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Heart disease and stroke
In Hungarian, stroke: a critical decrease in blood supply to a brain area, which is associated with the death of nerve cells. If you have diabetes, you are 5 times more likely to develop coronary artery disease or stroke. Why? Long-standing, inadequately controlled high blood sugar levels increase the likelihood of hardening of the arteries (atherosclerosis). As a result, the walls of blood vessels harden, and the blood flow path becomes narrower. So it is no longer difficult to imagine why it can cause angina (strong, dull and squeezing pain in the chest; as a result of reduced blood flow due to narrowing of the heart's vessels, the heart does not receive an adequate supply of energy and oxygen), heart attack and stroke (in the latter two cases, blood flow can be completely blocked, resulting in tissue death).
High blood sugar can damage the tiny blood vessels that feed the nerves. Damage to the peripheral nervous system (the nervous system outside the brain and spinal cord) is called leads to peripheral neuropathy. This can cause a stinging, burning or tingling sensation, the typical places of which are the toes, feet, fingers, but it can also spread to the trunk. In addition, limb numbness may occur, and in advanced cases, leg ulcer disease. Damage to the nerves of the digestive system is also common, in which case nausea, vomiting, diarrhea or constipation may occur. Neuropathy can also affect the urinary and genital organs, causing urination disorders, the urine remaining in the bladder stagnates, which favors the development of infections. Male genital involvement can cause impotence.
The cells of the retina in our eyes are responsible for the perception of light and our vision. The process of seeing is a very energy-demanding process, the cells of the retina need a continuous blood supply to get enough nutrients and oxygen. The vascular network of the nerve membrane is also damaged by high blood sugar levels, so that not enough nutrients and oxygen reach the cells, and fluid, sometimes blood, can leak out of the damaged blood vessels. That is why it is important to continuously maintain normal blood sugar levels at an optimal level and to have regular eye examinations. In advanced cases, retinopathy can be treated with a laser method, during which the pathologically changed areas of the retina are "burned" (coagulated) with the laser. In this way, the blood supply to the intact areas improves, and the risk of bleeding and adhesions decreases. It is important that further deterioration can only be slowed down, the original visual acuity cannot be regained.
Kidney disease (diabetic nephropathy)
In the case of diabetes, the small blood vessels in the kidney are also damaged based on the above mechanisms. Diabetic nephropathy is usually characterized by hypertension, i.e. high blood pressure, which must be treated. In severe cases, the disease can lead to chronic kidney failure, which is a life-threatening condition, since the kidney is unable to excrete harmful substances accumulated in the blood and perform its hormone-producing function. In such cases, the patient needs kidney replacement treatment (dialysis) or a kidney transplant.
During diabetes, due to damage to the nerves, the sensing function may be lost in certain areas. Thus, the patient does not feel it if he hits his leg or suffers other minor injuries. Added to this is the decrease in blood circulation, which together lead to leg ulcers. The essence of an ulcer is the death of the tissue surface, which creates a lack of tissue in the affected area. Ulcers are difficult to heal, and if they do go away, they can quickly recur. An ulcer is a condition that impairs life prospects and quality of life, and can be a serious source of infection for the entire body. Therefore, it is recommended to perform a daily self-examination of the foot and report any changes to the attending physician.
Smoking increases the risk of developing diabetes in men. Damage to blood vessels and nerves can lead to erectile dysfunction, which can be treated with medication. Diabetic women may complain of:
- loss of libido
- decreased pleasure from sex
- vaginal dryness
- decreased ability to orgasm
- pain during sex
The above symptoms can also be treated, in which the urologist or gynecologist can help.
Miscarriage, premature birth, developmental disorders
Pregnant women with diabetes have an increased risk. That is why it is very important to consult your obstetrician-gynecologist and diabetologist when planning your pregnancy! Maintaining a normal blood sugar level is especially important during pregnancy!
Oral symptoms of diabetes are dry mouth, reduced saliva production, and swollen gums, which increase the risk of oral mucosal infections. In addition to all of this, due to high blood sugar levels, wound healing and ossification disorders may be associated. As a result of the above, the risk of the following diseases is increased:
- periodontitis - periodontitis
- inflammations of the oral mucosa and tongue: inflammations caused by fungi (usually caused by candida albicans), bacterial infections
- periodontal disease - periodontitis
- precancerous conditions
High blood pressure disease (hypertension, hypertension)
More than two-thirds of people with type 2 diabetes have hypertension, but it also affects people with type 1 diabetes. We speak of hypertension when the blood pressure reaches or exceeds the value of 140/90 mmHg measured at rest on three separate occasions. Due to the increased chance of atherosclerosis caused by high blood sugar and the fat metabolism disorder associated with diabetes, the long-term target value for diabetic patients is below 130/80 mm Hg, regardless of age. Moreover, if there is kidney damage, the value should be lower than 120/75 mm Hg, since this represents the minimum risk of further complications. Even a few mm Hg matters, in the long run it can even save a life!
Hypoglycemia (too low blood sugar)
If you have type 2 diabetes and are receiving insulin treatment or some diabetes pills, you may occasionally experience hypoglycemic episodes (colloquially, the term "hypopos" is also used). Symptoms of mild hypoglycemia can be tremors, sweating, weakness, hunger, nausea, confusion, which condition can be easily resolved by eating or drinking some quickly absorbed sugar-containing food (e.g. dextrose) or drink (e.g. 100% fruit juices, syrups) . After that, it is recommended to consume complex carbohydrates (e.g. muesli bars, sandwiches or fruit), which ensure the maintenance of blood sugar levels in the long term. In the vast majority of cases, as a result of these, the blood sugar level settles, although the process may take several hours. If you have severe hypoglycemia, you may feel sleepy, confused, which may even end in loss of consciousness. If this occurs, the condition can be treated with an intramuscular injection of glucagon (for type 1 diabetics) or an intravenous infusion of glucose. Glucagon is a hormone that is also produced in the pancreas and changes the blood sugar level in the opposite direction to insulin, i.e. raises it, as it causes glucose to be released from the liver. Your diabetologist can provide you with a lot of useful advice on what exactly to do in the event of hypoglycemia.
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