Diabetes type 1 -complications of the disease-Acute complications Custom Search 1) Hypoglycemia means low glucose level in blood. For pre-school children value below 70mg/dl (3.9mmol/L) is considered hypoglycemic. For order children the corresponding value is less than 60mg/dl (3.3mmol/L). Hypoglycemia is dangerous as it can lead to convulsions, coma and brain damage when prolonged. If severe it can even lead to death. Symptoms of hypoglycemia can be vague. The child may feel weak, sweat excessively or have tremors. It can also manifest as behavioral changes. Older children may report some funny feeling. If not treated promptly it can lead to convulsions or loss of consciousness. Hypoglycemia occurs when the patient does not follow daily routine of timely food consumption or due to inadvertent injection of higher insulin dose. It is very important for parents to be aware of this. Mild hypoglycemia can be treated at home by giving concentrated glucose solution. Glucose should be really available in the homes of diabetic patients. If severe it may be necessary to hospitalize and give intravenous glucose. 2) Diabetic ketoacidosis: This complication results from uncontrolled diabetes. It should be suspected whenever random blood sugar is above 300mg/dl (16.6mmol/L) or if fasting blood sugar is above 240mg/dl (13.3mmol/L). As insulin is necessary for the proper consumption of glucose by the body cells its deficiency leads to poor utilization of glucose. As cells require energy they start breaking down fat in the body to derive energy-a process known as lipolysis. This leads to accumulation certain acidic substances in the blood known as ketone bodies (ketonemia). These ketone bodies are also excreted in the urine (ketonuria). The accumulation of ketone bodies tends to make the blood acidic (diabetic ketoacidosis). These biochemical changes affect the function of the brain and the patient may become comatose (diabetic coma). There will be severe dehydration and even shock. This is a potentially fatal condition requiring hospitalization, intravenous fluid administration, and Insulin infusion. Chronic complications of diabetes type 1Uncontrolled diabetes can lead to damage to the retina (diabetic retinopathy), kidneys (diabetic nephropathy). There complications can lead to loss of vision and damage to kidneys if not promptly treated. Laser treatment is used to treat diabetic retinopathy. Some drugs can be used to minimize damage to the kidneys. Optimal control of diabetic is vital for the prevention of serious forms of complications. Monitoring treatment of diabetes type 1As there is currently no cure for diabetes it is very important to monitor the patient to ensure adequate control of blood sugar. Parents should learn to check blood sugar at home using a glucometer. The level should be checked 3-4 times daily and the dosage of insulin adjusted after consulting the doctor. It is also desirable for parents to learn how to check urine for ketone bodies in order to detect ketoacidosis early. Blood sugar should be occasionally tested in a lab and the result compared with that of glucometer to ensure accuracy of the meter which can sometimes give erroneous results. Another test useful in assessing long term control of blood sugar in patients of diabetes type 1 is the estimation of a particular type of hemoglobin called glycosylated hemoglobin (HbA1c). This should be done at least once is three months. Diabetic patients are prone to develop diseases of blood vessels (atherosclerosis or hardening of arteries). As increase in level of cholesterol is a major risk factor patients of diabetes should get their cholesterol checked yearly. Diabetes can damage kidneys. Hence all patients who have been diabetic for 3 years or more should get urine checked for albumin. This should be done yearly. Some patients of diabetes develop hypothyroidism. Hence thyroid function tests should be done if the thyroid gland is enlarged. The tests should be repeated every year. Celiac disease is another problem which occurs is diabetic patients more frequently. Celiac antibodies should be checked if there are gastrointestinal symptoms. Yearly eye examination is also required for early detection and management of retinopathy in patients of diabetes type 1. Custom Search
Page last reviewed on 28th November 2010
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