eyes, foot examination, and kidneys.
   3. Avoid smoking.
   4. Adopt a healthy diet.
   5. Do regular exercise.
   6. Do take the medications as prescribed by the doctor.