Complications of Diabetes Mellitus are serious and well known. Spectrum of Diabetic complications is vast, from being most trivial to life threatening. Long term Diabetics are at very high risk of complications if they lack blood sugar control (more likely) and sometimes even otherwise (less likely). High BP and Cholesterol are the other two major harbingers. Inevitably Diabetics fall prey to its complications after several long yrs. According to WHO, Diabetes is predicted to become the seventh leading cause of death in the world by the year 2030.Total deaths from diabetes are projected to rise by more than 50% in the next 10 years. Hence its very essential to have proper understanding and accurate knowledge of when to seek medical intervention. Specifically those who have co-existing diseases like Hypertension, Thyroid disorders or Heart diseases or Kidney problems are at increased risk and should exercise extreme caution and follow the medical advice diligently.
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Major Complications of Diabetes Mellitus |
Heart Disease
It is a common complication of DM and in most cases inevitable in the end. It is #1 cause of death in Diabetics. Cardiovascular disease is responsible for between 50% and 80% of deaths in people with diabetes. Among the Heart diseases, most common is Ischemic Heart Disease also referred to as Coronary Artery Disease. It includes terms like Angina Pectoris, Myocardial Infarction. Colloquial term in use is “heart attack”. Other heart diseases that can occur are Hypertension, Cardiomyopathy, Valvular Heart Diseases etc. Many of us have heard about people suffering or dying on account of a heart attack. It occurs due to deposition of fat rich substances called plaques in the major arteries supplying the heart, causing blockages and irregular supply of blood to the heart. This results in decreased capacity of heart to pump blood to the entire body. Due to gradually increasing workload there is Heart failure and the pumping capacity falls substantially resulting in damage to vital organs like Brain, Kidney, Muscles etc. Person loses his ability to exercise and any effort results in severe chest pain, difficulty in breathing (dyspnea) and sometimes syncope or even frank stroke and paralysis. This process ends up in a multi-organ failure and eventually death.
Stroke / Cerebrovascular episode
Diabetes exposes an individual to sudden stroke on account of 2 reasons – one as described above due to heart failing to pump and other due to blockage of vessels that supply blood to brain. This can lead to a variety of manifestations from difficulty in speech to tongue / mouth deviation, headache, sensory loss and frank paralysis. Neurologic symptoms like paralysis may or may not recover completely.
Diabetic Retinopathy / Eye Disorders
Diabetes is one of the leading causes of blindness worldwide. Long term diabetics suffer from chronic damage to micro-circulation of the eyes and thereafter re-development, both cause decrease in vision and other visual problems like pain, increased eye pressure, flashes, lens damage etc. This spectrum of changes is known as Diabetic Retinopathy. Diabetes can also cause other eye disorders like Cataract, Glaucoma etc.
Diabetic Neuropathy
Also known as Peripheral neuropathy. DM after several years begins to affect peripheral nerves and causes decreased sensation. It usually starts from foot and gradually involves nerves of legs, arms and other parts of the body. This can lead to severe inability to perform daily activities. Frequent slipping of the footwear while walking is an early indicator of loss of sensation to toes and foot.
Diabetic Nephropathy / Chronic renal failure (CRF)
Diabetes is the leading cause of kidney failure, accounting for 44% of new cases in 2008.
Diabetes causes chronic damage to kidney. It causes deposition of certain substances in filtration apparatus of Kidney which decrease its capacity to filter the blood and excrete toxic substances. In addition, Kidney has a vital role in maintaining the fluid and electrolyte balance. Decreased kidney function causes abnormalities in fluid and electrolyte balance and subsequent acidotic state and sodium, potassium and calcium imbalances occur. These electrolytes are required for proper functioning of Heart, respiration, overall nutrition and many other important body processes. Accumulated toxic substances damage other organs like Brain, Liver, Heart and Kidney itself causing slow progression of disease and eventually the filtering stops and Kidney function ceases. This leads to end-stage renal disease (ESRD), dialysis and eventually death.
Peripheral Arterial Disease (PAD)
Overtime the peripheral vessels of the body like those supplying blood to arms and legs also suffer damage and subsequently develop blockages. This gradual decrease causes no or little symptoms initially but after prolonged period, it leads to pain on walking short distance, intermittent claudication. Gradually, Pain keeps on increasing and walk able distance keeps on decreasing thereafter gangrene of the limb ensues. Gangrenous parts need to be amputated or it may spread to healthy tissues.
Apart from those 6 common complications, diabetes causes several other serious and non serious complications like fungal infections, skin disorders, decreased immune function etc..
These will be discussed later. We will also learn how to prevent these complications, so stay tuned.
These will be discussed later. We will also learn how to prevent these complications, so stay tuned.