Diabetes Complications: What You Need to Know
As a certified diabetes educator (CDE), a common concern of my patients is of the long-term complications. Understandably so – there is a stigma associated with type 2 diabetes, especially if insulin is prescribed.
“I can’t take insulin!” I often hear. “My cousin was prescribed insulin. As soon as she started taking insulin, she ended up requiring an amputation.”
So I end up having to explain that insulin does not cause an amputation – if anything, it prevents the need for an amputation, and can stave off complications. But often, people are so reluctant to treat their diabetes that it can be too late.
So, even if it can be difficult to hear, let’s discuss the complications of type 2 diabetes – it can save your life.
What Are the Symptoms of Uncontrolled Diabetes?
Diabetes is often labeled as a “silent” disease. Why? Because uncontrolled diabetes symptoms typically don’t develop until blood glucose levels get quite high.
Diabetes is often diagnosed on a routine lab test. For example, your physician blood at a physical and find that your glucose level is high and find that you have diabetes. Or, you may have blood drawn for a surgery and also come away with a new diabetes diagnosis.
However, the situation sometimes occurs where blood glucose levels get to dangerously high levels – and begin to cause symptoms. These symptoms include:
- Polyuria (increased urination)
- Polydipsia (increased thirst)
- Polyphagia (increased hunger)
- Trouble concentrating
- Weight loss
However, just because the levels are high does not necessarily mean that long-term damage has been done to the body. It does mean, though, that something needs to be done as soon as possible to reduce the levels so that long-term damage is not done to the body.
Short-term Effects of Uncontrolled Type 2 Diabetes
Hyperosmolar hyperglycemic nonketotic syndrome (HHNS) is a relatively rare but potentially fatal condition that can occur as a result of uncontrolled blood glucose levels. It is also most likely to happen if you are ill and/or dehydrated.
When HHNS occurs, blood glucose levels begin to rise rapidly. As the blood glucose level begins to rise, the excess sugar needs to go somewhere, so it exits the body through the urine. This ultimately causes dehydration, which causes excessive thirst.
Symptoms of HHNS include:
- Blood glucose levels 600 mg/dL (33.3 mmol/L) or higher
- Dry mouth
- Flushed skin
Another short-term complication of type 2 diabetes is hypoglycemia – or low blood glucose levels. It may seem silly to include low blood glucose levels on this list, but hear me out.
If you’ve just been diagnosed with type 2 diabetes and start taking a sulfonylurea, or are just started on insulin, you are at risk for hypoglycemia. You’re also at risk for hypoglycemia when you make changes to your insulin regimen, so it is important to understand what hypoglycemia is.
Hypoglycemia is technically a blood glucose level of less than 70 mg/dL. Treatment includes consuming a carbohydrate, such as orange juice or regular soda, to help bring the glucose level back to a normal range.
It is important to recheck the glucose level to ensure that it has returned to that normal range.
Long-term Effects of Type 2 Diabetes
You know how when you visit your physician for a diabetes checkup, or you see your diabetes educator, they quiz you on when your last dilated eye exam was? Or you’re being sent to the lab for a urine microalbumin test? Or, once again, you’re being asked to take off your shoes and socks, and your feet and being poked and prodded?
Even if every test is fine, every single time, these tests are done on a routine basis to detect changes in your health. Once a change is detected, these tests then can detect worsening.
Long-term elevated blood glucose level affects the vasculature of the body – both the large vessels and the small vessels. When the large vessels are affected, it is called macrovascular complications, and when the small vessels are affected, it is called microvascular complications.