Complications of Type 2 Diabetes

The complications of Type 2 diabetes emanate from the hyperglycemia (state of high glucose levels in blood). Progression to these complications largely depend on how well the diabetics maintain the blood sugar within the normal range. The complications can be either long term or short term.

There are two major short term complications. Hypoglycemia and Hyperosmolar Hyperglycemic State (HHS). The former is usually seen in the individuals who are already using insulin therapy. The typical scenario is a patient on insulin who fails to ingest enough calories. The glucose level in their blood then goes below normal. Alternatively these patients may take in some calories but then engage in strenuous physical activity. This in turn depletes the available glucose leading to low blood sugars. They then experience generalized body weakness, confusion, sweating, anxiety, rapid heartbeat and other signs of hypoglycemia.

On the other spectrum of these short term complications is HHS. This is not a very common occurrence. When it does occur, it is usually in the elderly and sick diabetics. Blood sugar levels begin to climb and the body tries to compensate by getting rid of the excess via urine. This leads to dehydration. If the diabetics do not rehydrate the sugar levels in blood become very high and may lead to coma albeit in less than 20 percent on HHS. Frequent monitoring of the glucose levels is a good way of preventing the occurrence of this life threatening complications.

The long term complications can be grouped into microvascular and macrovascular. These ones affect the small and bigger blood vessels respectively. The small blood vessels affected are those of the eye, kidneys and the ones supplying the nerves. Diabetic retinopathy occurs when those small blood vessels are damaged by the high levels of glucose. This can result to cataracts and even blindness. In the United States diabetic retinopathy is the leading cause of new cases of blindness in people aged 25-74 .

Another microvascular complication is diabetic nephropathy. This is the most common cause of kidney disease in the developed world . The high glucose level directly or indirectly causes alteration in the structure of the kidney. This in turn leads to a defect in the functionality of the kidney. Microalbuminuria is usually a good marker of the extent of kidney damage. The physician collects urine samples in the lab and measures how much albumin is present. The level usually correlates to the extent of kidney damage.

Diabetic neuropathy can also occur in Type 2 diabetes. The small blood vessels that usually supply the nerves in become damaged. The nerves supplying the extremities are then deprived of nourishment, leading to their destruction. This plays an important part in the development of diabetic foot ulcers. These patients do not realize when they injure their extremities. When this injury does occur, the high level of glucose and diminished blood supply make it hard for the wounds to heal.

The development of these complications can be prevented by lifestyle modifications and ensuring that the blood sugar remain within the normal range. This can be achieved by adherence to medication and avoidance or unhealthy activities such as smoking.


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