Acute complications
• Acute Hypoglycemia (abnormally low level of blood sugar)
Patients may have cold sweat, shakiness, pallor, racing heartbeat, drowsiness or even unconsciousness. If the patient is conscious, 10-15g of carbohydrate can be applied, e.g. 3 lumps of cube sugar/ fruit candies, or 1/2 glass of normal soft drinks/fruit juice, and take 3-4 biscuits after the symptoms are improved.
• Acute Hyperglycemia (abnormally high level of blood sugar)
Patients may have deep, rapid breathing, nausea, vomiting and excessive thirst leading to unconsciousness or coma (a state of prolonged unconsciousness). Patients in this stage should be admitted to hospital as soon as possible.
Chronic complications
If diabetes mellitus is not adequately controlled and glucose level remains high over prolonged period, blood vessels and nervous system are easily impaired and result in long-term damage of organs or even failure.
Organ
|
Complications
|
Brain |
Cerebrovascular disease, e.g. stroke |
Eyes |
Retinopathy, cataract, glaucoma |
Heart and blood vessels |
Coronary artery disease, heart failure, high blood pressure |
Kidneys |
Proteinuria, infection, kidney failure |
Foot |
Neuropathy, vasculopathy, ulcer, infection
(Those who suffer from long-term ulcer of lower limbs may need amputation) |
Ideal glucose control can reduce complications. The conditions of glucose control could be known by the following methods:
1) HbA1c
Haemoglobin is a kind of protein in red blood cell which carries oxygen to body tissue and carbon dioxide away from body tissue. Glucose in blood can attach to haemoglobin. Since red blood cell has an average life of about 3 months, the average glucose level in the last 2-3 months of patients can be shown by measuring of HbA1c.
The ideal HbA1c level should be kept at <6.5%. Studies show that 1% decrease in HbA1c could reduce the risk of death of diabetes mellitus by 21% and diseases of capillary (e.g. retinopathy, kidney failure, etc.) by 37%.
2) Blood glucose value of fasting and after meal
Blood glucose value (mmol/L) |
Ideal |
Normal |
Poor |
Fasting |
4.0-6.0 |
<8.0 |
>10.0 |
2 hours after meal |
<8.0 |
<10.0 |
>12.0 |
Researches show that if patients could monitor glucose regularly by themselves, blood glucose could be better controlled and reduce the risk of complications.
3) Urine sugar
We can use Clinistix paper to test urine sugar. When blood glucose value is higher than 10mmol/L, the absorption capability of kidney decreases and therefore sugar could be found in urine. Hence, urince test for sugar cannot accurately reflect the true blood glucose value and fail to show hypoglycemic condition and it is not the best method to monitor glucose control by patients and reduce complications. In addition, age and drugs could also affect the accuracy of urine test of sugar.