Monday, December 11, 2023

The side effects of diabetes

On 15 July, 2023, Senior’s Today celebrated successfully completing 4 years of entertaining and keeping the Senior population of the country well informed about matters of current affairs, nutrition, health, lifestyle habits and a host of other senior-relevant topics. The weekly Health Live webinar hosted  Dr Dilip Nandamuri, a Senior Consultant Physician and Diabetologist at Yashoda Hospitals, Hyderabad who spoke on and answered questions about Diabetes- Side effects and Care.

Dr Dilip Nandamuri is a Senior Consultant Physician and Diabetologist at Yashoda Hospitals, Hitec City. He specialises in the treatment and management of Infectious Diseases, Diabetes, Hypertension, High Cholesterol Levels, Lifestyle Diseases, Thyroid Problems, Osteoporosis, and Inflammatory Disorders. He has experience conducting Phase 2-4 clinical trials and is well-known for his initiative and ability to work independently. With around two decades of experience,  Dr Nandamuri did his Post Graduation in General Medicine at the Rajah Muthaih Medical College and Hospital, Annamalai University, and earlier his MBBS from the AIMS, Mysore University. He is a member of leading professional organisations and has published several research papers over the years.

Diabetic complications are classified into:

  • Acute complications
  1. Hypoglycaemia- for a diabetic low blood sugar levels are taken as RBS below 75 mg/dL
  2. Diabetic ketoacidosis- patients with high, uncontrolled blood sugar levels can land into ketosis leading to multi organ failure and occasionally death
  3. Hyperosmolar non- ketotic state- occurs only in patients with type II diabetes. No ketosis is seen in this state but there are high blood sugar levels, disturbed electrolytes and can lead to multi organ failure
  • Chronic complications

These can further be divided into

  1. Microvascular
  2. Macrovascular

This division is on the basis of the vascularity/ size of the arteries involved.

Macrovascular complications include

  • Coronary Artery Disease- in simple words, patients developing a heart attack
  • Cerebrovascular Disease- stroke in the brain, when blood supply to the brain/ certain parts of the brain will be reduced or completely obstructed leading to paralysis of certain parts of the body depending upon the area involved.
  • Peripheral Artery Disease- compromise in the supply of blood to the peripheral arteries of the body, especially the lower limb- this can lead to diabetic foot ulcers, neuropathic pain, gangrene- this can lead to amputation

Microvascular complications include

  • Diabetic retinopathy- vascular complications leading to diminished vision or complete blindness in the eye
  • Diabetic nephropathy- gradual increase in the protein excretion from the kidneys leading to increased creatinine and urea in the blood, further leading to end stage kidney disease where the patient may require dialysis or even renal transplant
  • Diabetic neuropathy- blood supply due to the high blood sugar levels can cause damage to the nerves and lead to neuropathic symptoms such as tingling, numbness, pain and loss of sensations

Factors affecting the complications are:

  • the type of diabetes. Type I diabetes is common in children and is diagnosed at a young age. These patients are less prone to developing complications as compared to the patients who present with type II diabetes, affecting the people at a later stage in their life.
  • High blood pressure and uncontrolled hypertension
  • Smoking
  • Excessive alcohol intake
  • Obesity
  • Dyslipidemia

Patients with diabetes have high blood sugar levels, which means that the blood sugar levels in the blood are higher and the cells are not provided with adequate amounts of sugar to convert it into energy for utilisation.

And these high blood sugar levels circulate in the entire body leading to gradual damage and death of the cells where this blood circulates. This is a slow process.

This is why it is important to keep your blood sugar levels well within the limits of normal range- to avoid micro and macrovascular complications at a later stage in life.

Some figures for reference:

  • 20% of diabetic patients develop heart attack
  • 6-7% of diabetic patients develop diabetic foot, ulcers and gangrene, peripherals vascular complications
  • 18-19% of diabetic patients develop retinopathy
  • 3% of diabetic patients develop nephropathy
  • 25% of diabetic patients develop neuropathy
Dr Noor Gill
Dr Noor Gill, MBBS, deciphers the space between heartbeats, figuratively and literally. Powered by frequent long naps and caffeine, she believes that “knowledge without giving back to society is meaningless” and works to make caring cool again.

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