Diabetes Mellitus Complications

Diabetes Mellitus Complications

Uncontrolled blood glucose levels in patients with diabetes mellitus will cause various complications, both acute and chronic. Therefore, it is important for patients to monitor their blood glucose levels regularly.

Acute complications

The conditions included in acute DM complications are diabetic ketoacidosis (KAD) and Hyperosmolar Hyperglycemic Status (SHH). In these two situations the blood glucose levels are very high (at KAD 300-600 mg / dL, at SHH 600-1200 mg / dL), and the patient is usually unconscious. Because of the high mortality rate, patients should be immediately taken to the hospital for adequate treatment.

The state of hypoglycemia is also included in acute DM complications, where there is a decrease in blood glucose levels up to <60 mg / dL. Patients with unconscious DM should be considered to have a state of hypoglycemia. Things that can cause hypoglycemia such as patients taking too much medicine (most often sulphonylureas) or injecting too much insulin, or patients not eating after taking the drug or injecting insulin.

Symptoms of hypoglycemia include sweating, pounding, trembling, hunger, dizziness, anxiety and, if severe, loss of consciousness to coma. If the patient is aware, can be immediately given sweet drinks containing glucose. If the patient's condition does not improve or the patient is unconscious should be taken to the hospital for further treatment and monitoring.

Chronic complications

Uncontrolled diabetes mellitus in the long term will cause damage to blood vessels and nerves. Blood vessels that can be damaged divided into two types, namely large and small blood vessels.

Included in large blood vessels include:

• Heart blood vessels, which if damaged will cause coronary heart disease and sudden cardiac arrest
• The peripheral veins, especially on the limbs, which if damaged will cause ischemic injuries to the feet
• The blood vessels of the brain, which if damaged will be able to cause a stroke

Small blood vessel damage (microangiopathy), for example, concerns the retinal blood vessels and can cause blindness. In addition, there may be damage to the renal blood vessels that will cause diabetic nephropathy.

The most commonly damaged nerves are peripheral nerves, which cause numbness or numbness in the fingertips. Because of their numbness, especially on their feet, DM patients are often unaware of any foot injuries, increasing the risk of deeper wounds (foot ulcers) and the need for amputation. In addition to numbness, patients may also experience burning and vibrating legs themselves, more pain in the night and weakness in the hands and feet. In patients with peripheral nerve damage, it should be taught about adequate foot care thereby reducing the risk of injury and amputation.