1. Introduction
Diabetes is a chronic metabolic disorder that, if left untreated, can lead to serious and life-threatening complications. These complications do not occur overnight; they develop gradually over months or years, silently damaging organs, blood vessels, and nerves.
The complications of untreated diabetes are divided into two categories:
- Acute complications – These happen suddenly and can be life-threatening if not treated promptly.
- Chronic complications – These develop slowly over time and can lead to permanent damage to the body.
By the end of this lecture, you will learn:
✅ What happens when diabetes is not managed
✅ Acute and chronic complications of diabetes
✅ How these complications affect different organs
✅ Ways to prevent diabetes complications
Early intervention, proper blood sugar control, and a healthy lifestyle can help prevent most of these complications.
2. Acute Complications of Untreated Diabetes
Acute complications occur when blood sugar levels become dangerously high (hyperglycemia) or dangerously low (hypoglycemia). These require immediate medical attention as they can lead to coma or death.
2.1 Diabetic Ketoacidosis (DKA) – A Life-Threatening Emergency
🔴 What is it?
- DKA occurs when the body cannot use glucose for energy due to a lack of insulin.
- The body breaks down fat instead, producing toxic ketones.
- If left untreated, high ketone levels can cause coma or death.
🚨 Symptoms of DKA:
- Extreme thirst and frequent urination
- Fruity-smelling breath (due to ketones)
- Nausea, vomiting, and abdominal pain
- Rapid breathing and confusion
📌 Fact: DKA is most common in type 1 diabetes, but can also occur in advanced type 2 diabetes.
2.2 Hyperosmolar Hyperglycemic State (HHS) – Severe Dehydration
🔴 What is it?
- HHS occurs mostly in older adults with type 2 diabetes when blood sugar levels become extremely high (above 600 mg/dL or 33.3 mmol/L).
- Unlike DKA, ketones are not present, but severe dehydration can cause shock, seizures, or coma.
🚨 Symptoms of HHS:
- Extreme thirst and dry mouth
- Disorientation, drowsiness, and confusion
- Weakness and seizures
- High fever without sweating
📌 Fact: HHS has a higher death rate than DKA, making it a medical emergency.
2.3 Hypoglycemia (Low Blood Sugar) – The Hidden Danger
🔴 What is it?
- Hypoglycemia occurs when blood sugar drops too low (below 70 mg/dL or 3.9 mmol/L).
- It is caused by excess insulin, skipping meals, excessive exercise, or alcohol consumption.
🚨 Symptoms of Hypoglycemia:
- Shakiness, dizziness, and sweating
- Rapid heartbeat
- Blurred vision and confusion
- Loss of consciousness or seizures
📌 Fact: Severe hypoglycemia can lead to coma or death if untreated.
3. Chronic Complications of Untreated Diabetes
When diabetes remains uncontrolled for months or years, it causes irreversible damage to major organs.
3.1 Cardiovascular Disease – The Leading Cause of Death
🚨 What happens?
- High blood sugar damages arteries, leading to high blood pressure, heart attacks, and strokes.
- People with diabetes are 2 to 4 times more likely to develop heart disease.
💔 Major heart-related complications:
- Coronary artery disease (CAD) – Narrowing of heart arteries, leading to heart attacks.
- Stroke – A blocked artery in the brain causing paralysis or death.
- Peripheral artery disease (PAD) – Poor blood circulation to legs, leading to amputation.
📌 Fact: 80% of people with diabetes die from heart disease or stroke.
3.2 Diabetic Neuropathy – Nerve Damage
🚨 What happens?
- High blood sugar damages nerves, leading to pain, tingling, or loss of sensation.
- 50% of people with diabetes develop neuropathy.
🔥 Types of neuropathy:
- Peripheral neuropathy – Causes burning pain, numbness, and tingling in hands and feet.
- Autonomic neuropathy – Affects internal organs, leading to digestive issues, dizziness, or bladder problems.
📌 Fact: Nerve damage increases the risk of amputations due to slow-healing wounds.
3.3 Diabetic Nephropathy – Kidney Failure
🚨 What happens?
- High blood sugar damages kidney filters, leading to protein loss in urine.
- Over time, kidneys fail, requiring dialysis or a kidney transplant.
📌 Fact: Diabetes is the leading cause of kidney failure worldwide.
3.4 Diabetic Retinopathy – Vision Loss and Blindness
🚨 What happens?
- High blood sugar damages small blood vessels in the retina, leading to vision loss.
- In advanced cases, bleeding in the eye can cause blindness.
📌 Fact: Diabetes is the #1 cause of blindness in adults worldwide.
4. How to Prevent Diabetes Complications
The good news is that most diabetes complications can be prevented with early diagnosis and proper management.
✅ Control blood sugar levels – Keep fasting glucose below 126 mg/dL (7.0 mmol/L).
✅ Monitor blood pressure and cholesterol – Prevents heart disease and strokes.
✅ Exercise regularly – At least 30 minutes a day lowers blood sugar and improves circulation.
✅ Eat a healthy diet – High fiber, low sugar, and whole foods.
✅ Quit smoking and limit alcohol – Reduces the risk of neuropathy and heart disease.
✅ Get regular check-ups – Eye exams, foot checks, and kidney tests detect complications early.
📌 Fact: Lifestyle changes can reduce the risk of diabetes complications by up to 70%.
5. End of Lecture Quiz
Question 1:
Which of the following is an acute complication of diabetes?
A) Heart disease
B) Diabetic ketoacidosis (DKA)
C) Kidney failure
D) Blindness
Answer: B) Diabetic ketoacidosis (DKA)
(Rationale: DKA is a life-threatening condition that occurs when ketones build up in the blood due to insulin deficiency.)
Question 2:
Which diabetes complication is the leading cause of blindness in adults?
A) Cardiovascular disease
B) Diabetic retinopathy
C) Kidney failure
D) Stroke
Answer: B) Diabetic retinopathy
(Rationale: High blood sugar damages blood vessels in the retina, leading to vision loss and blindness.)
6. Online Resources for Further Learning
-
American Diabetes Association – Diabetes Complications
https://www.diabetes.org/diabetes/complications -
World Health Organization (WHO) – Diabetes Facts
https://www.who.int/news-room/fact-sheets/detail/diabetes
7. Summary & Key Takeaways
✅ Untreated diabetes can cause life-threatening complications.
✅ Acute complications like DKA and HHS require immediate medical attention.
✅ Chronic complications affect the heart, kidneys, nerves, and eyes.
✅ Early diagnosis and good diabetes management can prevent complications.
