Diabetes Association of Sri Lanka

Complications
	Diabetes is a chronic life- long condition. It needs careful control in order to prevent serious complications.



Short-term complications
	Low blood sugar (hypoglycaemia) Low blood sugar occurs due to an excess in therapy both tablets and insulin or absence of food in the presence of such medication. A significant drop in blood sugar usually below 60mg/dL will bring about the symptoms mentioned below:- Dizziness Altered level of consciousness Cold sweat Inability to perform ones duties such as walking and talking Blood sugar estimation would confirm same and the restoration to normality occurs fast by eating, drinking a sugary drink or an injection of glucose which should be done as an emergency. Ketoacidosis Ketoacidosis occurs when there is a lack of insulin in the blood often resulting from inter-current infection or a failure of insulin therapy. The body starts using stored fats and acid builds up in the circulation. Symptoms are Extreme weakness Nausea and vomiting Dryness of mouth Hyperventilation Replacement fluids are urgently required following the diagnosis together with insulin supplementation. Failure to do so can be fatal. Lactic acidosis When glucose is used for energy your body produces lactic acid. If there is an excessive build up of this chemical you can become ill. It is rare and was associated with phenformin therapy in the past. The latter drug has now been withdrawn and therefore the condition is rarely seen. Fungal/bacterial infections Bacterial infections such as abscesses, boils and sties, while fungal infections include athlete’s foot, vaginal infections and ringworm often plague a person with diabetes.

Long-term complications

	Diabetes affects the circulatory system and the long term complications are as follows:- Cardiovascular disease Cardiovascular disease such as heart disease and strokes are the commonest cause of morbidity and mortality in those suffering with diabetes. Heart attacks in people with or without diabetes over a period of seven years



	Adapted from Haffner SM, Lehtos, Ronnemaa T, Porala K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in non-diabetic subjects with and without prior myocardial infarction. N Engl J Med 1998;339 (4):229-234 Kidney disease (nephropathy)* Kidney failure is a major complication requiring costly therapy such as intermittent dialysis and kidney transplants. Eye disease (retinopathy) Retinopathy is caused by changes in the blood supply to the retina of the eye. This complication can cause altered vision and ultimately blindness in one or both eyes. Persons with diabetes are also prone to develop cataracts. Nerve disease (neuropathy) and amputations Nerve damage due to uncontrolled diabetes is a common complication. There can be a loss of sensation in the feet leading to injuries that are not detected or managed early resulting in loss of limbs.