What are the complications associated with diabetes?

The aim of treatment for every diabetic is to have a well-controlled and well-adjusted individual who understands and is responsible for the care of his condition. A diabetic has to live with his diabetes everyday, every hour and minute and he would need to realise that it is his responsibility to manage his disease as to prevent the short-term as well as the long-term complications.

The short-term complications are those of acute hypoglycaemias (low blood sugars) and hyperglycaemias (high blood sugars).

Hypoglycaemia:

Hypoglycaemia is a condition when your blood sugar level is below normal. It can be caused by the following

- Intake of a higher dose of oral tablets or insulin than that prescribed by your doctor

- Skipping meals.

- Consumption of alcohol

How do I know that I am in hypoglycaemic state ?

You will feel the following symptoms:

- Hunger

- Irritability

- Tiredness

- Poor concentration

- Sweating

- Tremors

- Palpitations

- Confusion

Is hypoglycaemia a dangerous condition ?

Yes. If not managed urgently ,it may lead to coma.

How can I manage my hypoglycaemia ?

Take 3 spoonful of sugar diluted in some water, or 125 ml of fruit juice or cokes. Always carry a sugary food with you.

Hyperglycaemia.

Hyperglycaemia is when there is an increase in the level of your blood sugar. The symptoms are the same as the symptoms of diabetes.

Why do I get a hyperglycaemia?


- You have taken too much of sugary foods.

- You have stopped practicing your physical exercise.

- You are undergoing some stressful conditions.

- You have not taken your medications for diabetes as prescribed.

- You have taken medications containing steroids.

Know the cause and consult your doctor for management.

It is now known that good control of blood sugars is associated with less risk of microvascular (small blood vessels) complications, that are seen in the eyes (retinopathy), in the kidneys (nephropathy) and in the nerves (neuropathy). The goal is to achieve an average blood sugar over at least 8 weeks of less than 7%, measured in a test called glycosylated haemoglobin , HbA1c.

In the eyes: at least 10-20% of type 2 diabetics have changes in their retina at diagnosis of their diabetes. The retinal changes occur without any symptoms and it is therefore essential that all diabetic patients should have at least an annual retinal check (fundoscopy) to detect these changes for which treatment with laser can halt or slow down their progression.

In the kidneys: not all diabetics will develop kidney complications. It is now clear that with good control of diabetes, early detection of low levels of protein in the urine and tight blood pressure control, diabetic kidney disease can be prevented or slowed in a significant number of patients. Once kidney disease is established, the course is relentless and end-stage renal failure becomes inevitable.

In the nerves: deterioration of nerve functions have been related to poor blood sugar control. Disease of the nerves is seldom a direct cause of death, but it is an important cause of suffering. All patients should be assessed regularly for disease of the nerves due to diabetes.

It is also known that to prevent long-term macrovascular (large blood vessel) complications, (cardiovascular and cerebrovascular) not only would the average blood sugar, HbA1c, need to be less than 7% but other risk factors should be well controlled, such as blood pressure (< 130/80 mmHg),
lipid level (total cholesterol < 5.0 mmol/l, Low-density lipoprotein, LDL-cholesterol < 3.0 mmol/l, High-density lipoprotein, HDL-cholesterol >1.2 mmol/l and triglycerides < 1.5 mmol).

What is important to realise is that all these complications can be retarded or avoided if these treatment goals are met.