A comprehensive analysis of diabetes complications: From testing to prevention and blood sugar management.

Details of Diabetes Treatment
Checking for Complications
Diabetic complications are an integral part of the overall pathological changes that occur during the onset and progression of diabetes. These changes can affect one organ or multiple organs and systems, and are related to the duration and control of diabetes. Generally, those with a short duration of diabetes and good control may not develop complications, or the complications may be mild, remaining in the stage of simple diabetes. Conversely, if diabetes has a long duration and is not well controlled for a long time, it is prone to multiple complications, and the severity of the lesions is also greater. Diabetic complications are mostly caused by long-term hyperglycemia, hyperlipidemia, hypercoagulability and hyperviscosity of the blood, endocrine disorders, especially hyperinsulinemia, and particularly atherosclerosis and microvascular disease. Complications are widespread and diverse. Common complications include: diabetic ketoacidosis, non-ketotic hyperosmolar coma, diabetic lactic acidosis, diabetic heart disease, diabetic cerebrovascular disease, diabetic gangrene, diabetic neuropathy, diabetic nephropathy, diabetic retinopathy, and various infections caused by diabetes. Among these, diabetic macrovascular and microvascular diseases are the most common.

Acute Complications of Diabetes
Acute complications of diabetes are mainly divided into two categories: acute metabolic disorders and infections.
A short-term lack or excess of insulin, or conditions such as infection, stress, or improper use of hypoglycemic drugs, can cause the patient's blood sugar to be too high or too low, resulting in acute metabolic disorders; these include diabetic ketoacidosis, diabetic hyperosmolar coma, hypoglycemic coma, and lactic acidosis. These acute complications are very dangerous and can be life-threatening.

● Diabetic Ketoacidosis
Typical symptoms of diabetes worsen, such as increased thirst, increased appetite, and increased urination; significant weight loss in a short period; significant loss of appetite, nausea, vomiting, and abdominal discomfort, often accompanied by headache and drowsiness; deep and rapid breathing, with a rotten apple smell (acetone) in the exhaled breath. As the condition progresses, severe dehydration, decreased urine output, poor skin elasticity, sunken eyeballs, weak and rapid pulse, and decreased blood pressure occur. In the late stages, various reflexes become sluggish or even disappear, leading to drowsiness and even coma.

● Hyperosmolar Nonketotic Diabetic Coma
The onset is often preceded by polyuria and polydipsia, but polyphagia is not obvious, or appetite may even decrease, which is often overlooked. Dehydration gradually worsens as the disease progresses, leading to neuropsychiatric symptoms, including drowsiness, hallucinations, disorientation, hemianopsia, flapping tremor of the upper limbs, epileptic seizures (mostly localized seizures or monoplegia, hemiplegia), and finally coma, without the deep, rapid breathing characteristic of acidosis.
● Diabetic Hypoglycemic Coma
Diabetic hypoglycemic coma is common in type 1 diabetes patients because they are sensitive to insulin and their blood sugar fluctuates greatly; even a slightly higher dose of insulin can cause hypoglycemic coma. In type 2 diabetes patients, hypoglycemic coma is common when taking large amounts of hypoglycemic drugs, taking hypoglycemic drugs on an empty stomach, or significantly increasing physical activity without timely meals and reducing insulin dosage. When the renal function of patients with diabetic nephropathy deteriorates, insulin excretion is delayed. If the insulin dosage is not reduced at this time, hypoglycemia can easily occur.
Diabetic hypoglycemic coma is characterized by an unbearable feeling of hunger, palpitations, and cold sweats. In severe cases, there are profuse sweating, dizziness, headache, hand tremors, pale complexion, fatigue, blurred vision, blackouts, flashing lights in the eyes, and slurred speech.
● Diabetic Lactic Acidosis
Diabetic lactic acidosis usually has a rapid onset, but the symptoms and signs are non-specific and vary depending on the cause. Those caused by hypoxia have cyanosis, shock, and symptoms of the primary disease; those caused by drugs often have a history of taking drugs or alcohol and various signs of poisoning. Generally, patients have deep, rapid breathing, confusion, drowsiness, and coma, sometimes accompanied by nausea, vomiting, and abdominal pain.

(1) Recurrent pyogenic skin infections such as boils and carbuncles, which may sometimes lead to sepsis or septicemia.
(2) Fungal skin infections, such as athlete's foot. (3) Candidal vaginitis and Bartholin's gland inflammation are common complications in women.
(4) The incidence of concomitant pulmonary tuberculosis is higher than in non-diabetic individuals. The lesions are often exudative and caseous, easily spreading and forming cavities, and lower lobe lesions are also more common.
(5) Among urinary tract infections, pyelonephritis and cystitis are the most common, especially in female patients. Recurrent infections can become chronic. Renal papillary necrosis is a serious but uncommon complication, typically presenting with high fever, renal colic, hematuria, and the passage of necrotic renal papillary tissue in the urine, with a high mortality rate.