Question

a) Discuss the most common acute complications of diabetes mellitus.

b) List the common long-term complication of diabetes mellitus.

c) Which infection in diabetes causes the most morbidity and why?

Answer 1

a.Acute Complications of diabetes mellitus

1.Metabolic complication

A. Hypoglycemia is an acute complication of diabetes where there is abnormally low blood glucose.

Symptoms:

Anxiety, Hunger, Sweating, Pale skin, Fatigue, palpitations, irritability

If untreated the condition worsens and lead to confusion, blurred vision, seizures and loss of unconscious.

Treatment: For mild case sugary drinks or food. And in severe cases, an injection of glucagon or intravenous infusion of dextrose,

B. Hyperglycemia:   

It is an acute complication of diabetes where there is a very high blood glucose level.

Symptoms::

Fatigue, increased thirst, frequent peeing, blurred vision, headache etc.

C:Diabetic ketoacidosis and coma:

Caused by the gross arrangement of carbohydrate and fat metabolism brought on by a severe deficiency of insulin and is characterised by hyperglycemia, presence of excess ketone bodies in blood and urine and metabolic acidosis.

D.Nonketotic hyperosmolar coma.

Here blood sugar level often exceeds 600mg/dL. and Ketoacidosis will be absent. Plasma osmolarity rises above 360 mosmol/L and there is profound cellular dehydration. When the fluid loss becomes severe hypernatremia develops.

Symptoms:

Extreme weakness and drowsiness, which leads to coma.

Treatment:

Correction of fluid depletion and hyperosmolar state.

2. Infective Complications

Medical: Systemic infections, pneumonia, urinary tract infection, skin infection.

Surgical complications: Boils, Carbuncle, diabetic gangrene.

b. Long term complications of diabetes

1. Cardiovascular system complications: Ischemic heart diseases, cerebrovascular disorders like thrombosis, occlusion of major vessels causes gangrene and ischemia.

2.Nervous system complications:

Peripheral neuropathy, autonomic neuropathy, cerebrovascular occlusions.

3.Excretory system- kidney complication: Recurrent UTI chronic pyelonephritis, renal failure.

4.Eye; Cataract, retinopathy, glaucoma,

5.Respiratory system: Pulmonary tuberculosis.

6.Alimentary system: Stomatitis, xerostomia, halitosis, loosening of teeth.

7.Bone and joints: Osteoporosis.

8.Skin: Monilial infection, pruritus.

c.Which infection in diabetes causes the most morbidity and why?

Gangrene.