Long-term poor control of diabetes may lead to a variety of complications, among which the common severe types include acute metabolic disorders (such as ketoacidosis), microvascular disease (retinopathy, nephropathy), macrovascular disease (cardiovascular and cerebrovascular disease), neuropathy and diabetic foot. These complications may affect organs throughout the body, and the risk needs to be reduced through standardized treatment and daily management.
1. Acute metabolic disorder
Diabetic ketoacidosis (DKA)
It is common in type 1 diabetes or severe hyperglycemia. Due to the lack of insulin, fat decomposition produces ketone bodies, which causes acidosis, manifested as nausea, deep and rapid breathing, confusion, and even coma, requiring emergency medical treatment.
Hyperosmolar hyperglycemic state (HHS)
It is common in type 2 diabetes, with extremely high blood sugar (usually more than 33.3 mmol/L), increased blood osmotic pressure, leading to dehydration, impaired consciousness, and a high mortality rate, requiring immediate rehydration and insulin treatment.
2. Microvascular disease
Diabetic retinopathy
Long-term high blood sugar damages the tiny blood vessels in the fundus, leading to blurred vision and fundus hemorrhage, and in severe cases, blindness. Regular fundus examination is a key preventive measure.
Diabetic nephropathy
Impaired renal filtration function, early manifestations of microproteinuria, later development of renal failure, requiring dialysis or kidney transplantation. Controlling blood pressure and blood sugar can slow progression.
3. Macrovascular disease
Cardiovascular disease
Diabetes significantly increases the risk of coronary heart disease and myocardial infarction. High blood sugar accelerates atherosclerosis, and comprehensive management of blood pressure and blood lipids is required.
Cerebrovascular disease
The risk of stroke is 2-4 times higher than that of ordinary people, manifested as sudden limb numbness and speech disorders, and transient ischemic attacks (TIA) should be alert.
4. Neuropathy and diabetic foot
Peripheral neuropathy
Numbness, tingling or decreased sensation in the hands and feet may be accompanied by autonomic nerve damage such as gastrointestinal dysfunction (such as gastroparesis) and urination disorders.
Diabetic foot
Due to nerve damage and vascular occlusion, the feet are prone to infection and ulcers, and amputation is required in severe cases. Check the feet daily, avoid trauma, and wear loose shoes and socks.
Prevention and management recommendations
Blood sugar control: Glycated hemoglobin (HbA1c) should be controlled below 7% to reduce fluctuations.
Regular screening: Check the fundus, urine microalbumin, electrocardiogram and foot nerve function every year.
Lifestyle intervention: low-sugar diet, moderate exercise, smoking cessation and alcohol restriction.
Comprehensive treatment: When combined with hypertension or hyperlipidemia, medication (such as ACEI antihypertensive drugs, statin lipid-lowering drugs) is required simultaneously.
The severity of diabetic complications is directly related to blood sugar control. Early detection and standardized treatment can significantly improve prognosis.