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Diabetic complications

Eyes, Diabetes, Weight loss | February 5, 2020 | Author: Naturopath

Eyes, diabetes, obesity

Diabetic complications

Being diabetic is not only a health concern in itself, there are also a number of health complications which can arise from the disorder. Kidney disease, stroke, risk of blindness and limb amputations are amonst the list of concerns. Being aware of what could go wrong, having regular heart health, podiatry, eye and dental checks along with healty eating, exercise and strict monitoring of blood sugar can help avoid many problems.

There are three types of diabetes, with differing complications. 

  • Type 1 – An autoimmune disease resulting in a condition where the pancreas produces little or no insulin. Insulin is a hormone needed to assist the transport of sugar into cells for use by the body.
  • Type 2 – is is a progressive condition in which the body becomes resistant to the normal effects of insulin (insulin resistant) and/or gradually loses the capacity to produce enough insulin in the pancreas. Type 2 has a family history and genetic component.
  • Gestational diabetes – occurs sometimes during pregnancy and will often resolve after the birth of the baby.
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Common diabetic complications Common diabetic complications¬†

  • Eye disease – affecting vision and possibly leading to blindness
  • Heart disease – heart attack and stroke
  • Neuropathies – loss of feeling, limb amputations, kidney disease, vision loss
  • Immune – frequent infections, poor healing
  • Reduced circulation – erectile dysfunction, poor wound healing
  • Poor oral health – inflammations, bacterial and fungal infections, tooth decay, dry mouth, changes in taste
  • Sleep apnea - a disorder where breathing frequently stops and starts whilst asleep
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  • Hearing loss
  • Coeliac disease
  • Dysregulated sugar – causing hyperglycaemia or hypoglycaemia

Diabetic neuropathy (DPN)

This is a progressive damage to nerves throughout the body caused by sugar and can affect many parts of the body. Diabetic peripheral neuropathy (DPN) is the most common chronic complication of diabetes and is not always found until the damage has occurred. Foot ulceration is a classic sign. DPN is associated with hyperglycaemia, blood pressure and cholesterol. Treating these risk factors can reduce the progression of neuropathies.
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Autonomic neuropathy (AN) can affect internal functioning of the body. This can include reduced stomach emptying, diabetic diarrhoea, bladder dysfunction and orthostatic hypotension (light-headedness, weakness, faintness and syncope).

Kidneys disease

Kidney disease can happen without any symptoms till it is too late. The kidneys do an important job in filtering waste from the blood into urine. The nerves in the kidneys can be damage by unregulated sugar (poor sugar control). The earlier kidney disease is detected, the better the chance of slowing or stopping its progression.
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Heart health

Heart healthHigh blood glucose, over time, can damage the blood vessels and nerves which control the heart.

Having diabetes increases the risk of having a heart attack or stroke – resulting in death. Risk factors which increase the chances include high blood pressure and high cholesterol. Managing blood glucose, blood pressure and maintaining healthy cholesterol levels will help reduce these risk factors.

  • High blood pressure means the heart must work harder, putting a strain on the heart, damaging blood vessels and increasing the risk of stroke or heart attack and damage to eyes and kidneys.
  • High levels of LDL cholesterol can clog blood vessels and impede blood flow.
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  • Excess fat around the waist is a risk factor for heart disease.
  • Smoking damages blood vessels and increases the risk of heart disease and damage to lower legs resulting in poor wound healing and risk for amputation. Smoking also causes dry mouth.
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Oral health

  • Gum inflammation (gingivitis) 
  • Periodontitis - infection and inflammation of the ligaments and bone support of the teeth
  • Fungal infections - poor glucose control leads to pathogen growth due to the sweet environment
  • Dental carries – high glucose increase plaque levels.
  • Dry mouth occurs when blood glucose levels are high
  • Taste disturbances – medications for diabetes, blood pressure and cholesterol can affect taste
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Reduced circulation

Poor wound healing especially in the lower limbs can lead to ulcerations. gangrene and amputations.

Vision problemsVision problems

Diabetic retinopathy is damage to the back of the eye from sugar and is related to the amount of time sugar has been out of control. Diabetic retinopathy can lead to blindness. 

Sexual Health

Erectile dysfunction is a common manifestation in male diabetics. It is associated with a metabolic syndrome, hypertension, atherogenic dyslipidaemia, lower (eGFR) - estimated glomerular filtration rate (considered the best test to measure kidney function), higher albumin/creatinine ratio and more severe small fibre neuropathy.

Hearing

High blood glucose can damage the nerves and blood vessels in the ear affecting the supply of oxygen or blood which eventually can result in hearing loss.

Sleep apnea

Obstructive sleep apnea (OSA) alters glucose metabolism, promotes insulin resistance and is associated with development of type 2 diabetes. Obesity is the key factor involved in the affects of OSA on type 2 diabetes.
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HyperglycaemiaHyperglycaemia

This happens when there is too much sugar in the blood and is often symptomless

Hypoglycaemia

This is when blood sugar levels drop too low and can happen with certain type 2 diabetic medication, but is more common in people who inject insulin in type 1.  

Most important – Monitor blood glucose levels. When glucose is allowed to remain high in the body – damage is being done.

Coeliac disease

Both coeliac disease (CD) and diabetes type 1 diabetes (T1D) are autoimmune diseases sharing a common genetic susceptibility. Notable the HLA gene, with both diseases having an initiating link to genetic and environmental factors. Classic symptoms of CD include diarrhea, bloating, weight loss, and growth failure (in children), but these digestive symptoms of CD may not be obvious and so this complication may be over looked. Other symptoms may include constipation, heartburn, neuropathy and ataxia (lack of muscle control) among others. Iron deficiency and low-bone density are clinical signs of CD. Diagnosis is by positive serologies biopsy of the epithelial cells of the duodenum. Following a strict gluten-free diet is essential and will often pose further challengers to the type 1 diabetic.
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The bottom line

If you have diabetes, insulin resistance or are over-weight it is especially important to follow a healthy food diet, enjoy regular exercise and don’t smoke. Address blood pressure and cholesterol issues. Have regular dental checks.  A podiatrist will help keep feet healthy.

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References

https://diabetesnsw.com.au/about-diabetes/complications/what-are-the-complications-associated-with-diabetes/

https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011

https://www.diabetesaustralia.com.au/type-2-diabetes

https://www.diabetesaustralia.com.au/gestational-diabetes

An update on the diagnosis and treatment of diabetic somatic and autonomic neuropathy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381801/

Estimated Glomerular Filtration Rate (eGFR) https://www.kidney.org/atoz/content/gfr

https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/heart-disease-stroke

https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/gum-disease-dental-problems

Sleep Apnea in Type 2 Diabetes https://spectrum.diabetesjournals.org/content/29/1/14

Type 1 Diabetes and Celiac Disease: Clinical Overlap and New Insights into Disease Pathogenesis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4156157/

https://www.diabetes.co.uk/diabetes-complications/hearing-loss-and-deafness.html

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