What are the complications of diabetes?
1. Acute complications
(1) Diabetic ketoacidosis coma (Type 1 diabetes): Diabetes not effectively controlled, leading to severe metabolic disturbance in the body, with accumulation of ketones. Positive for ketones in urine, blood ketones >5mmol/L. Most diabetic patients die from this complication.
(2) Non-ketotic hyperosmolar coma in diabetes (Type 2 diabetes): Poor control of blood glucose leads to extremely high blood sugar, blood glucose >33.3mmol/L (600mg/dl), even up to 83.3~266.6mmol/L (1500~4800mg/dl). Clinically, severe dehydration and neurological symptoms may appear, such as sunken eyeballs, cracked lips, decreased blood pressure, oliguria or anuria, epilepsy, restlessness, hypersensitivity, drowsiness, coma etc., with a very high mortality rate that requires rapid treatment.
(3) Hypoglycemia: Hypoglycemia is the most common and important complication during diabetes treatment. Hypoglycemia refers to venous plasma glucose concentration below 2.8mmol/L (50mg/dl). When hypoglycemia occurs, there may be a series of symptoms of sympathetic nerve excitement and central nervous system dysfunction, serious cases may result in coma. Persistent severe hypoglycemia can lead to irreversible brain damage, even death, so hypoglycemia must be handled urgently. Common causes of hypoglycemia include after antidiabetic drug treatment, reduced food intake or malabsorption, excessive exercise, alcohol consumption, hepatic source diabetes, newborns of diabetic pregnant women, Type 2 diabetes.
2. Chronic complications
(1) Eye disease: Vision fatigue, blurred vision, visual impairment, and complete blindness. Ophthalmic examination can detect cataracts and retinopathy.
(2) Cardiovascular disease: Clinically, symptoms such as dizziness, palpitations, chest tightness and pain, shortness of breath with exertion may occur.
(3) Kidney disease: Early stages have no symptoms, middle to late stages may present with back pain, edema, proteinuria, chronic renal failure, and severe cases may develop uremia.
(4) Brain disease: Clinically, symptoms such as lethargy, forgetfulness, dementia, headache, dizziness, stroke, hemiplegia etc. may be observed. CT scan may reveal brain atrophy, cerebral infarction etc.
(5) Gangrene: Early stages may show leg pain, gradually developing into intermittent claudication, then progressing to rest pain. The foot may develop ulcers, blackened necrosis (dry gangrene) due to minor trauma or compression, and severe cases may require amputation.
(6) Neuropathy: Peripheral neuritis may cause numbness and pain in the extremities; peripheral neuropathy may cause sensory or motor impairment, muscle atrophy, paralysis in corresponding areas; autonomic neuropathy may cause abnormal sweating, orthostatic dizziness, syncope, palpitations, fixed fast heart rate, constipation or diarrhea, urinary incontinence or retention, erectile dysfunction etc.
(7) Metabolic changes: Hyperlipidemia, osteoporosis, gout etc.
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