Diabetes, short-term consequences: symptoms and types

The consequences of diabetes and short-term complications depend on whether you have your diabetes under control. Complications of diabetes (also known colloquially as ‘diabetes’) are the possible additional consequences of diabetes. A distinction is made between short-term complications and long-term complications. Short term means that these complications occur quickly in your body. These complications occur when your blood glucose is not under control; you then reach a dangerously high or low level. With the exception of hypoglycemia (low blood glucose), you should consider all complications discussed below as medical emergencies.

Short-term diabetes complications

  • What is diabetes?
  • Preventing short-term complications
  • Diabetes consequences: hypoglycemia
  • What is hypoglycemia?
  • Hypoglycemia symptoms
  • Treatment of hypoglycemia
  • Diabetes consequences: diabetic ketoacidosis
  • What is diabetic ketoacidosis?
  • Ketoacidosis treatment
  • Diabetes consequences: hyperosmolar syndrome
  • What is hyperosmolar syndrome?
  • Symptoms
  • Treatment of hyperosmolar syndrome

What is diabetes?

Diabetes is a chronic medical condition in which the body is unable to properly regulate blood sugar (glucose) levels. There are two main types of diabetes: type 1 and type 2.

In type 1 diabetes, the body does not produce insulin, a hormone that helps regulate blood sugar levels. This type of diabetes is usually diagnosed in children and young adults and requires daily insulin injections to control blood sugar levels.

In type 2 diabetes, the body does not use insulin effectively, a condition known as insulin resistance. This type of diabetes is usually diagnosed in adults and can be treated with a combination of lifestyle changes, such as diet and exercise, and medications.

Both types of diabetes can cause serious health complications if left untreated, including heart disease, nerve damage, kidney disease and vision loss. However, with proper treatment, people with diabetes can live healthy and active lives.

A distinction is made between short-term complications and long-term complications. Long-term complications are discussed in this article.

Preventing short-term complications

Serious short-term complications of diabetes are generally caused by high glucose levels when blood glucose is less well controlled. In principle, all short-term complications can be avoided by taking your medications at the right times, checking your blood glucose regularly and eating the right foods at the right times. If you do that, there is little chance that you will suffer from a short-term complication. Short-term complications develop within days or even hours and respond quickly to adequate treatment. Diabetics must always be on their guard to prevent them from experiencing (acute) disruptions.

Diabetes consequences: hypoglycemia

What is hypoglycemia?

Hypoglycemia refers to a situation in which the blood glucose level has dropped to such an extent that all kinds of complaints arise. It occurs almost exclusively in diabetes patients who use insulin or certain blood glucose lowering tablets. If you consume too much of this or if you exercise too much or eat too little, eat too late or skip a meal, your blood glucose can become so low that you develop symptoms. In that case, the injected amount of insulin or the ingested glucose-lowering agent is already effective to process the expected supply of glucose from food in the intestines, while there is no supply of glucose from the intestines because you eat too little or too late. . The result is a sharp drop in blood glucose levels. Even if you consume more glucose than normal (for example because you exercise more than normal), this can lead to a sharp and sudden drop in blood glucose levels. In most people, a level of 3.3 mmol/l (59.4 mg/dl) or lower leads to complaints.

Hypoglycemia symptoms

The symptoms of hypoglycemia can be classified into two groups:

  • Sympathetic symptoms : these are due to stimulation of the adrenergic system (a system of neurotransmitters and receptors in the nervous system) in response to a decrease in glycemia or sugar levels in the blood. This causes side effects of the hormones (especially adrenaline) that the body releases to counteract the glucose-lowering effect of insulin.
  • Neuroglycopenic symptoms : these are symptoms that occur because the brain does not receive enough fuel, resulting in a decline in thinking skills; these are due to a decrease in blood glucose levels in the cerebral circulation.

The sympathetic and neuroglycopenic symptoms can occur separately, together or sequentially.

Fatigue / Source: Istock.com/BartekSzewczyk

Neuroglycopenic symptoms include:

  • headache;
  • concentration disorders;
  • visual disturbances (such as double vision);
  • fatigue;
  • confusion, anxiety or restlessness;
  • convulsions;
  • unconsciousness, or being unable to wake up.

Sympathetic symptoms include:

  • pale skin;
  • sweating, perspiration;
  • fast heart rate;
  • palpitations, or the feeling that your heart is beating too fast;
  • fear;
  • shaky;
  • feeling of hunger.

If you develop hypoglycemia, you can no longer think clearly. You make simple mistakes and others may think that you have really hit the bottle.

Treatment of hypoglycemia

In the case of a moderately severe hypo, you can take measures yourself by immediately taking quickly absorbable carbohydrates or sugars in the form of dextrose or sugar cubes as soon as the first signs appear. Then take slowly absorbing carbohydrates (for example a sandwich), so that you do not have problems again due to falling blood glucose levels. If the diabetic is no longer able to take anything, a doctor must inject concentrated glucose without delay. An alternative is to inject glucagon, which increases your blood glucose within 20 minutes. This can be administered subcutaneously or into the muscle. This can be done by a housemate and is especially useful if the diabetic has consumed food in the previous hours, as glucagon releases glucose from the storage (glycogen) in the liver. You need a doctor’s prescription for a glucagon set.

Diabetes consequences: diabetic ketoacidosis

What is diabetic ketoacidosis?

If you suffer from high blood sugar for more than just a few days in a row, you may develop a condition called ‘diabetic ketoacidosis’. This is a serious condition that can manifest itself in a matter of days or even a few hours and requires immediate admission to hospital. With ketoacidosis you have a very high blood sugar level with many acids in the blood (acidosis). All patients receiving insulin treatment may develop ketoacidosis. This includes all people with type 1 diabetes and some people with type 2 diabetes. Ketoacidosis is sometimes diagnosed in diabetics who control their disease with tablets or diet at a time when they are very ill.

If there is no insulin in your blood, fuel from glucose cannot be transported to the body’s cells. The body then searches for an alternative energy source. The body will use and burn fat stores. This produces acidic by-products (ketones), which can be used as an alternative energy source when glucose is not available. However, like glucose, ketones require insulin to be used as fuel by the cells in the body. If there is no insulin in the bloodstream, the amount of ketones and glucose in the blood will gradually rise and these substances accumulate. This throws the blood chemistry out of balance, which can have harmful consequences. Your body will try to expel the excess ketones through the urine, resulting in you becoming extremely thirsty.

In addition to thirst, you should be alert to the following symptoms:

  • Nausea and vomiting due to the build-up of acids and the loss of important body substances.
  • Rapid breathing, also called Kussmaul breathing , after the man who first described it. Your body will try to get rid of the acid through the lungs. Your breath may smell sour due to the acetone. This smell is therefore often described as the smell of nail polish and sometimes also as ‘apple smell’.
  • Extreme tiredness and drowsiness. This is because your brain is fed with thick blood and important substances are flushed out with your urine.

Ketoacidosis treatment

Without adequate treatment, ketones and blood sugars will continue to rise, causing you to fall into a potentially fatal coma. Ketoacidosis requires professional treatment. The basis of the treatment consists of the following improvements that must take place simultaneously:

  • the restoration of the right amount of water in the body;
  • lowering the acidity of the blood by removing ketones;
  • replenish lost substances, such as potassium;
  • bringing blood glucose levels to normal.

Diabetes consequences: hyperosmolar syndrome

What is hyperosmolar syndrome?

Hyperosmolar syndrome refers to a condition in which the blood contains too high a concentration of glucose. Like ketoacidosis, this is a medical emergency that requires medical treatment in a hospital. It is a condition of severe dehydration and dysregulation of diabetes, which occurs in situations where you have not drunk enough. This often concerns older diabetics who live alone and suffer a stroke or an infection, which disrupts their diabetes and prevents them from drinking enough fluids. This often concerns people who lose a lot of fluid due to vomiting and diarrhea, where the fluid loss is not replenished and who often have a mild form of type 2 diabetes that sometimes goes unnoticed and untreated.

Symptoms

The symptoms often develop slowly and you start to feel sicker day by day. The main symptoms are:

  • Frequent urination. When your blood sugar level rises, your body will try to release the glucose through the urine.
  • Thirst. Discharging glucose through the urine leads to fluid loss, which ultimately results in dehydration. This makes you extremely thirsty, your skin feels dry and you may feel confused (sometimes you don’t realize how sick you are).
  • Deep-set eyes and rapid pulse. This is due to dehydration.
  • Weakness. Because your blood glucose starts to rise and you don’t get enough fluid, your blood pressure starts to drop and you become increasingly weak.
  • Drowsiness and reduced consciousness. Eventually you can end up in a coma.
  • Leg cramp.

A high blood sugar level in combination with a lot of fluid loss makes your blood thick and sticky (viscous), which can lead to the formation of blood clots, which increases the risk of a heart attack or stroke.

Treatment of hyperosmolar syndrome

Treatment will consist of:

  • replenishing the lack of water in your body;
  • lowering your blood glucose level (through insulin treatment); and
  • replenishing substances your body has lost, such as potassium, sodium and chloride.

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