Diabetes mellitus comprises of a group of metabolic disorders. Below is the list of the complications that may cause by diabetes mellitus.

Ophthalmology

This is the leading cause of new cases of blindness. Diabetic patients are 25 times more prone to eye problems. Although blindness is not rare, but it is preventable!

• Background retinopathy
• Maculopathy
• Non proliferative diabetic retinopathy
• Proliferative diabetic retinopathy
• Macular edema
• Cataracts
• Rubeosis iridis

Renal

Diabetic patients are 5 times more prone to kidney disease (diabetic nephropathy can gradually damage small filtering units of the kidney. This eventually leads to protein in the urine, high blood pressure and declining kidney function.)

• Proteinuria (albumin excretion rate >300 mg/24 hours)
• End stage renal disease (ESRD)
• Type IV renal tubular acidosis
• Hypertension (this is a common co-existing condition in diabetic, particularly in patients with central obesity)

Neurology

It will affect both sensory and motor.

• Distal symmetric polyneuropathy
• Polyradiculopathy
• Mononeuropathy (third and fifth nerve palsy; foot drop)
• Autonomic neuropathy

- dizziness as the result of postural hypertension

- gustatory sweating

- dysphagia (difficulty swallowing)

- abdominal fullness

- nausea and vomiting

- diarrhea

- impotence

- retrograde ejaculation

- difficulty with micturation

- overflow incontinence

Gastrointestinal

• Gastro paresis
• Diarrhea
• Constipation

Genitourinary

• Cystopathy
• Erectile dysfunction
• Female sexual dysfunction

Cardiovascular

• Coronary artery disease
• Congestive heart failure
• Heart attack – (2-4 times higher risk compared with people without diabetes mellitus)
• Peripheral vascular disease (intermittent claudication, absent pulses, rest pain, gangrene)
• Cerebrovascular accident (Stroke) – In diabetes mellitus patient, there is 6 times higher risk for stroke (fatty deposits in the coronary artery. Blood vessels in the heart and body can gradually get blocked with fat and then blood clots)

Lower extremity

• Foot deformity (hammer toe, claw toe, Charcot foot)
• Arterial and venous ulcer
• Amputation of limbs - 20 times more prone to lower limb amputation. Good care of infected legs may prevent amputation.

Others

• Necrobiosis lipoidica diabeticorum
• Psychological problems
• hyperlipidaemia

CONCLUSION:

There are so many intimidating complications of diabetes that we know. Most probably there are still a lot more that we do not know. For those who have diabetes, please control your blood sugar level. If you cannot prevent the complications from happen, at least you can delay them! And for those healthy ones, take very good care of yourself. Do your best to stay healthy. You can start today by having healthy diet and proper exercise.

Reference:

1. Harrison’s Manual of Medicine. 16^th edition. 2005.
2. Oxford Handbook of Clinical Medicine. 4^th edition.1998.
3. Health fact sheet by Sanofi Aventis.
4. Quick reference cards by Medical Protection Society. 2001.

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