Diabetes Mellitus- Complications of Diabetes -I

Diabetes has been described as a diseas of complications. The complications of diabetes are more torturing than the disease itself. Acute complications can arise at any time during the course of the disease whereas more dreaded chronic complications slowly unfold themselves years after the onset of diabetes. Control of diabetes does help in warding off its acute complications but whether it delays or mitigates the chronic complications or not is a controversial issue. Hence prevention of diabetes requires special importance:

Acute Complications of Diabetes:

1. Diabetic Coma (Unconsciousness)

Diabetic comma is mostly seen in Juvenile (Child or Young diabetics) but is uncommon in persons suffering from maturity onmset diabetes. Before the discovery of insulin, more than half of Juvenile diabetics died of diabetic coma. We must say thanks to effective treatment with insulin because it has brought down mortality rate to 1-2% due to this complication. Such type of unconsciousness ensues when the concentration of glucose in the blood rises much above normal, a condition called Hyperglycemia. The disintegration of stored fat inside the body is commensurate with the amount of glucose in blood. The end-products of fat disintegration are ketone bodies which due to their acidic nature render the blood acidic. The body tries to get rid of these harmful ketone bodies by producing more and more urine. This results into a reduction in the fluid content of the blood, hence increasing the concentration of ketone bodies. This acidified blood untowardly affects the brain to give rise, first to drowsiness and lethargy and then gradually to diabetic coma.

The probable reasons for the rise of glucose in blood are:

1. Undetected or untreated diabetes
2. Consumption of carbohydrate containing refined foods, especially sugar
3. Inadequacy or total lack of external (medicinal) insulin.
4. Development of resistance inside the body to medicinal insulin.
5. A decrease in the effectiveness of medicinal insulin due to some other infection or disease.
6. A stressful physical condition like surgery or pregnancy.

A diabetic may become unconcious even when the concentration of glucose in the blood drops much below normal. However such unconciousness ensues rapidally. On the other hand unconciousness due to excessive glucose and ketosis is a slowly developing condition. Hours or days before its advent a patient experiences symptoms like dryness of mouth, acute thirst, profuse urination, headaches, nausea vomitting, abdominal pain, weakness, laboured breathing, irrevalent answers to questions and drowsiness. Of these symptoms nausea vomitting, drowsiness and irrevalent answers to asked questions are probably the most common. We have to realise the seriousness of the situation and if the patient is not treated promptly, he gradually becomes unconscious. In some child diabetics, hyperglycemic coma has been seen to set in very fast, i.e., 12 to 24 hours.

Diabetic coma is a medical emergency and calls for urgent expert treatment. The patient must be immediately hospitalised so that he can be given insulin, fluids and salts like potassium through a vein and be regularly monitored. Infact, hyperglycemic coma should not in the first place be allowed to occur. Its prevention is relatively easy provided-

1. The patient must have good knowledge of the disease and its treatment.
2. The concentration of glucose in blood is not allowed to rise by fastidiously adhering to correct, timely diet and medicines.
3. The dosage of insulin is maintained even if food is not taken in other illnesses.
4. Even the most initial warning signs and symptomsof hyperglycemica described above are immediately heeded to and necessary steps are taken.

Thanks,
Team- Knowledge is Healing