Diabetic Ketoacidosis :
This may occur in case insulin therapy is interrupted or due to the
stress of an infection or illness. Usually patients stop their insulin
because of nausea or vomiting, which is a mistake. The lack of insulin
causes blood glucose to rise rapidly, excessive fluid and electrolyte
loss from the body and subsequent dehydration. There are increased fatty
acids in the circulation, more nausea and vomiting and a vicious cycle
is established. The person thus has:
- Dry skin, temperature below normal
- Air hunger, 'ketone' smell on the breath
- Kidney shut-down
- Coma and if untreated - death
What to do?
Take the person to a doctor immediately for, where the management
includes the following:
- Testing the urine for ketones & blood sugar level
- Replacement of fluids lost
- Restoration of electrolyte balance
- Investigation and treatment of the underlying case
Long-term complications of Diabetes
The problems arise because of the effects the disease has on both small
and large blood vessels and include blindness due to diabetic
retinopathy, difficulty in walking, chronic ulceration of the feet,
bladder and bowel problems due to neuropathy, angina, heart failure and
gangrene due to atherosclerosis. However, the nearer the blood glucose
is to the normal levels, the fewer and less severe are the
complications.
I. Diabetic Retinopathy: This is the commonest cause of blindness
between the ages of 30 to 65 years. To detect this, a regular check-up
by an eye specialist is a must. Symptoms are worse in cases of a long
duration and early onset of disease, smoking and excessive alcohol
consumption. Treatment is in the form of retinal surgery
(photocoagulation)
II. Diabetic Neuropathy: a common complication, usually presents with
'glove-and -Stocking' type( involving the hands and the feet) of
impaired sensation. There may be pain in the legs, worse at night,
burning sensations in the soles of the feet and a sense of numbness in
the feet. Muscles of the hands and feet may be weakened, besides
problems with passing urine, impotence, bowel disturbances.
III. Diabetic Foot: in this condition a foot ulcer presents after a
trivial trauma, or may be due to necrosis under a callus(corn).
Treatment includes antibiotics for the infection and good control of
diabetes alongwith professional foot-care. Avoidance of amateur
chiropody is a must in such cases. In severe, irretreivable cases,
amputation may have to be performed.
IV. Diabetic Nephropathy: results from long-standing, uncontrolled
disease, with a history of hypertension.This may be a cause of premature
deaths in young diabetic patients. The earliest presenting feature is
the presence of protein in urine.
Treatment is aimed at control of the disease along with control of
blood pressure, since otherwise it accelarates the process.
As stated earlier complications of diabetes involve multiple organ
systems and cause much morbidity and economic loss to the patients.
Better dianbetic control, regular check-ups and prompt intervention in
case of detection of a complication helps.
How Is Diabetes Diagnosed? |
Treatment |
Diet in Diabetes |
Diabetes & Exercise 
