Diabetes mellitus is known for its severe complications. Blindness, cardiovascular diseases, trophic ulcers – all this can manifest itself in a patient, if you do not keep blood sugar under control and do not follow the recommendations of the doctor.
Coma with diabetes
Coma in patients with diabetes mellitus is an extremely life-threatening complication of the disease associated with an increase in the blood sugar level (hyperglycemia) or a decrease in it (hypolikemia).
Hypoglycemic coma occurs during the treatment of “long” insulin, exclusion of carbohydrates from the diet, prolonged hunger. Hypoglycemia first develops – it begins suddenly with trembling, excessive sweating, headache, weakness, and palpitations. If at this time to give the patient fast-digesting carbohydrates (sugar, honey or jam, candy, fruit juice), glucose gets into the blood and the person’s condition improves. For those who take long insulin, hypoglycemia may occur overnight, and then patients complain of nightmares, superficial sleep, confused consciousness. In the morning, a diabetic can wake up irritable, lethargic.
If sugar falls to extremely low numbers during sleep or wakefulness, and no measures have been taken to increase it, a person may fall into a hypoglycemic coma. This life threatening condition is characterized by:
- heart rhythm disorder
- increased muscle tone (and atony deepening coma),
- lowering blood pressure
- depression of consciousness.
If a person with diabetes mellitus has blood glucose 2.5–3 times or more, hyperglycemic may develop. coma. It is preceded by several days of indisposition, strong thirst, nausea, headache. Then the patient falls into a state of prostration, loses consciousness. The pulse becomes weak, blood pressure decreases, breathing becomes noisy and frequent. Due to the development of ketoacidosis, there is a smell of acetone from the patient’s mouth. Sometimes coma occurs without ketoacidosis, and is called hyperosmolar — this is an extremely serious complication, resulting in a mortality rate of 50%.
Cardiovascular disease in a diabetic patient
Diabetes contributes to the development of cardiovascular diseases. How does vascular lesion develop? Special protein-carbohydrate complexes settle on their walls, which reduce the elasticity of the walls and narrow the lumen. Because of this, many organs and systems are affected: renal failure, retinopathy, trophic ulcers and gangrene of the lower extremities develop. Insufficient blood supply to the legs leads to intermittent claudication, when the patient cannot walk without interruptions, and stops to wait out the pain.
Patients with diabetes are at risk of having heart diseases, as the vessels feeding this organ do not cope with the task due to a decrease in the elasticity of their walls and a narrowing of the lumen. This can lead to the emergence of such severe diseases as coronary artery disease, heart attack and stroke. Arrhythmia may also develop when the heart rhythm is disturbed due to a decrease in sensitivity and conduction of nerve fibers.
Nephropathy and edema in patients with diabetes
Patients with diabetes may find swelling. First of all, the edema affects the legs, since it is the legs that carry the greatest load, and the blood flow is slower here than in other parts of the body because of the distance from the heart.
Why does swelling develop in diabetes mellitus? There can be two reasons:
- “Diabetic foot.”
Complex disorders related to the lesion of blood vessels, joints and nerve fibers. Thinned brittle walls of blood vessels pass blood plasma into the extracellular space. Due to a violation of the sensitivity of the nerve endings, a person may not notice the discomfort of edema that appears.Swelling of the limbs are dangerous because they can lead to vein thrombosis. They also increase the risk of injuries and infections, and this is fraught with long healing of wounds and the development of trophic ulcers.
- Diabetic nephropathy.
In humans, blood filtration in the capillaries of the tubules and kidney glomeruli is impaired. Excessive fluid retention is manifested by edema. Nephropathy develops gradually, and initially has no symptoms. Patients with diabetes should not neglect the planned examination, in time to identify pathology.
Trophic ulcer in diabetes
Another complication of diabetes is a trophic ulcer. The disease got its name due to the fact that the patient’s nutrition (trophy) of tissues and skin is disturbed. The predisposing factor is the presence of vascular complications (angiopathy) and diabetic polyneuropathy (changes in nerve sensitivity).
A trophic ulcer is preceded by a period when visually there are no problems, but there are already unpleasant feelings:
- sore legs and feet,
- skin sensitivity reduction
- redness and the appearance of dark spots on it.
Then the first defects appear on the skin, which develop from superficial damage, cracks, and corns. The next stage is the aggravation of the condition. The wound is covered with bloom, the discharge becomes purulent. The wound smells unpleasant, a scab appears above it. Due to the reduced sensitivity of the nerves, even with the most terrible- looking ulcers, patients sometimes do not experience pain. If you do not start the treatment of the disease, it progresses further, spreading to the bones, muscles and nerve fibers. The person feels bad, he has a fever, fever appears.The final stage is gangrene, or tissue necrosis.
Treatment of trophic ulcers in diabetic patients consists of local therapy. At the beginning of the disease, the wound is treated with antiseptics, drugs are prescribed to improve the nutrition of tissues. At the stage of purification, the ulcer is freed from plaque and treated with antiseptics. If this does not help, add to treatment. antibiotics. During wound healing, it is advisable to use drugs for skin regeneration.
Diabetic polyneuropathy in diabetics
Diabetic polyneuropathy is a common complication of the disease, expressed in the defeat of peripheral nerves, which entails trophic and vegetative-vascular disorders, decreased sensitivity, paralysis.
Polyneuropathy in patients with diabetes progresses gradually, but inevitably, and it can not be cured. Medicine can offer only means to prevent further development of the disease and drugs to improve the quality of life.
The cause of polyneuropathy is the deterioration of the blood supply and the negative effect of elevated blood glucose on the nerve. The disease manifests itself first by weakening of some reflexes or by the defeat of individual nerves. Then the process progresses and captures more and more nerve fibers. Another way of developing the disease is nerve damage in the legs, accompanied by pain, impaired sensitivity and paresis, trophic ulcers, and changes in the joints.
In patients with diabetes, retinopathy may develop over time, cataracts and glaucoma deteriorate, leading to blindness.
Retinopathy is a lesion of the retina of the eye of a non-inflammatory nature, which develops due to an impaired blood supply to the eyes. The retina is responsible for the transformation of light passing through the lens into an image that is transmitted via the optic nerve to the brain. With retinopathy, small vessels are damaged, and the nutrition of the eye deteriorates. The development of complications depends on the duration of the disease and the quality of treatment: the longer the diabetic experience, the higher the likelihood of eye problems. And if you do not keep blood sugar under control, retinopathy will appear in a short time.
Retinopathy in diabetics may have the following forms:
- Background – the blood vessels of the eye are already damaged, but the vision is still normal.
- Maculopathy – damage to the central part of the retina.
- Proliferative form, when new growths appear on the back wall of the eye instead of the affected vessels, in order to provide food and oxygen supply.
In patients with diabetes mellitus, another eye disease, cataract, is also developing rapidly. The so-called dimming or misting of the eye lens. As a result, the eye cannot focus on the image, and the person does not see well.
Diabetes mellitus also contributes to the appearance of glaucoma, when fluid accumulates inside the eye, due to which pressure rises, vessels and nerve fibers are damaged, and vision drops. Symptoms of the disease are headache and eye pain, lacrimation, blurred vision, halo when looking at the source of light. The danger of glaucoma is that the external manifestations are most often absent until the severe stage with loss of vision occurs.