Diabetes Mellitus is a metabolic disorder in which the body is unable to handle sugar. This leads to high blood glucose levels. Diabetes is increasing globally, both in rural and urban areas and has become a cause for concern for W.H.O. and all concerned.
High blood glucose levels are responsible for increased urination, due to increased osmolarity. Increased urination leads to increased feeling of thirst. Along with these, the person usually also has increased appetite. But these typical symptoms indicating high blood glucose may not be present all time.
A person can have high glucose levels and may be without symptoms. He may not know he is a diabetic or he may know but not care about it.
He may think that since he does not have any problem, there is no need to take any medicines. But in both situations, the body will suffer from high blood glucose levels and he is bound to develop complications.
A person with very high blood glucose may go into coma acutely and can die due to the metabolic derangement triggered by high blood glucose levels.
Over a period of time, retina (part of the eye responsible for vision), is the first part to be affected by high blood glucose levels.
In fact examination of the retina can give the first indication of an uncontrolled diabetic status of a person, even though he may have no other symptoms.
Kidneys are also damaged by uncontrolled high blood glucose and after some time an individual can develop renal failure, which is irreversible.
Good control of diabetes after this stage can only prevent progress of the kidney damage but not revert it.
All components of the nervous system are damaged by uncontrolled diabetes.
The peripheral nerves get damaged after long standing diabetes, even if it is well controlled. But with poorly controlled diabetes, the damage occurs with greater severity.
This manifests as tingling, numbness, e.t.c. affecting mainly the hands and feet. Muscles may get damaged leading to difficulty in climbing stairs, combing or dressing, e.t.c. activities which involve proximal muscles of limbs.
Affection of autonomic nervous system leads to diarrhoea or constipation, giddiness and worse still sexual impotence. Unfortunate part is that this impotence is irreversible.
Therefore apart from the physical damage it is devastating mentally for the sufferer.
Increased glucose levels in blood also lead to accelerated atherosclerosis (deposition of fat on lining of blood vessels). This leads to increased risk of hypertension, heart diseases and strokes.
A person with uncontrolled diabetes is more susceptible to infections, because a glucose rich blood also becomes a rich media for bacteria and other microbes to grow.
Therefore these people usually have non healing wounds and ulcers. Diabetic women usually suffer from fungal infections of the genital parts which is resistant to treatment.
Diminished or absent sensations due to neuropathy, combined with susceptibility to resistant severe infections is the cause for,” diabetic foot”, where an individual develops non healing severe wounds in the foot.
Blood circulation of the limbs is also affected due to increased thickening of blood vessel walls caused by accelerated atherosclerosis in diabetics.
This results in gangrene (total death of tissues) of the limbs. Only treatment option left at this stage remains amputation of the affected limb, which is unfortunate.
If a woman develops diabetes during pregnancy, she is at high risk of having large size baby and associated complications and even intrauterine death.
Considering these complications, it is important to educate people about diabetes and the necessity for keeping it under control. Every individual 40 years and above should be tested for diabetes, at least once every year.
During pregnancy, every woman should be tested for diabetes.
If found positive, these individuals should adhere to regular treatment and diet restrictions. Alcohol and smoking aggravate the complications caused by diabetes and interfere with good control. Therefore they should be avoided.
Following a, “diabetic diet” and good compliance with treatment, diabetic individuals can have a good quality of life with no complications.