Complications of diabetes fall into two categories: short-term and long-term. Here, we delve into the short-term complications associated with diabetes.
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Short-Term Problems of Diabetes
Low Blood Sugar: Hypoglycemia
Sometimes, your blood sugar level can become too low. This is called hypoglycemia. It can happen for a few reasons:
- Not Eating Enough: Especially after taking medicines that lower your blood sugar or insulin.
- Too Much Insulin or Medicines: Taking too much insulin or certain pills can lead to low blood sugar.
- Exercising Too Much: Doing a lot of exercise can cause your blood sugar to drop, especially if you take diabetes medicines. When you exercise, your cells use up glucose, which makes your blood sugar go down.
Signs of low blood sugar include feeling shaky, sweating, a fast heartbeat, confusion, and irritability. If you don’t treat it, low blood sugar can lead to coma or even death.
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What to Do if You Have Low Blood Sugar
In the hospital, doctors may give you a special sugar solution through your veins. At home, you can treat it by drinking sweet juice or taking glucose tablets. If it’s really bad and you can’t wake up, a hormone called glucagon can be given as a shot to raise your blood sugar. If you’re going out, always carry your glucagon kit. It’s important to teach your family and friends how to use it in case you can’t. If someone with low blood sugar becomes unconscious, don’t try to give them food or drink – it might make them choke. If you take insulin and you’re drinking alcohol, be careful. Alcohol can lower your blood sugar quickly. Men can have about 3 units of alcohol, and women can have about 2 units. It’s also a good idea to eat while you’re drinking alcohol.
Acidic Blood: Ketoacidosis
Ketoacidosis is when your blood becomes too acidic due to a buildup of certain chemicals called ketones. This happens when your body doesn’t have enough insulin to use glucose for energy, so it starts breaking down fat instead. This can be serious and even lead to a coma. It’s more common in type 1 diabetes but can happen in type 2 diabetes as well, especially in older people. Often, an infection triggers it, like a urinary tract or chest infection.
How Ketoacidosis Happens
When you don’t have enough insulin, your blood sugar goes up, and your body cells start burning fat. This releases ketones and makes your blood more acidic. At the same time, your body loses water and salts through urine, leading to dehydration. Your cells don’t get enough energy from glucose, so they start using fat for energy, which makes ketones. This makes your body’s pH more acidic. Your body tries to get rid of the extra acids by making you breathe faster and deeper.
Signs of Ketoacidosis
- Feeling tired
- Breath smelling like fruit or nail polish remover
- Being very thirsty
- Peeing a lot
- Losing weight
- Having a dry mouth
- Feeling confused or agitated
- Throwing up
- Belly pain
- No appetite
- Flu-like symptoms
- Feeling lazy and not interested in things
- Breathing deeply and quickly
- Going into a coma if it’s not treated
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Preventing Diabetic Ketoacidosis
When you’re sick or have an infection, your body needs more insulin. So, if you’re taking insulin, you might need more during these times. Check your blood sugar often and adjust your insulin if needed. If your blood sugar is high, your urine can show if there are ketones. It’s a good idea to have strips at home to check your urine for ketones.
Sometimes, stomach problems like gastritis can cause acidosis. People might think they need less insulin when they have stomach symptoms like nausea and vomiting, but this can actually lead to acidosis.
Diagnosing and Treating Ketoacidosis
Doctors can diagnose it by checking your blood sugar and urine for ketones. They might also take a blood sample from your artery to check the acidity level. They’ll also rule out any infections. If you have ketoacidosis, you’ll likely need to go to the hospital. You might get fluids through an IV, insulin through an IV, and extra potassium if needed. If there’s an infection, antibiotics can help.
The good news is that if ketoacidosis is caught and treated early, you usually recover within a few days. But if it’s not treated quickly, it can become very serious.
Severe Hyperglycemia: Hyperosmolar NonKetotic Coma (HONK)
Hyperosmolar nonketotic coma is a serious issue seen in people with type 2 diabetes, especially when they have infections or stress. This is different from ketoacidosis, which is more common in type 1 diabetes. HONK happens when your blood sugar becomes really high, and you get dehydrated. Unlike ketoacidosis, there are no ketones in your body or urine, and your blood doesn’t get too acidic. HONK is more likely in older people with diabetes, as they might not feel thirsty even when they’re dehydrated. If they lose too much water, it can lead to shock, fainting, coma, or even death.
What Causes Hyperosmolar Coma
Severe infections like urinary or respiratory tract infections, as well as heart attacks, not following your diet or insulin plan, kidney problems, certain medications, fever, illness, bleeding ulcers, blood clots, high blood sugar, trauma, stroke, and pancreatitis can all cause HONK.
Symptoms of Hyperosmolar Coma
Signs of HONK are caused by high blood sugar and dehydration. These include extreme thirst, weakness, tiredness, confusion, headache, restlessness, trouble speaking, and even paralysis. If you notice these symptoms and your blood sugar is high, contact your doctor. A blood sugar level above 600 mg/dL is often a sign of HONK.
Diagnosis and Treatment
Doctors can diagnose HONK by checking blood sugar levels, your body’s osmolality, the ratio of urea to creatinine in your blood, and your urine for sugar. Unlike ketoacidosis, HONK doesn’t usually involve serious acid imbalances.
If you have HONK, you need medical care right away. You’ll likely need to go to the hospital. The treatment plan involves insulin to lower blood sugar and fluids through an IV to rehydrate your body. If there’s an infection, your doctor might prescribe antibiotics.
Staying Safe from Complications
To avoid these diabetes complications:
- Monitor Your Blood Sugar: Regularly check your blood sugar as your doctor recommends.
- Know About Infections: During sickness, your body needs more insulin. Adjust your insulin doses accordingly.
- Stay Hydrated and Nourished: Keep yourself hydrated and eat balanced meals.
- Listen to Your Body: Pay attention to how you’re feeling and get help if needed.
Remember, managing your diabetes well can greatly reduce the chances of facing these problems.
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