Diabetes Mellitus is a Medical condition that results in many serious complications if left untreated. It affects many body organs in different degrees depending on the Type of Diabetes that the person has.
It is estimated that about 462 Million people suffer from Type 2 diabetes worldwide, which is the most common type of diabetes. About 1.5 million people die each year due to complications of diabetes according to WHO.
The damage caused by diabetes can be divided into Acute and Chronic complications depending on how quick the damage occurs. The acute complications occur over few hours or days while chronic complications occur slowly over months to years.
Read detailed explanation of some of the acute damages caused by diabetes mellitus below.
Acute complications
Acute complications of diabetes are very serious in that a person can die in few days if they are not attended to in time. The three main acute complications are:
- Hypoglycemia
- Diabetic Ketoacidosis (DKA) and
- Hyperglycemic Hyperosmolar State (HHS)
Hypoglycemia
Hypoglycemia, simple known as low blood sugar is defined as blood sugar reading of 3.4mmol/l or lower. It can rapidly lead to permanent brain damage if the reading is too low. Remember Human brain depends on glucose in order to function properly.
Low blood sugar can result from many things in people with diabetes, these include:
- Not Eating for a long time while the person is on diabetic medication
- Injecting with insulin and not eat or injecting with incorrect dose of insulin
- Infections may cause Hypoglycemia as bacteria consumes lot of glucose
- Binge drinking alcohol.
Symptoms of low blood sugar vary depending on how low the blood sugar is. You may have one or more of the following symptoms:
- Dizziness
- Loss of consciousness and coma
- Excessive hunger
- Sweating
- Confusion or behavior changes
- Weakness and feeling lightheaded
- Seizures are also common especially those who have consumed alcohol
If a person known with Diabetes Mellitus develop the above mentioned symptoms, especially those who are having Type 1 diabetes and everyone else who is using Insulin injection, you should start correcting low blood sugar at home before going to a health care facility.
You can give the person sweet drink or candies if they are awake if the symptoms improve and you have no way of checking the blood sugar, then they should continue to eat solid food as well and seek medical help as soon as possible to confirm the diagnosis of Hypoglycemia and rule out other medical conditions.
Everyone with Diabetes Mellitus should have a home glucometer to monitor glucose and check it whenever they are not feeling well. Most people own a Glucagon pen (GlucaGen® Hypotkit®) to inject in the case of hypoglycaemia while away from the food source or health facility.
Diabetic Ketoacidosis (DKA)
Diabetic ketoacidosis is a complication of diabetes characterized by high blood sugar and excess ketone bodies in the blood. This cause the pH of the blood to drop, becoming more acidic and the person suffers metabolic acidosis.
DKA is common in type 1 diabetes mellitus. Some patients develop DKA as a first sign of diabetes mellitus, others develop it while they are on diabetic treatment if they are not compliant or if treatment is not working well.
The reason a person develop accumulation of ketone bodies is: The body cannot utilize glucose due to lack of insulin, it then find other means of producing energy through burning of triglycerides (fat) and amino acids (proteins). There is also increase in Ketone bodies which are acidic.
The person with DKA will have the following symptoms and signs:
- Signs of High blood sugar such as frequent micturition, fatigue, dizziness, blurry vision
- Nausea and Vomiting
- Abdominal cramps
- Diarrhea
- Headache
- Coma
- Rapid deep breathing pattern called Kussmaul Breathing
- Ketones in the urine (test by urine Dipstick)
All people with DKA are admitted in ICU for treatment, this is because there are many things that may be abnormal which accompany Acidosis. Patients with DKA usually also have low potassium, Kidney failure, Dehydration, and other electrolyte imbalances that take time to be corrected.
Hyperglycemic Hyperosmolar State (HHS)
Hyperglycemic hyperosmolar state (HHS) is a more fatal complication of diabetes mellitus. It is a common complication of Type 2 diabetes. It has a mortality rate of up to 20%
It also develops more slowly (over few weeks) compared to DKA which develop over few days and Hypoglycemia which takes only few hours.
HHS has similar symptoms to DKA except that there are no ketone in the urine and acidosis is not severe. Blood sugar is very high in these patients, above 30mmol/L.
People with HHS usually come to hospital with altered mental state, other symptoms are:
- Severe dehydration with fluid deficit of more than 6 litres
- Seizures
- Weakness of one side of the body mimicking Stroke.
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