Complications of diabetes

D iabetic neuropathy is a common complication of diabetic mellitus (DM) in which nerves are damaged as a result of high blood sugar level that is not well controlled. Similarly, it is a condition where nerve damages happen due to injuries to the blood vessels that supply the nerves resulting in pain, numbness, tingling sensation and vision loss. Diabetic neuropathy is a debilitating problem that occurs in nearly half of the people with DM. It is a late finding; it may also come with complication of eye disease. It can affect any part of the body that is controlled by nerves. It slows down stomach functions, bladder and sexual functions as well as causes balance and unstable gait of an affected person.

This condition occurs in both Type 1 and Type 2 DM. This condition sets in within 10 years of developing diabetes. Tight glucose control can prevent, delay or slow the progression of diabetic neuropathy in patients with Type 1 DM. Proper foot care is necessary in patients with DM. In addition, DM patients should be educated on foot care and advised to check their feet daily as well as have annual foot examination. Daily foot care is important in preventing complications of diabetic neuropathy. Feet must be checked for signs of cracking skin, open areas and signs of infection, especially between the toes and around toenails. Applying ointment to most areas between the toes should be avoided, wearing properly fitted foot is very crucial. New shoes are a common cause of skin tear. Hence, gently and slowly putting new shoes on should be done at all times to avoid walking around on barefoot and cutting nails improperly. Do not expose feet to hot objects or chemicals.

Symptoms

Some of the symptoms of DM are muscle weakness, muscle atrophy (shrinking of the muscles) which is permanent pain, numbness, cramping, feelings of needles and pin sensation, more on the hands and feet. In some cases, loosing feelings, not being aware of any pain on extremes and when the nerve damage extends to the heart, symptoms such as exercise intolerance, fatigue, dizziness, light headedness occur. In addition, DM affects the activities of the stomach by causing paralysis in any part of the digestive system, causes inability of food to slowly move down the tract resulting in bloating, pain, nausea, diarrhea and malnutrition. Furthermore, it affects the bladder function through the inability to sense a full bladder and bladder muscles slow activity resulting in urinary retention and incomplete voiding of urine which can progress to urine incontinence and bladder infection.

When erectile dysfunction occurs in DM, it is as a result of diabetic nerve damage mostly due to uncontrolled blood sugar. Erectile dysfunction occurs in men with diabetics from 35 years of age. DM is a primary cause of pelvic area neuropathy leading to a decrease in the chemical that is required to initiate an erection. In women, diabetic neuropathy may cause vaginal dryness, decreased perineal sensation, painful sex as well as reduced libido. Early detection and control of diabetics and some contributing factors like smoking, alcohol use and high blood pressure can help delay progression.

Diabetic retinopathy (Diabetic blindness): Poor control of blood glucose and longer duration of having diabetics toe for a long period of time occurs equally in type1/2 and lack of not doing annual eye examination to detect the initial signs of the complications of diabetics. This is defined as a long time pathological complication. There may also be damages due to vasculature of the retina, too much glucose causing abnormal blood vessels growth/swelling and leaking of fluid from blood vessels resulting in vision loss or blindness. There are two different types -one more serious than the other, and requiring major surgery which can be corrective but in most cases blindness is irreversible