Categories: Family & General Medicine

6 Complications of Uncontrolled Diabetes

Diabetes Mellitus is a condition in which the body is not able to efficiently convert glucose in the blood into energy. As a result, blood-sugar levels start rising. This conversion is facilitated by a hormone called insulin secreted by the pancreas. Diabetes is of 2 types: In type-1 diabetes, not enough insulin is produced by the pancreas, while in type-2, the body is not able to use the insulin to convert the blood-sugar into energy. Irrespective of the type, diabetes leads to several complications, when detected late, when untreated for long or when the severity is high.

6 Major Complications

1. Cardiovascular related

For no clear reason, high blood-sugar increases the likelihood of cholesterol depositing on the walls of the arteries. These deposits harden over time and form a plaque thereby narrowing the artery and constricting blood-flow. This condition is called atherosclerosis. Sometimes, unstable plaques crack and expose their lipid core that initiates a harmful sequence of events, Blood cells, particularly platelets, are attracted to the site creating a blood clot. In smaller arteries, the blood clot can restrict or completely cut-off the blood-flow. This means, that part of the body receives less oxygen than before, causing one or more tissues to fail. When this happens in the heart, it increases the risk of heart-attack and heart-failure, and if this happens in the brain, it increases the risk of stroke.

2. Nervous system related

As discussed above, high blood sugar can affect circulation in both major and minor arteries. Some of these minor arteries supply blood to the nerves. When blood supply is restricted in such arteries, the nerve function is affected. Further, high blood-sugar is also known to interfere with the ability of the nerves to send signals. This result in a condition called diabetic neuropathy. When that occurs in the arms and legs, it is called peripheral neuropathy. When it happens in the major organ systems, it affects them, for e.g. the digestive and reproductive systems, causing a wide range of symptoms and complications. Any nerve in the body can be affected , even the involuntary nervous system ( over which we have no control) which is called the Autonomic Nervous System e.g the nerves of the heart.

Also Read: Diabetic Neuropathy – Types and Symptoms

3. Kidneys related

As mentioned in point A, diabetes increases the risk of atherosclerosis in any part of the body, including the kidneys. In the kidneys, there are millions of tiny filters called nephrons which do not get enough oxygen-rich blood now, so their function starts failing slowly, and the condition is called early-stage kidney disease. Restricted blood-flow in the smaller arteries causes blood to accumulate in the larger arteries of the kidney increasing blood-pressure there. The combination of kidney function failing, high blood-pressure and high blood-sugar causes a vicious circle leading to chronic kidney failure. The consulting Diabetologist will educate the patient on signs and symptoms of kidney disease to look out for, so that quick medical action can be taken. Symptoms include swelling in parts of the body which is due to fluid retention in the body’s tissues, poor appetite, loss of sleep, trouble concentrating, fatigue and diarrhea.

4. Vision related

Both neuropathy in the nerves of the eyes, and atherosclerosis in the arteries that supply blood to different parts of the eyes, are likely in diabetics. This leads to complications such as:

Glaucoma: Pressure starts building-up in one or both eyes which damages the optic nerve there.
Cataract: High blood-sugar causes changes in the structure of the lens of the eye(s). The lens become thicker, less flexible and less transparent, which accelerates development of cataracts.
Retinopathy: High blood-sugar cuts off blood supply in tiny blood-vessels in the back of the eye that supply blood to the retina, causing damage to the same.
Macular edema: This is an outcome of retinopathy. Retinopathy causes swelling and fluid build-up in the macula which is a part of the retina. As a result, vision becomes blurry.

If diabetes is not kept in check, the above conditions can worsen leading to loss of vision in one or both eyes.

5. Skin related

Atherosclerosis and neuropathy in tiny blood vessels that supply blood to the skin leads to several skin conditions over time. This includes but is not limited to: dryness or dry skin which causes pain and itchiness. The person may develop boils, rashes and blisters over time. There can be redness, cracks, skin tears and calluses. He/she may have inflamed hair-follicles and there may be styes on the eyelids. The person is also more prone to infection in any part of the body, including the skin. Diabetes is associated with appearance of darkly pigmented patches on the skin, called Acanthosis Nigricans.

6. Feet and Mouth related

Feet: Diabetes can cause changes in the structure of the foot, one such example being clawed toes where the last 4 toes are bent down awkwardly in a claw-like shape. Diabetics are more prone to infection which results in pain, fluid oozing, and itching in the legs. The person can also develop sores, ulcers and gangrene. This is because infections take longer to heal in a person with diabetes. Often it may lead to need for surgery, even amputation if not salvageable. We have already covered this in an earlier article.
Teeth and gums: The small blood-vessels in the mouth that supply blood to the teeth and gums suffer from the same issues described above. As a result, there is less oxygen-rich blood supplied to the gums and teeth which causes tooth decay and gum infections such as gingivitis. There can be redness, soreness, swelling and bleeding in the gums. Further, high blood-sugar causes more sugar in the saliva, which in turn invites bacterial infection. The bacteria produce excess acid that damages the teeth and gums. Some people may even lose some teeth.

Other complications

Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS): In this, the blood-sugar starts rising alarmingly. The body then tries to get rid of the extra sugar through the urine. This leads to frequent urination, hence dehydration and sometimes death.
Hypoglycemia: In many cases, the blood-sugar of a diabetic also drops drastically which can be dangerous and comes with its own set of complications.
Diabetic Ketoacidosis: In type-2 diabetes, the body is not able to make use of the insulin, so the body’s cells become starved of glucose. They start burning stored fat for energy, a process which releases by products called ketones. High ketone levels in the body leads to a dangerous condition called Diabetic ketoacidosis which comes with its own complications.
Gastroparesis: One or more nerves that control the stomach muscles can undergo neuropathy due to diabetes. This leads to partial paralysis of the stomach where-in the stomach cannot empty its contents as usual. This leads to symptoms like nausea and feeling full very soon.
Cancer related: People with type-2 diabetes are more prone to cancer than healthy people with the risk being highest for bladder, breast, endometrial, liver, pancreatic and colorectal cancers.
Infection: Diabetes and the constant presence of high levels of sugar in the blood weakens the immune system. As a result, the body cannot fight pathogens quickly leading to infections in one or more parts of the body. Also, it takes longer for a person with diabetes to heal from cuts, bruises and injuries, which again invite infection in that area.
Skeletomuscular system: Persons with Diabetes are more prone to osteoporosis. All other parameters being the same.
Mental health related: Persons with type-1 or 2 diabetes are prone to depression while those with type-2 diabetes are also prone to dementia, and over time – Alzheimer’s.
Sexual health related: Erectile dysfunction in men and frigidity in women, are common consequences of diabetes. Women may also suffer from vaginal thrush, an infection caused by yeast (a type of fungus) and urinary tract infection.
Dyslipidemia: Some patients with Type-2 diabetes develop this condition that is marked by low levels of good cholesterol, and high levels of bad cholesterol and triglycerides.

Reviewed by Dr Suresh S Venkita, Group Medical Director, Kauvery Hospitals

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

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