The complications of diabetes can be divided into acute and
chronic complications.
Acute complications
- Diabetic ketoacidosis (DKA)
- Hyperglycemic hyperosmolar non-ketotic syndrome (HHNS)
Acute complications of diabetes can occur at any time in the
course of the disease.
Chronic complications
- Cardiovascular - Heart disease, peripheral vascular
disease, stroke
- Eye - Diabetic retinopathy, cataracts,
glaucoma
- Nerve Damage - Neuropathy
- Kidney Damage - Nephropathy
Chronic complications are responsible for the majority of
illnesses and death associated with diabetes. Chronic complications
usually appear after several years of elevated blood sugars
(hyperglycemia). Since patients with type 2 diabetes might have
elevated blood sugars for several years prior to diagnosis, these
patients might have evidence of complications at the time of
diagnosis.
Basic principles for preventing complications of
diabetes
- Take your medicines (pills and/or insulin) as prescribed by
your doctor.
- Monitor your blood sugars closely.
- Eat a sensible diet. Do not skip meals.
- Exercise regularly.
- See your doctor regularly to monitor for complications.
Diabetic ketoacidosis (DKA)
- This results from untreated hyperglycemia.
- Blood sugars typically range from 300 to 600.
- This occurs mostly in patients with type 1 diabetes (uncommon
in type 2).
- It occurs due to a lack of insulin.
- Your body breaks down its own fat for energy, and ketones
appear in the urine and blood.
- It develops over several hours.
- It can cause coma and even death.
- It typically requires hospitalization.
Symptoms of DKA
- Nausea, vomiting
- Abdominal pain
- Drowsiness, lethargy
- Deep, rapid breathing
- Increased thirst
- Fruity-smelling breath
- Dehydration
Causes of DKA
- Inadequate insulin administration
- Infection
- Heart attack (myocardial infarction)
Preventing DKA
- Take your medicines as prescribed.
- Monitor your blood sugar closely, especially when you are
ill.
- Maintain a balanced diet with regularly scheduled meals.
- Keep yourself well-hydrated.
- Exercise regularly.
- Call or see your doctor if you or family members notice
symptoms suggestive of DKA and/or your blood sugar is elevated
(above 300).
Hyperglycemic hyperosmolar non-ketotic syndrome
(HHNS)
- This has a more gradual onset than DKA (days to even
weeks).
- It occurs in patients with type 2 diabetes, especially the
elderly.
- It usually occurs when patients are ill or stressed.
- Blood sugars typically are greater than 600.
- Symptoms include frequent urination, drowsiness, lethargy, and
decreased intake of fluids. HHNS is not typically associated with
nausea, vomiting, or abdominal pain.
- It is not associated with ketones in the blood.
- It can cause coma or death.
- It typically requires hospitalization.
Preventing HHNS
- It is similar to DKA.
- Take your medicines as prescribed by your doctor.
- Monitor your blood sugars carefully, especially when ill.
- Keep yourself well-hydrated.
- Call or see your doctor if you or a family member suspect that
you might have symptoms of HHNS and/or your blood sugars are
elevated.