Complications of diabetes

High blood glucose levels can lead to short-term as well as long-term health complications.

Learning self-management of your diabetes will include knowing what to do when your blood glucose levels go too high (hyperglycaemia) or too low (hypoglycaemia). You will also learn to prevent and monitor long-term complications with the help of your annual cycle of care checks.

Short-term complications

Hyperglycaemia or high blood glucose occurs when your blood glucose level (BGL) is above 15.0 mmol/L. A one-off high BGL is no reason to be worried. Try to figure out the cause: (food/drink, stress). If it happens regularly, it may be time to review your diabetes with your GP or diabetes educator.

If hyperglycaemia occurs for a whole day or longer you are at risk of becoming unwell. Symptoms of hyperglycaemia include:

  • More frequent urination
  • Increased thirst
  • Headaches
  • Feeling tired

Hyperosmolar hyperglycaemic state (HHS) can occur in people with type 2 diabetes where BGLs are very high. It develops slowly over days, usually due to an underlying illness. HHS is potentially a life-threatening emergency.

What can you do?

  • Have a sick day plan
  • Keep hydrated
  • Monitor your blood glucose levels
  • Contact your GP or diabetes team

Diabetic ketoacidosis (DKA) can occur in people with type 1 diabetes and occasionally in people with type 2 diabetes. DKA develops when there is a lack of insulin in the body. Without insulin, glucose cannot enter the body’s cells for energy. The body will break down fat for energy. When this happens, chemicals called ketones are released and build up in the blood. Ketones are acidic, and if not treated quickly, you can become very sick and will need medical attention immediately.

What can you do?

  • Have a sick day plan
  • Make sure you have a glucose meter that can check blood ketones
  • Seek immediate medical attention if your blood ketones are over 1.5 mmol/L, or if
    • you have pain in your stomach
    • your breathing gets faster or changes or smells sweet (acetone)
    • you feel sick or vomit

Hypoglycaemia (low blood glucose)

A hypo is any blood glucose level below 4.0 mmol/L. You may not feel a hypo, but some of the signs and symptoms include:

  • drowsy
  • rapid heart rate
  • sweating
  • hungry
  • difficulty concentrating

A hypo must be treated immediately. If not, there is a risk of losing consciousness.

What can you do?

  • If you take insulin or gliclazide, have a hypo management plan
  • Always keep your glucose monitor with you
  • Always keep some hypo treatment with you
  • Make sure your friends and family know how to manage a hypo
Long-term complications

With any type of diabetes, high blood glucose can impact different parts of your body. Damage can occur over time to the blood vessels and nerves. This can affect the heart, brain, kidneys, eyes and feet, and may also cause digestive problems or problems with sexual function.

Read about your annual cycle of care to help monitor and prevent long-term complications.

It is important for people who are injecting insulin to regularly change injection site, this reduces the risk of getting scar tissue build up under the skin called Lipohypertrophy. If you inject insulin into these areas, it can affect insulin absorption and lead to unpredictable blood glucose levels.

People who have type 1 diabetes can be at higher risk of developing other autoimmune conditions such as coeliac disease and thyroid dysfunction, these can be checked with a blood test once a year.

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