What are the complications of Diabetes Mellitus?
Acute complications
• Acute Hypoglycemia (Blood glucose <3.9mmol/L)Patients may have cold sweat, shakiness, pallor, racing heartbeat, drowsiness or even unconsciousness. If the patient is conscious, 15g of simple carbohydrate can be applied, e.g. 3 lumps of cube sugar/ fruit candies, or 1/2 glass of normal soft drinks/fruit juice, and take15g complex carbohydrate eg. a small piece of bread or 3-4 biscuits after the symptoms are improved.
• Acute Hyperglycemia (abnormally high level of blood sugarBlood glucose >15mmol/L)
Patients may experience deep and rapid breathing, nausea, vomiting and excessive thirst, and may lead to unconsciousness or coma. Patients must be admitted to hospital as soon as possible.
Chronic complications
If diabetes mellitus is not adequately controlled and glucose level remains high over a prolonged period, blood vessels and nervous system are easily impaired and can result in long-term damage or even failure of body organs.
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) Glycated Haemoglobin A1c (HbA1c)
Haemoglobin is a protein found in red blood cells which carries oxygen to body tissues and carbon dioxide away from body tissue. Glucose in blood can attach to haemoglobin. Since red blood cell has an average life span 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 below 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.