Hong Kong Pacific Diabetes & Endocrine Centre
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diabetes

Hong Kong Pacific Diabetes
& Endocrine Centre

Diabetic Complications

Acute diabetic complications

Hypoglycemia
Hypoglycemia may occur if blood glucose level is too low. Patients may have symptoms of sweating, tremor, palpitation, fatique or even coma.

Acute Hyperglycemia
If the patient has very high blood glucose and/or with the pressence of ketone in the urine, he may be suffering from diabetic ketoacidosis or hyperosmolar non-ketotic hyperglycaemia. This is a medical emergency and the patient may present with nausea, vomiting, marked dehydration and even coma.

Chronic diabetic complications

Diabete is said to be a disease of ‘blood vessels’. Chronic hyperglycemia (too high blood glucose level) can damage the blood vessels and nerve and cause problems in many parts of our body. These are known as chronic diabetic complications.

Eye Problems (Diabetic retinopathy)
High blood glucose level will damage and weaken the tiny blood vessels in the retina of the eye. There will be fluid leakage from the weakened blood vessels and bleeding from the newly proliferated fragile blood vessels. Vision will be affected. Blindness may result if retinopathy gets worse with retinal detachment. Early retinopathy does not have any symptoms, therefore annual retinal screening is mandatory for early detection and treatment of diabetic retinopathy.

Foot Problem (Diabetic Foot)
Chronic hyperglycemia results in nerve damage, known as neuropathy. Neuropathy most often affects the feet and legs. Patient may lose feeling in the legs or may have a painful tingling sensation. A sore may easily developed in the diabetic foot, which can become infected. In serious case, the foot may need to be amputated.

Kidney Damage (Diabetic Nephropathy)
Diabetes can damage the blood vessels in the kidneys and alter the kidney filtration of waste products. Early sign of diabetic nephropathy is the presence of protein in the urine. If left untreated, further kidney damage will end up in kidney failure and eventually dialysis. It is important to test for the presence of proteinuria yearly and be put on medications that can help protect the kidneys from damage.

Heart disease and Stroke
Diabetic patients are at greater risk for heart disease and stroke. Common heart disease include coronary heart disease, angina, congestive heart failure.
High blood pressure and high cholesterol level will damage the blood vessels in the heart and brain, further increasing the risk of heart disease and stroke.

Optimal glycemic control can significantly reduce the risk of diabetic complications

To prevent diabetic complications, keep the blood glucose level as close to normal as possible. The treatment goal of fasting blood glucose level is between 4 to 6mmol/L, 2-hour post meal blood glucose level should be less than 8mmol/L. The goal of haemoglobin A1c is below 6.5%.

High blood pressure and cholesterol level will increase the risk of cardiovascular complications. Healthy diet and medications are important to bring the blood pressure and cholesterol back to normal.