Makindo Medical Notes

Related Subjects: Type 1 DM | Type 2 DM | Diabetes in Pregnancy | HbA1c | Diabetic Ketoacidosis (DKA) Adults | Hyperglycaemic Hyperosmolar State (HHS) | Diabetic Nephropathy | Diabetic Retinopathy | Diabetic Neuropathy | Diabetic Amyotrophy | Maturity Onset Diabetes of the Young (MODY) | Diabetes: Complications |

Diabetic Complications in Type 1 and Type 2 Diabetes

• Acute Complications
  • Diabetic Ketoacidosis (DKA): Typically seen in Type 1 diabetes, this is a life-threatening condition resulting from a severe lack of insulin, causing a buildup of ketones.
  • Hyperglycaemic Hyperosmolar State (HHS): More common in Type 2 diabetes, HHS results in extremely high blood glucose levels, leading to severe dehydration and altered consciousness.
  • Hypoglycaemia: Low blood sugar levels, a potential side effect of insulin or sulfonylureas, can cause confusion, seizures, and loss of consciousness.
• Ophthalmological Complications
  • Cataracts: Diabetics have a 2-5 times higher risk of developing cataracts compared to the general population.
  • Non-Proliferative Diabetic Retinopathy: Early-stage retinopathy where blood vessels in the retina weaken and leak small amounts of blood, causing swelling.
  • Proliferative Diabetic Retinopathy: Advanced retinopathy where new, fragile blood vessels grow in the retina due to oxygen deprivation. These vessels can bleed and lead to retinal detachment, which may cause blindness.
  • Macular Oedema: Swelling in the retina’s macula, leading to vision loss. Often seen in patients with retinopathy, causing reduced visual acuity and, in some cases, blindness.
  • Rubeosis of the Iris: Growth of abnormal blood vessels on the iris, increasing the risk of glaucoma.
  • Glaucoma: Increased pressure in the eye that damages the optic nerve. Diabetics have twice the risk of developing glaucoma compared to the general population.
• Renal Complications / Nephropathy
  • Proteinuria: Presence of excess proteins in the urine, indicating kidney damage.
  • End-Stage Renal Disease (ESRD): Progressive kidney failure requiring dialysis or kidney transplantation.
  • Type IV Renal Tubular Acidosis: A condition where the kidneys fail to acidify the urine, commonly seen in diabetic nephropathy.
• Neurological Complications
  • Distal Symmetrical Polyneuropathy: Numbness, tingling, and pain, typically affecting the feet and hands.
  • Polyradiculopathy: Pain and weakness affecting one or more nerve roots, often in the legs.
  • Mononeuropathy: Sudden weakness in a single nerve, such as the facial or foot nerve.
  • Autonomic Neuropathy: Damage to nerves controlling internal organs, leading to digestive, bladder, and cardiovascular issues.
  • Diabetic Amyotrophy: Muscle weakness and wasting, usually in the thighs, accompanied by severe pain.
• Gastrointestinal Complications
  • Gastroparesis: Delayed stomach emptying, leading to nausea, vomiting, and bloating.
  • Fatty Liver Disease: Accumulation of fat in the liver, commonly associated with Type 2 diabetes.
  • Diarrhoea: Can be related to autonomic neuropathy affecting the intestines.
  • Constipation: A common issue in diabetic patients due to autonomic neuropathy.
• Genitourinary Complications
  • Cystopathy: Diabetic bladder dysfunction, leading to urinary retention or incontinence.
  • Erectile Dysfunction: A common complication in men with long-standing diabetes.
  • Female Sexual Dysfunction: Includes decreased lubrication and arousal due to nerve damage.
  • Genital/Vaginal Candida: Increased susceptibility to fungal infections due to high glucose levels in tissues.
• Cardiovascular Complications
  • Ischaemic Heart Disease (IHD): Narrowing of the heart’s blood vessels, leading to angina or myocardial infarction (heart attack).
  • Heart Failure (HF): Often presenting as HF with preserved ejection fraction (HFpEF), where the heart struggles to pump blood effectively.
  • Peripheral Vascular Disease (PVD): Narrowing of the blood vessels in the limbs, increasing the risk of ulcers and amputations.
  • Stroke: Increased risk of both ischemic and hemorrhagic strokes in diabetic patients.
• Lower Limb Complications
  • Foot Deformities: Conditions such as hammer toe and claw toe, often caused by neuropathy and motor dysfunction.
  • Charcot Joint: Progressive degeneration of weight-bearing joints, leading to deformity and disability.
  • Foot Ulceration: Diabetic foot ulcers can lead to infection and amputation if not properly managed.
  • Peripheral Vascular Disease (PVD): Impaired circulation increases the risk of non-healing ulcers and tissue loss.
  • Amputation: A severe complication of poorly managed diabetic foot disease, PVD, and infection.
• Dermatological Complications
  • Cellulitis: Bacterial skin infection, often developing from a small break in the skin, such as an ulcer.
  • Furunculosis and Folliculitis: Recurrent skin infections of hair follicles.
  • Necrobiosis Lipoidica: Yellowish-brown patches of thinning skin, commonly found on the shins.
  • Acanthosis Nigricans: Dark, velvety skin patches, often seen in the folds of the skin, associated with insulin resistance.
  • Digital Sclerosis: Thickening and stiffening of the skin, particularly on the fingers and toes, leading to reduced joint mobility.
  • Eruptive Xanthomatosis: Yellowish, waxy skin eruptions, usually