Diabetes is one of the rapidly growing health problems throughout the globe. When it is caught early it can be managed effectively, but if it is left untreated and does not keep it under control then it will start to control your body and can cause serious, even life-threatening complications from your head to your toe. In this article, we will discuss how uncontrolled diabetes can create complications and damage the different parts of the body.
What is Diabetes Mellitus?
Diabetes is a chronic metabolic disorder that reduces the ability of the body to control blood sugar (glucose) levels. It’s either due to incompatibility of the body to make insulin or when the body becomes resistant to the insulin or both.
Insulin is a hormone that is released from the pancreas, a gland located behind your stomach to control the amount of glucose in the blood. When we eat food, carbohydrates are converted into glucose by our digestive system and are then absorbed into the bloodstream, where it is supplied throughout the body to serve as energy fuel.
The surge in blood glucose level stimulates the release of insulin, a hormone that acts as a key to unlock the cell door and assists the glucose to be taken up by body cells where it is either converted into energy or stored as glycogen for future use.
In the absence of insulin, glucose isn’t able to enter the cells of the body, to utilize as a source of energy, as the concentration of glucose increases in the bloodstream it leads to a condition known as hyperglycemia. Hyperglycemia is the main characteristic of diabetes mellitus and if it’s not taken care of then it can lead to many other serious health complications.
Types of Diabetes Mellitus
There are different types of diabetes with different causes but with the same problem, too much glucose in the bloodstream. The types of diabetes are:
Type 1 diabetes
It is also called insulin-dependent diabetes, or juvenile-onset diabetes as it is usually diagnosed in childhood or early age.
It is an autoimmune disorder in which our body attacks our cells with antibodies, in the case of type 1 diabetes body defense system attacks insulin-producing beta cells of the pancreas which results in the damage of the organ and not being able to produce insulin. The exact reason for this autoimmune reaction is still unknown but the combination of genetic, viral, and environmental factors can be the risk factors.
People living with type 1 diabetes need insulin injections daily to control their blood glucose level that’s why it is also called insulin-dependent diabetes.
Type 2 diabetes
It is also called insulin-independent or adult-onset diabetes because it is usually diagnosed later in age, but nowadays it’s become more common in children and teens because of childhood obesity.
It happens when your body cells become resistant to insulin. In this type of diabetes either pancreatic cells are not making enough insulin or they are making enough insulin but your body is not responding to it as it should, because the body has developed resistance to the effect of insulin. It is linked with inherited factors and poor lifestyles such as being overweight and lack of exercise.
This type of diabetes can be treated by adopting a healthy lifestyle including exercise and healthy eating habits, but after some time most people with type 2 diabetes require oral medication and insulin to control their blood glucose level.
It is also called borderline diabetes. It is a condition where the body’s blood sugar level is higher than normal but it’s not high enough to be diagnosed as diabetes mellitus. People with prediabetic are at most risk of developing type 2 diabetes and other health conditions such as heart problems and stroke.
Taking certain preventive measures such as healthy diets, exercise, and reducing weight can delay, or even prevent the onset of full-blown diabetes.
It is a type of diabetes that is diagnosed during pregnancy in a woman who never had diabetes before pregnancy. It is usually diagnosed in the second trimester and disappears after the baby’s birth, but having gestational diabetes increases the risk of type 2 diabetes for both mother and baby later in life.
Complications Of Diabetes Mellitus
As diabetes is a systemic disease, its effects can be seen in all parts of the body. It is very important to manage diabetes with proper treatment to avoid any long-term effects. If it’s not taken care of, the complications of diabetes can become severe and they can start to damage the body. Let’s understand how diabetes affects and create complications in different systems and organs of the body
Diabetes And Cardiovascular System
Diabetes is a major risk factor for cardiovascular disease. The problem starts as too much glucose in blood damages the endothelial tissues of blood vessels as well as impaired their ability to repair the damage. The damaged endothelium does not expand or relax normally.
On the other hand, insulin resistance also affects fat metabolism which leads to a higher concentration of triglycerides and LDL (bad cholesterol) in the body. The body tries to control the further damage to blood vessels by depositing cholesterol within them but too much deposition of cholesterol causes the hardening and narrowing of the blood vessels and cause the s formation of plaques. This condition is known as Atherosclerosis. It decreases the blood flow to different organs including the heart and increases the risk of a heart attack.
Secondly, as the body is already facing difficulty using the glucose and other nutrients properly, the heart is also not able to draw enough energy to perform its work efficiently and this can lead to heart failure.
Diabetes And Nervous System
The brain uses glucose as the primary source of energy and it’s sensitive to the amount of sugar it receives as a fuel.
Brain functions such as thinking, memorization, and learning are dependent on the level of blood glucose and how efficiently the brain uses it as an energy fuel. Too low glucose level (hypoglycemia) and too high glucose level (hyperglycemia) both are the main complications of diabetes and both are bad for the brain and affect its performance.
Hyperglycemia affects the supply of oxygen-rich blood to the brain by damaging the blood vessels. This low supply over a while can become the reason for cellular death which is known as brain atrophy and can cause problems with memory and thinking and eventually can lead to vascular dementia.
Hypoglycemia, which is usually the side effect of diabetes medications, also stops the supply of oxygen to the brain. Symptoms of low blood sugar are immediate and may include feeling dizziness, shaking, or irritability and having trouble walking or talking. Very low blood sugar levels can even cause passing out, seizures and coma. Some people with low blood sugar levels do not have any symptoms at all.
That’s why people with diabetes need to look after their glucose levels daily before it causes any serious problems. The long-term effects of hypoglycemia are still unclear but research shows that it can be linked to depression, dementia, and attention span.
Nerve damage happens in diabetes to almost everyone and is known as diabetic neuropathy. Hyperglycemia causes nerve cells to die. The nerve cells can allow the sugar to enter into cells with or without insulin but in the absence of insulin nerve cells are unable to utilize sugar efficiently and sugar starts to accumulate in the cell. It causes damage or even death of nerve cells and results in numbness and tingling in different parts of the body as all organs in the body depend on healthy nerves.
Pain in your feet and legs is a common sign of diabetic neuropathy. Because of the numbness, small cuts and sores are not able to be noticed and can grow into big wounds. Diabetes also affects the immune system and blood flow which compromises the healing process of the body. In some severe cases, amputation of the foot or affected area is required.
Since diabetes causes atherosclerosis, it also increases the chances of stroke.
Diabetes And Kidney
Diabetes can affect kidney function mainly in two ways:
Kidney disease (diabetic nephropathy):
Each kidney consists of millions of tiny filters called nephrons. Due to hyperglycemia, kidneys have to work harder than normal to remove excess glucose from the blood which causes damage to these filters and they start to leak abnormal amounts of protein from the blood into the urine.
Diseases of the kidney blood vessels (Endovascular disorders):
Because diabetes causes high blood pressure which results in the furring up of the artery to the kidneys which causes blockage and reduces blood supply to the kidneys and causes scarring of the kidney blood vessels.
Diabetes and Eyes
Diabetes can affect your eyesight in many ways. It starts to damage the eyes which can lead to poor vision and even blindness.
Hyperglycemia for a long period can harm the minute blood vessels in the back of the eye, they start to swell and leak fluid and blood. New and weak blood vessels also start to grow, these new blood vessels can start to bleed into the middle part of the eye, leading to scarring or increasing the pressure inside your eyes.
Following are the four types of eye disorders that can happen in case of diabetes:
The retina of your eyes senses the light and converts it into signals to decode by the brain so you can see.
In the early stage of diabetic retinopathy, the blood vessels become weak and swell and start to leak into the retina. This stage is called non-proliferative diabetic retinopathy, but if this condition gets worse then some blood vessels are blocked and new blood vessels start to grow and proliferate on the surface of the retina. These new blood vessels can cause severe vision problems. This is called proliferative diabetic retinopathy.
Diabetic macular edema:
The macula is located near the center of the retina, its function is to provide clear vision and enable us to see fine details. Diabetes causes swelling of the macula which is called diabetic macular edema. After some time this can affect the sharp vision leading to partial vision loss or blindness.
Diabetes can damage the optic nerve (the bundle of nerves that connect the eye to the brain) and can lead to loss of vision and blindness.
The lenses of the eyes are clear in shape and provide sharp vision but as we age they start to become cloudy, however in diabetes this process accelerates. According to research high blood glucose level causes deposits to build up in the lenses of the eyes and causes cataracts.
Diabetes and Immune System
Diabetes also has a prolonged and devastating effect on the immune system. It weakens the immune system and makes the body more susceptible to diseases and infections.
As diabetes increases the chances of atherosclerosis, it reduces the blood flow towards the site of injury, which leads to less supply of white blood cells, nutrients, and other healthy cells required for healing purposes. This act delayed the healing process of the body and makes it easier for bacteria and viruses to enter the body and cause infection.
On the other hand, hyperglycemia also decreases the production and maturation of neutrophils in the bone marrow which are the first line of defense and cause a reduction in blood neutrophils to count. It also affects the mobility of the leukocyte to reach the site of infection.
Complement systems that increase the ability of antibodies and phagocytic cells to eliminate disease-causing germs from the body also get affected by hyperglycemia as it causes defects in complement receptors and weakens their ability to cause phagocytosis.
Hyperglycemia also promotes the production of harmful molecules in the body which hinder the ability of the body to fight infection and increase the level of glycogen in the body which leads to increased acidity and gives a perfect environment for microbes to thrive.
Diabetes and Skin
Another organ that gets affected by diabetes is the skin. Too much glucose in the blood prompts the body to increase urine production by drawing a lot of fluid from the cells for removing the excess glucose, which in turn makes the skin dry.
Another reason for dry skin in diabetes is damaged nerves, especially in the legs and feet. Damaged nerves fail to send the signal to the skin for perspiration which helps the skin to keep soft and moist.
Overly dry skin can become itchy and can easily be cracked and peeled. Scratching of the skin can create small openings which provide an easy way for organisms to get under the skin, whereas excessive amounts of sugar and a weak immune system provide a good breeding ground for microbes to grow and cause infections.
Insulin resistance and obesity may also cause dark raised patches on your neck, armpits, groin, or other parts of the body. This is called “acanthosis nigricans“.
Diabetes and Oral Health
Oral health problems are very common with diabetes. People with diabetes have a higher risk of the following:
Uncontrolled diabetes can reduce the flow of saliva (spit) which in turn leads to a dry mouth. A dry mouth can further cause soreness, ulcers, infections, and tooth decay.
The mouth naturally carries many bacteria, when sugar and starches in food meet with these bacteria they form a sticky film on teeth called plaques. This plaque contains acid that attacks the surface of teeth (enamel and dentin ) which further results in cavities and gum disease. . As the sugar level increases, there is a higher chance of tooth decay.
Early gums disease (gingivitis)
As diabetes weakens the immune system of the body, it is necessary to keep good oral hygiene. If the plaque is not removed with regular brushing and flossing it will harden under the gum line into a substance called tartar (dental calculus). After some time this tatar starts to irritate the baseline of the teeth called gingiva and the gums start to bleed easily and swell. This condition is known as “gingivitis”.
Advanced gum disease (periodontitis)
If gingivitis is not cured on time then it can lead to a more serious infection called periodontitis which affects the soft tissue and bone that support the teeth. Periodontitis eventually causes teeth to disengage from the jawbones and gums and cause teeth to loosen and possibly fall out. Periodontitis is more severe in people with diabetes because of the weak immune system and slow healing process.
It is a fungal infection caused by the yeast candida Albicans. Signs of thrush include painful white and red patches inside the mouth. People with diabetes are more likely to develop thrush and that’s why it is important to maintain good oral health in diabetes.
Diabetes And Bladder
Higher glucose levels make the bladder handle a large quantity of urine and increase the urge to use the bathroom which can cause you sleepless nights.
Because diabetes damages the nerves it makes the body unable to sense when the bladder is full and could leak pee. On the other hand, weakened urinary muscle makes it difficult to empty the bladder fully.
Poor bladder control, weakened immune system and high blood glucose level increases the chances of urinary tract infections (UTI).
Diabetes And Sexual Organs
Diabetes also affects sexual organs, and the nerve damage due to diabetes can create issues in sex. Numbness, pain, or lack of feeling can occur in the genitals which leads to erectile dysfunction (ED). Nerve damage also makes it difficult to have any sexual stimulation and orgasm.
Diabetes And Gut
Diabetes also affects gut health. It is the leading cause of gastroparesis. Gastroparesis is a condition where food remains in the stomach for a longer period rather than passing into the small intestine when it should. It happens because high blood glucose damages the vagus nerve that connects the digestive system to the brainstem and hampers its ability to send signals to stomach muscles to empty the stomach.
Diabetic gastroparesis is more dangerous than other forms of gastroparesis because it delays the digestion of food and causes very high or very low levels of blood sugar, which further damages the vagus nerve.
Diabetes also affects the balance of good and bad bacteria in the gut, this is called dysbiosis. Too many bad bacteria cause hindrances in food digestion and lead to inflammation in the gut. Some researchers linked dysbiosis with type 2 diabetes.
Diabetes and Mental Health
People with diabetes are 2 to 3 times more likely to have depression and anxiety disorders, and the fluctuation of blood glucose levels also causes mood swings.
According to some research, the possible link between blood sugar levels and mental disorders are mentioned below:
Insulin resistance in the brain:
Insulin receptors are present throughout the brain’s emotional regulation centers to absorb and utilize glucose as a source of energy. As Insulin resistance develops it may become the reason for mood issues.
Decreases brain cells growth:
The process of neurogenesis in which new brain cells generate may be damaged by diabetes. This is due to debilitated mitochondria (the cell organelle which produces energy from sugar) after insulin resistance developed.
Defective wiring of brain cells:
According to research, insulin resistance changes the signaling pathways that are required for optimal wiring of brain cells, related to reward and learning behavior. This dysfunctional wiring results in depressive symptoms and decreases the ability to handle stress.
Insulin prompts chronic stress hormone:
Insulin is responsible to regulate various hormones associated with stress response, as insulin resistance develops in the brain, it may impair the negative feedback on the brain’s stress hormone pathways and cause depression through abnormal stress response in the brain.
It is believed that TNF alpha, a pro-inflammatory chemical increases diabetes and decreases the level of serotonin in the brain. Serotonin is a neurotransmitter that’s believed to act as a mood stabilizer.
Diabetic Ketoacidosis (DKA)
Due to insulin insufficiency, the body is not able to use glucose as a source of energy so it starts to use fat. The burning of fat produces an acid called ketone. When they build up in the body 1they make blood extremely acidic and become toxic to the body. It’s considered the most dangerous diabetic health complication.
To manage and control diabetes and to delay and prevent the complications related to diabetes these are some key points:
- Check and maintain your blood sugar level regularly and try to keep it on target range as much as possible
- keep an eye on blood pressure and try to keep it under normal range
- Try to control your cholesterol level and not let it out of limit
- Stick to a healthy diet plan
- Do exercise regularly and be physically active
- Keep control of body weight and try to keep it under a healthy BMI
- Stop smoking
- Take medication as they are instructed
- See the doctor regularly
Diabetes is a disease that has many consequences. Uncontrolled diabetes can lead to blindness, kidney failure, heart attacks, strokes, amputations, etc. To avoid these life-threatening complications it is very important to adopt a healthy lifestyle that includes a healthy diet, regular exercise, and keeping in check blood glucose levels. By making certain changes in lifestyle and taking proper treatment, anyone with diabetes can live a healthy and longer life.