Type 1 Diabetes

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Type 1 Diabetes Complications

EMERGENCY COMPLICATIONS:

• DIABETIC KETOACIDOSIS

  In a person with type 1 diabetes, the body will use fat as a fuel if insulin is not present. The by-products of fat metabolism are ketones. Ketones build up in the blood and "spill" over into the urine.

  A condition called ketoacidosis develops when the blood is made acidic by the ketones.

• HYPOGLYCEMIA

  Hypoglycemia (low blood glucose) occurs when the balance between insulin, food intake, and exercise is disturbed. Symptoms of mild hypoglycemia include hunger, nervousness, and fast heart rate. More serious hypoglycemia can lead to confusion and even loss of consciousness. Loss of consciousness due to low blood sugar is called hypoglycemic coma.

• VASCULAR DISEASE

  By age 55, about 35% of men and women with type 1 diabetes have died from a heart attack compared to 8% of nondiabetic men and 4% of nondiabetic women.

  People with type 1 diabetes are also at higher risk to develop blockages in the major arteries of the legs than nondiabetics. Lower the risk of vascular disease by aggressively treating cholesterol and blood pressure, exercising regularly, and avoiding or quitting tobacco products.

• MICROVASCULAR DISEASE

  Microvascular (small vessel) changes occur in capillaries of every organ of the body. There is a thickening of the wall of the small blood vessels. These changes are responsible for many of the diabetes complications.

• EYE COMPLICATIONS

  Changes in the small blood vessels of the retina (also known as diabetic retinopathy) predispose the diabetic to several eye disorders. After 15 years of diabetes, 80% of diabetics will have some diabetic retinopathy.

  If bleeding and scarring has developed, a retinal detachment may occur, causing blindness. Vascular changes in the iris may cause obstruction of the flow of ocular fluid and cause glaucoma. Diabetics are also more likely than nondiabetics to develop cataracts.

• DIABETIC NEPHROPATHY (kidney disease)

  Kidney abnormalities may be noted early in the disease. Poorly controlled diabetes may accelerate the development of kidney failure. Urinary tract infections in diabetics tend to be more severe and may result in kidney damage.

  Diabetics are more vulnerable to kidney damage from high blood pressure than nondiabetics.

• DIABETIC NEUROPATHY(nerve damage)

  People with diabetes may develop temporary or permanent damage to nerve tissue. Diabetic neuropathy is more likely to develop if blood glucose is poorly controlled. Some diabetics will not develop neuropathy, while others may develop this condition relatively early.

  On average, symptoms such as numbness and tingling occur 10 to 20 years after diabetes has been diagnosed.

• DIABETIC FOOT PROBLEMS

  The feet of people with diabetes are very susceptible to infection and injury. Many diabetes-related hospital admissions are for foot problems, and a significant number of non-accident-related leg amputations are performed on diabetics.

  Several foot problems are common in people with diabetes, including skin changes (loss of hair; loss of ability to sweat; and dry, cracked skin), arterial insufficiency (impaired blood supply to feet), neuropathy, and specific foot deformities (hallux valgus, bunion, hammertoe, and calluses).

• SKIN AND MUCUS MEMBRANE PROBLEMS

  People with diabetes are more likely than nondiabetics to develop infections. Hyperglycemia (high blood sugar) predisposes diabetics to fungal infections of the skin, nails, and female genital tract and to urinary tract infection.